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Feto-maternal osmotic balance at term. A prospective observational study
Kalmar Cty Hosp, Sweden; Karolinska Inst, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Kalmar Cty Council, Sweden.
Karolinska Inst, Sweden.
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2018 (English)In: Journal of Perinatal Medicine, ISSN 0300-5577, E-ISSN 1619-3997, Vol. 46, no 2, p. 183-189Article in journal (Refereed) Published
Abstract [en]

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 amp;lt; 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 amp;lt; 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.

Place, publisher, year, edition, pages
WALTER DE GRUYTER GMBH , 2018. Vol. 46, no 2, p. 183-189
Keyword [en]
Albumin; arterial cord; fetal; hyponatremia; maternal; obstetric; osmolality; vasopressin; venous cord
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:liu:diva-145475DOI: 10.1515/jpm-2016-0425ISI: 000423987200009PubMedID: 28862988OAI: oai:DiVA.org:liu-145475DiVA, id: diva2:1188357
Available from: 2018-03-07 Created: 2018-03-07 Last updated: 2018-03-07

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Brudin, LarsTjernberg, Ivar
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