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Feto-maternal osmotic balance at term. A prospective observational study.
Moen, Vibeke; Brudin, Lars; Tjernberg, Ivar; Rundgren, Mats; Irestedt, Lars.
Afiliación
  • Moen V; Department of Anaesthesiology and Intensive Care, Kalmar County Hospital, S-39185 Kalmar, Sweden.
  • Brudin L; Department of Medicine and Health Sciences, University Hospital Linköping, Linköping, S-58185, Sweden.
  • Tjernberg I; Department of Clinical Chemistry and Transfusion Medicine, Kalmar County Hospital, Kalmar County Council, S-39185 Kalmar, Sweden.
  • Rundgren M; Department of Physiology and Pharmacology, Karolinska Institutet, S-17177 Stockholm, Sweden.
  • Irestedt L; Section of Anaesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, S-17177 Stockholm, Sweden.
J Perinat Med ; 46(2): 183-189, 2018 Feb 23.
Article en En | MEDLINE | ID: mdl-28862988
OBJECTIVE: We performed the present study to investigate the feto-maternal osmotic relationship at term with the hypothesis that, in contrast to the literature, maternal plasma osmolality is lower than fetal levels. In a previous study, we found that maternal plasma sodium at delivery was consistently lower than the sodium in the umbilical artery. Our aim was to corroborate these results with analysis of osmolality. METHODS: Blood was sampled from 30 women immediately before cesarean section and from the umbilical artery and vein before cord clamping and osmolality, sodium and albumin were analyzed. RESULTS: Maternal osmolality was (mean; 95% confidence interval) 287.0 (285.8-288.2) mOsmkg/kg, arterial cord osmolality was 289.4 (287.9-291.0) mOsm/kg and venous cord osmolality was 287.3 (286.0-288.5) mOsm/kg. The paired difference between maternal and umbilical arterial osmolality was mean (SD) -2.4 (3.3) mOsm/kg (P<0.001), between maternal and umbilical vein -0.3 (3.0) mOsm/kg (P=0.63) and between umbilical artery and vein -2.1 (2.8) mOsm/kg (P<0.001). CONCLUSION: Maternal osmolality was significantly lower than arterial cord osmolality confirming our previous results. The feto-maternal osmotic gradient favors water transport from the mother to the fetus and may increase the fetal risk of water intoxication when the mother ingests or is administered large volumes of electrolyte free solutions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Concentración Osmolar / Arterias Umbilicales / Venas Umbilicales / Cesárea / Nacimiento a Término / Sangre Fetal / Intercambio Materno-Fetal Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Perinat Med Año: 2018 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Concentración Osmolar / Arterias Umbilicales / Venas Umbilicales / Cesárea / Nacimiento a Término / Sangre Fetal / Intercambio Materno-Fetal Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Perinat Med Año: 2018 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Alemania