**2.1 Population studied**

The pregnant women had consulted the Obstetrics department of the Hôtel-Dieu Hospital in Lyon, France (Professor D Raudrant). They were informed of the risks of fetal blood sampling and gave their consent.

The study was conducted in accordance with the recommendations of the Helsinki Declaration, paragraph II-6, and was approved by the hospital's Ethics Committee.

The gestational age at the time of blood sampling was calculated from the date of the last menstrual period, and confirmed by early ultrasound examination, carried out between 8 and 12 weeks of gestation.

#### **2.1.1 Pathological group**

This comprised 53 fetuses, with an average gestational age of 28.5 ±4.45 weeks of amenorrhea, for which the ultrasound examination had revealed one or more congenital malformations.

The various fetal anomalies found are described in table 1; in all cases, they were confirmed at birth or the end of pregnancy. The fetal blood sampling allowed a karyotype analysis which proved normal for all the fetuses in this group, so a chromosomic anomaly could be ruled out. Fetal growth was assessed in successive ultrasound examinations, by the measurement of three characteristic parameters: the transversal abdominal diameter, the biparietal diameter and the femoral length, the values being compared to those of the department's reference tables based on gestational age. Some fetuses presented growth restriction, associated with the morphological anomaly.

#### **2.1.2 Control group**

It is composed of 73 fetuses, with an average gestational age of 26.3 ±5.7 weeks of amenorrhea, in which cordocenteses were carried out for the prenatal diagnosis, due to a risk incurred by the fetus: suspicion of infection (30 cases of toxoplasmosis, 2 cases of rubella, 13 cases of varicella), fetal karyotype check (18 cases), and risk of fetal thrombopenia (10 cases). These fetuses were not affected by the suspected pathologies and had a normal karyotype; they had a normal morphology, growth and vitality for their gestational age.

All the babies were born at full term, had a birth weight above the 10th percentile of the reference curves in the department; their good health was confirmed by pediatric examination. The group studied could be regarded as similar to a reference population.

162 From Preconception to Postpartum

The aim of the work was to identify cases of fetal suffering and / or malnutrition, and to

The results were compared with those of a control group of 73 healthy fetuses, with an average gestational age of 26 ± 5.7 weeks of amenorrhea, the results of which have already

The pregnant women had consulted the Obstetrics department of the Hôtel-Dieu Hospital in Lyon, France (Professor D Raudrant). They were informed of the risks of fetal blood

The study was conducted in accordance with the recommendations of the Helsinki

The gestational age at the time of blood sampling was calculated from the date of the last menstrual period, and confirmed by early ultrasound examination, carried out between 8

This comprised 53 fetuses, with an average gestational age of 28.5 ±4.45 weeks of amenorrhea, for which the ultrasound examination had revealed one or more congenital

The various fetal anomalies found are described in table 1; in all cases, they were confirmed at birth or the end of pregnancy. The fetal blood sampling allowed a karyotype analysis which proved normal for all the fetuses in this group, so a chromosomic anomaly could be ruled out. Fetal growth was assessed in successive ultrasound examinations, by the measurement of three characteristic parameters: the transversal abdominal diameter, the biparietal diameter and the femoral length, the values being compared to those of the department's reference tables based on gestational age. Some fetuses presented growth

It is composed of 73 fetuses, with an average gestational age of 26.3 ±5.7 weeks of amenorrhea, in which cordocenteses were carried out for the prenatal diagnosis, due to a risk incurred by the fetus: suspicion of infection (30 cases of toxoplasmosis, 2 cases of rubella, 13 cases of varicella), fetal karyotype check (18 cases), and risk of fetal thrombopenia (10 cases). These fetuses were not affected by the suspected pathologies and had a normal karyotype; they had a normal morphology, growth and vitality for their

All the babies were born at full term, had a birth weight above the 10th percentile of the reference curves in the department; their good health was confirmed by pediatric examination. The group studied could be regarded as similar to a reference population.

Declaration, paragraph II-6, and was approved by the hospital's Ethics Committee.

define the blood chemistry profile of this fetal population.

restriction, associated with the morphological anomaly.

been published (Bon et al., 1997, 2007).

**2. Materials and methods** 

sampling and gave their consent.

**2.1 Population studied** 

and 12 weeks of gestation.

**2.1.1 Pathological group** 

malformations.

**2.1.2 Control group** 

gestational age.


Table 1. Pathological group. Fetal anomalies observed.

The ketone bodies content was determined by a fluorimetric enzymatic micromethod based on the measurement of NADH fluorescence (Olsen, 1971). Fluorescence was quantified on a spectrofluorimeter, the Kontron SFM (Kontron, Zurich, Switzerland), the excitation and emission wavelengths being 350 and 460 nm respectively. The reagents (lactate dehydrogenase, beta-hydroxybutyrate dehydrogenase, NADH, NAD) were supplied by

The adult blood reference values with the techniques used are from 0.018 to 0.078 mmol/l

The cholesterol concentrations were measured by an enzymatic assay using a cholesterol esterase (EC 3.1.1.13) and a cholesterol oxidase (EC 1.1.3.6.) (Biomérieux, Marcy l'Etoile,

The hCG content was determined using the IMx automated analyser (Abbott Diagnostics,

The comparative study between the results of the control group and the pathological group was carried out using the Student's t-test (unpaired series) and the Mann-Whitney U test (non-parametric test). The search for a possible relation between different constituents measured in the umbilical venous blood was carried out by calculating the linear correlation coefficient r and the Spearman coefficient rs. The significance of the correlations was

In the control group, an analysis by linear regression was used to study any changes in the

The results obtained from fetuses with malformations were compared with those from

The means and standard deviations were calculated for all 53 fetuses and per sub-group, with a minimum of 3 cases per category of malformation. When a type of anomaly is

**3.1 Gasometric and acid-base parameters in the umbilical venous blood (tables 2 and** 

The results were compared with norms established in the control population for the gestational age considered, as the pH, pO2 and SaO2 decrease physiologically in the UVB during gestation, whereas the pCO2 and the bicarbonate concentration rise (Bon et al., 1997). The acidemia and hypoxemia statuses were defined by pH and pO2 values beyond a standard deviation below the mean, and the hypercapnia statuses by pCO2 values higher by

parameters according to gestational age (expressed as weeks of amenorrhea).

A p value below 0.05 was considered to be statistically significant.

presented only by one or two fetuses, the results are given individually.

control fetuses, with normal growth and morphology.

more than one standard deviation to the mean.

for aceto-acetate and 0.050 to 0.100 mmol/l for beta-hydroxybutyrate.

Abbott Park, United States), by a microparticle enzyme immunoassay.

France); the reference interval in adult blood is 3.6 – 7 mmol/l.

Boehringer (Mannheim, Germany).

**2.4 Statistical analysis** 

**3. Results** 

**3, figure 1)** 

evaluated with Fisher's exact test.
