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Fetal Oxygenation and Acid-Base Balance Flashcards

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  1. Fetal hemoglobin (HbF) differs from adult hemoglobin (HbA) in that HbF:

    Answer: Has a higher affinity for oxygen at any given PO2

    Fetal hemoglobin has a higher oxygen affinity than adult hemoglobin because it binds 2,3-DPG less effectively, allowing more efficient oxygen extraction from maternal blood at the placenta.

  2. The oxyhemoglobin dissociation curve is shifted to the RIGHT in fetal blood compared to maternal blood, meaning:

    Answer: Fetal hemoglobin loads oxygen more easily at the placenta

    A leftward shift (not rightward) of fetal HbF means it loads oxygen more readily at the placenta; stating a rightward shift relative to maternal blood is incorrect — HbF curve is actually left-shifted, meaning higher affinity.

  3. The normal umbilical vein pH at delivery is approximately:

    Answer: 7.32 – 7.43

    Normal umbilical vein pH is 7.32–7.43, reflecting oxygenated blood returning from the placenta with better acid-base status than umbilical artery blood.

  4. Which condition best describes fetal asphyxia?

    Answer: Hypoxia with significant metabolic acidosis and risk of organ damage

    Fetal asphyxia is a severe condition combining hypoxia with metabolic acidosis (significant base deficit) that places the fetus at risk for end-organ damage including brain injury.

  5. Cord blood gas sampling is most indicated when:

    Answer: There are concerns about fetal well-being during labor or delivery

    Cord blood gases are indicated when there are concerns about fetal well-being (e.g., non-reassuring FHR pattern, low Apgar scores, meconium-stained fluid) to objectively assess fetal acid-base status at delivery.

  6. A normal umbilical artery bicarbonate (HCO3-) level at delivery is approximately:

    Answer: 22 – 26 mEq/L

    Normal umbilical artery bicarbonate is approximately 22–26 mEq/L, reflecting adequate bicarbonate buffering capacity in the fetus at delivery.

  7. The threshold for significant metabolic acidemia in umbilical artery blood that is associated with risk of neonatal neurologic injury is a pH of:

    Answer: < 7.10

    An umbilical artery pH less than 7.10 is the widely accepted threshold for significant metabolic acidemia associated with increased risk of neonatal hypoxic-ischemic encephalopathy and adverse neurologic outcomes.