Feto-maternal osmotic balance at term. A prospective observational study
-
Vibeke Moen
,
Lars Brudin
Abstract
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.
Acknowledgements
The authors would like to thank the mothers who participated in the study and are grateful to midwives, nurses and colleagues who patiently supported the study. Dr. K. Rockstroh and Dr. H Persson diligently collaborated in the execution of the study.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review article
- Fetal cardiac tumors: clinical features, management and prognosis
- Original articles – Obstetrics
- Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection
- Gaps in obstetric care processes – we can only improve what is being measured
- Tokophobia (fear of childbirth): prevalence and risk factors
- Adjuvant administration of 17-α-hydroxy-progesterone caproate in women with three or more second trimester pregnancy losses undergoing cervical cerclage is no more effective than cerclage alone
- The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?
- NLRP genes and their role in preeclampsia and multi-locus imprinting disorders
- Original articles – Fetus
- Diagnostic value of perinatal autopsies: analysis of 486 cases
- Feto-maternal osmotic balance at term. A prospective observational study
- Original articles – Newborn
- Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section
- Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark
- Critical congenital heart disease screening with a pulse oximetry in neonates
- DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma
- A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio
- Letter to the Editor
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Reply to: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
- Response to the Letter to the Editor, “Risk factors of uterine rupture with a special interest to uterine fundal pressure: methodological issues”
- Re: Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
Artikel in diesem Heft
- Frontmatter
- Review article
- Fetal cardiac tumors: clinical features, management and prognosis
- Original articles – Obstetrics
- Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection
- Gaps in obstetric care processes – we can only improve what is being measured
- Tokophobia (fear of childbirth): prevalence and risk factors
- Adjuvant administration of 17-α-hydroxy-progesterone caproate in women with three or more second trimester pregnancy losses undergoing cervical cerclage is no more effective than cerclage alone
- The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?
- NLRP genes and their role in preeclampsia and multi-locus imprinting disorders
- Original articles – Fetus
- Diagnostic value of perinatal autopsies: analysis of 486 cases
- Feto-maternal osmotic balance at term. A prospective observational study
- Original articles – Newborn
- Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section
- Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark
- Critical congenital heart disease screening with a pulse oximetry in neonates
- DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma
- A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio
- Letter to the Editor
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Reply to: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
- Response to the Letter to the Editor, “Risk factors of uterine rupture with a special interest to uterine fundal pressure: methodological issues”
- Re: Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
