Gynecologic and obstetric investigation
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Lactate, pH, pO2, and pCO2 were determined in arterial, venous, and free-flowing mixed umbilical cord blood obtained from deliveries of apparently healthy neonates. The goals of this study were to establish reference ranges for lactate and pH against which results in cases of high-risk labor and delivery could be compared, to see how the gases correlated with these values, and to determine whether easily accessible mixed umbilical cord blood can serve as the sample in lieu of cord arterial or cord venous blood. ⋯ Differences of > 0.5 mmol/l occurred between mixed and arterial cord bloods in 21 patients, and between mixed and venous cord bloods in 6 of the 48 patients, respectively. We conclude that (1) less than 2.5% of deliveries of apparently healthy neonates have arterial, venous, or mixed cord lactates > or = 7.0 mmol/l and pH < or = 7.15, (2) neither cord venous pO2 nor pCO2 correlate well with cord venous lactate, and (3) readily available mixed cord blood is a satisfactory specimen for the measurement of venous cord latate.
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Gynecol. Obstet. Invest. · Jan 1996
Case ReportsSuccessful pregnancy in a patient with severe pulmonary hypertension.
Pulmonary hypertension carries a grave prognosis during gestation with maternal mortality rates as high as 30-50%, even in patients with a good pre-pregnancy functional status. A case of a successfully managed pregnant woman with severe pulmonary hypertension, due to a surgically repaired atrial septal defect, is reported. She was admitted at 29 weeks of gestation with severe dyspnea at rest, orthopnea, tachypnea, cyanosis and edema of the extremities (functional class IV). ⋯ The patient died 1 year later from severe cardiopulmonary insufficiency due to the gradual progression of her severe pulmonary disease. In conclusion, prevention or interruption of pregnancy should be recommended strongly for women with pulmonary hypertension. However, if a woman, despite medical advice, chooses to continue her pregnancy, she can benefit from a prompt and well-balanced management, even in the presence of severe impairment of her functional status.