Sven Sjöstedt

Acid-base balance of arterial blood during pregnancy, at delivery, and in the puerperium

Abstract pH, P CO 2 , BB, standard bicarbonate, and BE in the capillary blood were measured in 330 pregnant women during pregnancy or during delivery and in 50 women in the puerperium. The values found for the capillary blood correspond to those in the arterial blood. During pregnancy women have respiratory alkalosis and metabolic acidosis, both of which are accentuated during delivery. During pregnancy the pH rises about 0.02 and the P CO 2 falls about 5 mm. Hg. At the same time the BE falls about 2 mEq. per liter. During the puerperium these values gradually return to normal. The possible hormonal cause of these changes is discussed.Abstract pH, P CO 2 , BB, standard bicarbonate, and BE in the capillary blood were measured in 330 pregnant women during pregnancy or during delivery and in 50 women in the puerperium. The values found for the capillary blood correspond to those in the arterial blood. During pregnancy women have respiratory alkalosis and metabolic acidosis, both of which are accentuated during delivery. During pregnancy the pH rises about 0.02 and the P CO 2 falls about 5 mm. Hg. At the same time the BE falls about 2 mEq. per liter. During the puerperium these values gradually return to normal. The possible hormonal cause of these changes is discussed.

Hydrogen Concentration, Carbon Dioxide Tension and Acid Base Balance in Blood of Human Umbilical Cord and Intervillous Space of Placenta

In a previous paper (Sjostedt, Rooth and Caligara, 1960) we reported on the oxygen tension (PO2) in the blood of the human umbilical cord and the intervillous space of the placenta. It is the purpose of this paper to report on the pH and the carbon dioxide tension (pCO2) in blood from the same sources in order to give a more complete picture of the gas exchange of the foetus and of its acid base balance.

Haemoglobin in cord blood in normal and prolonged pregnancy.

Four hundred and fourteen healthy infants born in the Department of Obstetrics and Gynaecology were investigated. In no case was pregnancy complicated by toxaemia. All infants were delivered spontaneously without complications in occipitoanterior presentation and they showed no signs of asphyxia. In order to obtain reliable information on the duration of gestation, the dates on menstrual age were carefully checked. Only cases with a regular menstrual cycle were included and any in which the duration of pregnancy was in doubt were excluded. Techniques

Oxygen Saturation in the Umbilical Vessels of the Human Fgtus in Normal and Prolonged Pregnancy

The oxygen saturation in the umbilical cord has been studied in 363 cases with special reference to the duration of pregnancy. There was no apparent change in the oxygen saturation with advancing fœtal age and there was definitely no decrease in the mean oxygen saturation in 52 cases where pregnancy was prolonged beyond the 42nd week.The probable physiological values for the oxygen saturation in the fœtal blood from the 36th to the 45th week are 65 to 70 per cent in the umbilical vein and 40 to 45 per cent in the umbilical arteries.

The Oxygen Tension of the Blood in the Umbilical Cord and the Intervillous Space

During recent years there has been a revival of the interest in oxygen saturation in the umbilical blood; this work was started in the 1930s by Haselhorst and Stromberger (1931) and several papers have been published by different groups (Walker and Turnbull, 1953; MacKinney, Ehrlich, Goldberg and Cantwell, 1955; Rooth and Sjostedt, 1955, 1957; Bancroft-Livingston and Neill, 1957; Tumbull and Baird, 1957). It should be remembered, however, that measurements of oxygen saturation mainly give an indication of the amount of oxygen present in the blood. For a more complete picture of the oxygenation it is also necessary to know the oxygen tension (PO2) since that is the force by which oxygen is pressed from the vessels into the tissues and because the physiological effect of the oxygen depends solely on its P02* As oxygen in foetal circulation is obtained from maternal blood in the intervillous space of the placenta, a comparison between the levels of P02 in the intervillous space and in the umbilical vessels will indicate the diffusion pressure drop of the oxygen between the maternal and foetal circulation in the placenta.

The Oxygen Tension in the Cord Blood after Normal Delivery

In order to understand the oxygen supply of the fetus, it is necessary to know the oxygen capacity, the oxygen saturation, the oxygen tension, the pH of the fetal blood, and the dissociation curve. The circulation rate in the fetus, which is so far unknown, is also of fundamental importance. Direct measurements of the oxygen tension in the cord blood seem only to have been made by Beer, Bartels, and Raczowski (1955). They used the potentiometric method of Bartels (1951). Their mean values, 22.4 mm. Hg. in the umbilical vein and 9.2 mm. Hg. in the arteries are lower than might be expected from the oxygen saturation analyses made in our series of uncomplicated deliveries (Rooth and S jostedt, 1955, 1957). A wider knowledge of the oxygen tension (PO,) in the cord blood is therefore necessary. This knowledge is also fundamental in understanding the rise in oxygen tension after birth and the subsequent vasomotor reactions in different vascular systems of the newborn infant.

OXYGEN SATURATION IN THE UMBILICAL CORD

Asphyxia is one of the main causes of foetal death and is considered of importance in the development of cerebral palsy and other nervous disorders of childhood. When studying asphyxia it was found necessary to investigate the degree of hypoxia in the foetal blood. For this purpose the oxygen saturation of the hemoglobin in the vein and the arteries of the umbilical cord was measured in cases of spontaneous and forceps deliveries and Caesarean section.

The Oxygen Tension of the Amniotic Fluid during Oxygen Administration to the Mother

The aortic pressure of the rabbits fell considerably and the right ventricular pressure remained unchanged or rose after Indian ink injection. With a moderate dose, the blood pressure changes were reversible. In the microscopical examination, atelectatic areas, contracted arteries and corrugated capillaries were found in the fndian-ink treated lungs. The lungs of the runnings animals were well expanded with opened arteries and filled capillaries. The findings were explained as being due to a neurovascular function or capillary erection.

Treatment of Vaginal Candidiasis with Cu-Oxine-Complex

In recent years Candida albicans has became increasingly important as a cause of disease in human beings. This is due, among other things, to the increasing frequency of diabetes and to the more common use of broad spectrum antibiotics. In a search for an antimetabolic capable of inhibiting the life processes of the funges by investigating the demands of fundamentally important substances as well as the requirement of vitamins and trace elements, Nordbring-Hertz (1955) discovered that 8-hydroxyquinoline (oxine), which has relatively long been used in agriculture as an inhibitor of Fusarium, Ceratostomella and Penicillium (Zen tmeyer, 1943, 44), had a pronounced inhibiting action on the growth of Candida albicans. As in the treatment of other microorganisms (Sorkin et al. 1g51), addition of copper potentiated the effect of the oxine on Candida. Nordbring-Hertz also showed that the highly stable Cu-oxine-complex has an even stronger effect on Candida. Since it was known that other oxiquinoline preparations can be administered by mouth as well as locally to the vagina, it was decided to study the effect of Cuoxine-complex on vaginal candidiasis.

Über die Geburt in dorsoanteriorer Vorderhauptslage

Die sogenannte dorsoanteriore Yordcrliauptslage, auch mcntooder frontoposteriore oder hintere, ja sogar vordere Vorderhauptslage genannt, gehiirt zu den allerscltensten Kindslagen lmv . Kopfhaltungen. Die Znhl der vcriiffentlichten Falle belauft sich auf nicht mehr als 11, was cinen gcwissen Aufschluss ubcr die Frequcnz dieser Kindslage geben mag. Zwcifclsohne ist die Zalil 1 1 jedoch cin Minimum, da bei spontanen Geburten diese Kopfhaltung sicherlich biswcilen ubersehen werdrn kann. Ausserdem kiinnen unveriiffcntlichtc Falle vorhanden sein. Der crstc ].‘all wurde i. J. 1903 von AHLFELD mitgetc41. Die ubrigen einschllgigen Yeroffentlichungen sind: LINDIC 1!)20 (1 1:aIl). HOSSENUECK 1024 (1 Fall), HOGLER 1!)27 (3 Falle), NAUJOKS 1928 (1 FaQ KOBES 1!)20 (1 Fall), NORDMEYER 1935 (1 Fall), JENO 1!)37 (1 Fall), NEUWEILER 193!) (1 evtl. 2 Faille), EMMRICII 1!1.11 (1 Fall). VEGH 1!)42 (2 Falle). An der Lunder Fraucnklinik haben wir i. J. l!Mi cincn 1;aIl dieser seltencn Kindslage vcrzeichncn kiinncn.