Correlation of fetal hypoxia with intra-abdominal pressure during childbirth in patients with obesity


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Аннотация

Objective. To study the correlation of the parameters of the umbilical arterial blood acid-base status (ABS) and intra-abdominal pressure (IAP) during childbirth in patients with obesity. Subjects and methods. The investigators conducted a prospective randomized study involving 135 patients with spontaneous labor who were divided into 4 groups: 1) a control group of 38 persons; 2) 36 with first-degree obesity; 3) 40 with second-degree obesity; 4) 21 with third-degree obesity. IAP was investigated using the indirect transvesical method. The indicators of gas composition, ABS, and blood lactate concentration in the umbilical artery were studied. Results. The severity of fetal hypoxia was related to the level of IAP and the method of analgesia in labor. Correlation analysis of the relationship between the indicators of fetal hypoxia to the level of IAP showed that there was a strong correlation of pH, lactate, and IAP in labor pains (r=- 0.73 and 0.73; p<0.001). When epidural analgesia was used, the mean lactate values were significantly lower, but pH and pO2 were higher (p<0.05) than those in the subgroups, in which narcotic analgesics were administered. Conclusion. The level of IAP during childbirth affects the severity of fetal hypoxia. The high level of IAP in labor is the most likely reason for the high rate and severity of neonatal asphyxia in parturient women with obesity. In parturient women with high baseline IAP levels, epidural analgesia is the method of choice for pain relief in labor.

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Рұқсат жабық

Авторлар туралы

Igor Salov

V.I. Razumovsky Saratov State Medical University

Email: Sarhospl@mail.ru
Doctor of Medical Sciences, Professor, Head of the department of Obstetrics and Gynecology

Dmitriy Marshalov

V.I. Razumovsky Saratov State Medical University

Email: MarshalD@mail.ru
Candidate of Medical Sciences, Lecturer at the Department of Obstetrics and Gynecology

Aleksej Petrenko

V.I. Razumovsky Saratov State Medical University

Email: Lesha.petrenko.66@mail.ru
Candidate of Medical Sciences, Lecturer at the Department of Emergency emergency and anesthesia-resuscitation

Әдебиет тізімі

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