Vhm. Karsdorp et al., AMINO-ACIDS, GLUCOSE AND LACTATE CONCENTRATIONS IN UMBILICAL-CORD BLOOD IN RELATION TO UMBILICAL ARTERY FLOW PATTERNS, European journal of obstetrics, gynecology, and reproductive biology, 57(2), 1994, pp. 117-122
Objective: To study possible relationships between abnormal placental
perfusion, hypoxemia and impaired fetal nutrient supply. Study design:
Umbilical artery flow velocity waveforms were assessed in high risk p
regnancies and compared with controls. Three groups were studied. In g
roup I (n = 13) the pulsatility index (PI) was within normal limits, i
n group II (n = 9) PI was > 2 S.D. in the presence of positive end dia
stolic velocities and in group III (n = 13) end diastolic velocities w
ere absent. pH and Po-2 levels and concentrations of amino acids, gluc
ose and lactate were measured in umbilical blood obtained at cesarean
section (n = 35). Results: An inverse correlation was found between co
ncentrations of essential amino acids concentrations and the pulsatili
ty index in the umbilical artery (P = 0.03). No correlation with hypox
emia was found (P = 0.32). The glycine/valine ratio was significantly
increased in the groups with abnormal Doppler velocity indices (P = 0.
02). Glucose concentrations were significantly reduced in the case of
absent end diastolic velocities (P = 0.001). No significant difference
s were found between the three groups concerning lactate concentration
s and acid-base balance parameters. Conclusions: These findings, espec
ially the increased glycine/valine ratio, which is characteristic for
kwashiorkor, indicate that abnormal placental perfusion is associated
with impaired fetal nutrient supply, in the presence of a normal fetal
oxygenation.