Fetal and maternal transcutaneous PCO2 levels during labour and the influence of epidural analgesia.

ABSTRACT

The Departments of Obstetrics and Gynaecology of the Hvidovre University of Copenhagen and the Free University of Amsterdam collaborated in a study on the relationship of maternal and fetal acid-base state in the intrapartum period. Transcutaneous PCO2 levels of mother (tcPCO2m) and fetus (tcPCO2f) were continuously recorded in 52 patients during labour. TcPCO2f and tcPCO2m correlated significantly (r = 0.42, P < 0.002). During the first stage of labour, a rather stable level was found for tcPCO2f (7.7 +/- 1.6 kPa) and tcPCO2m (4.4 +/- 0.8 kPa). TcPCO2m decreased significantly to 3.8 +/- 0.7 kPa (P < 0.01) in the hour before full cervical dilatation, probably due to maternal hyperventilation as a reaction to painful uterine contractions. TcPCO2f likewise showed a tendency to a decrease to a mean value of 7.4 +/- 1.5 kPa. In eight cases epidural analgesia was applied because of painful uterine contractions. Prior to the epidural analgesia, tcPCO2m (3.8 +/- 0.8 kPa) and tcPCO2f (6.7 +/- 1.7 KPa) were significantly lower in this subgroup compared to the total population. After pain relief by application of epidural analgesia, tcPCO2m and tcPCO2f returned to the population mean.