Variability of Continuously Measured Arterial pH and Blood Gas Values in the Near Term Fetal Lamb

Abstract

In fetal sheep, arterial blood gas values show considerable spontaneous fluctuations. The aim of the present study was to obtain quantitative data on fetal blood gas variability. Accurate assessment of the intraindividual variations can hardly be obtained from intermittent blood samples, but requires continuous measurement. For this purpose we developed a small extracorporeal flow-through cuvette, containing pH and blood gas electrodes and the fiber optic probe of an oximeter. The cuvette is connected through two catheters to the fetal circulation. Blood from the carotid artery flows through the cuvette at a constant rate of 2 mL/min and is drained into the jugular vein. Continuous recordings for 6 h were obtained from five chronically instrumented sheep fetuses at 134-137-d gestational age. Intraindividual variability of fetal arterial blood pH (pHa), partial pressure of arterial blood CO₂ (Paco₂) and O₂ (Pao₂), and saturation of arterial blood (Sao₂) is quantitatively described. The individual variation coefficients ranged from 0.1 to 0.4% (pHa), from 1.4 to 7.6% (Paco₂), from 2.5 to 5.5% (Pao₂), and from 3.6 to 7.0% (Sao₂). The 5th to 95 percentile intervals (Δ) of the individual blood gas values ranged from 0.03 to 0.09 (pHa), from 0.3 to 1.6 kPa (Paco₂), from 0.22 to 0.5 kPa (Pao₂), and from 10.5 to 26.0% (Sao₂). These findings indicate that considerable fluctuations in fetal arterial blood gases occur during a 6-h period. These fluctuations are associated with uterine contractures and changes in maternal and fetal activity.