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Fetal Plasma Hypoxanthine Level in Growth-Retarded Fetuses Before Labor¹

Department of Obstetrics and Gynecology (R.S., Y.Y., Y.O., S.S., K.K., J.A.), Nippon Medical School, Tokyo, 113 Japan; and the Center for Perinatal Biology (G.G.P.), Loma Linda University, Loma Linda, California 92350

Address all correspondence and requests for reprints to: Yoshio Yoneyama, M.D., Nippon Medical School, Department of Obstetrics and Gynecology, 1–1-5, Sendagi, Bunkyo-ku, Tokyo, 113 Japan.

Hypoxanthine is one of the purine nucleotides and is presumed to accumulate during hypoxia and acidemia. It remains uncertain, however, whether plasma hypoxanthine concentration is a useful indicator of fetal asphyxia; and its relationship to other markers of fetal physiologic state is not clearly defined. The aim of this study was to evaluate whether the level of fetal plasma hypoxanthine is correlated with fetal hypoxia and acidosis in growth-retarded fetuses before the onset of labor.

Cordocentesis was performed in 34 growth-retarded fetuses at 31–35 weeks’ gestation for the measurement of umbilical venous plasma concentrations of hypoxanthine, hemoglobin and lactate concentrations, blood gases, and base deficit. Umbilical venous plasma hypoxanthine concentration was found to be increased significantly, in parallel with the degree of acidosis (r = -0.74, P < 0.05) and base deficit (r = -0.41, P < 0.05), but not to bear a significant relationship to the degree of hypoxemia or other measured variables. We conclude that increases in the plasma concentration of hypoxanthine may reflect an impaired physiological state in growth-retarded fetuses before labor.