Severity of Fetal Hypoxia Revealed With Maternal Blood Test

January 13, 2014

January 7, 2014

Clare Whitehead, MBChB from Mercy Hospital for Women, conducted a maternal blood test measuring messenger RNA (mRNA) expression of hypoxia-induced genes. The test aimed to provide a noninvasive method to monitor fetal hypoxia/academia severity during the antepartum stage of pregnancy.

jan7-severityLactate levels in umbilical arterial cord blood and mRNA expression of hypoxia-related genes in maternal blood were linked in two studies by Whitehead and her colleagues. The first study sampled maternal blood during induced labor as a gauge of acute hypoxia, while the second study sampled maternal blood during pregnancy among women with severe fetal growth restriction (FGR) as a gauge of chronic hypoxia.

Researchers took maternal blood samples for the induced labor study from 30 women before induction at the beginning of uterine contractions, at the start of second-stage labor and at delivery. Instantly after birth, scientists tested and analyzed umbilical cord blood lactate levels; lactate levels higher than 6 mmol/L were considered hypoxic. Mothers in the hypoxic group were matched by gestation, parity, and maternal characteristics to mothers whose umbilical cord blood did not show hypoxia.

With more tests such as genome-wide microarray analysis of fetal and maternal blood taken at the moment of birth among others, Dr. Whitehead and her research associates developed a hypoxia gene expression score showing a strong connection between maternal hypoxia gene expression and fetal acidemia.

In the second study on chronic hypoxia, scientists compared blood samples from 20 women carrying severely growth-restricted fetuses with 30 control patients who had normal-growth fetuses delivered at term without complications. The two groups were matched by gestation, parity, and maternal characteristics

In addition, placental samples and maternal blood analysis were conducted among the participants. Scientists discovered a strong correlation (r, 0.76; P = .008) between hypoxia gene expression score inmaternal blood samples of the fetal growth restricted group on the day of delivery with fetal acidemia as determined by umbilical pH at birth.

According to the research authors, “fetal acidemia is associated with perinatal death or complications. For example, a previous study of 604 neonates delivered at 33 or fewer weeks' gestation showed that an umbilical cord pH of 7.20 or less was associated with a likelihood ratio for fetal death of 4.2.”

Researchers concluded that “measuring hypoxia-induced mRNA in maternal blood may form the basis of a novel non-invasive test to clinically determine the degree of fetal hypoxia/acidemia while in utero.”

Developments in maternal and fetal monitoring methods allow clinicians to give the best healthcare. Together with these innovations, clinics and hospitals need top-quality fetal monitoring systems to ensure optimal maternal care and fetal safety.

AIV offers accessories and repair services for fetal monitoring systems. View AIV’s full line of accessories and services at

About the Author

Laura Collier

Laura Collier

Laura Collier has a Bachelor’s Degree in Communications and a Master’s Degree in Business Administration from the University of North Florida. She is the Marketing Manager at AIV, Inc.

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