Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal acidemia

Andres, Robert L.; Saade, George R.; Gilstrap, Larry C.; Wilkins, Isabelle; Witlin, Andrea G.; Zlatnik, Frank J.; Hankins, Gary D.V.

doi:10.1016/s0002-9378(99)70316-9

Cited by 131 publications

(99 citation statements)

References 18 publications

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“…Furthermore, both Doppler ratios and BW showed a significant association with neonatal venous pH values. Interestingly, no significant association was seen between any of these parameters and arterial pH, a result that challenges the classic dogma indicating that arterial pH values more accurately reflect fetal outcome [15,16] . In fact, while venous pH values reflect acid-base interchanges in the sinusoids, arterial pH values reflect acid-base interchanges in the fetus.…”

Section: Summary Of the Resultsmentioning

confidence: 63%

Neonatal Acid-Base Status in Fetuses with Abnormal Vertebro- and Cerebro-Placental Ratios

et al. 2015

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Objective: A low cerebro-placental ratio (CPR) at term suggests the existence of failure to reach growth potential (FRGP) with a higher risk of poor neonatal acid-base status. This study aimed to evaluate whether similar findings were also seen in the vertebral artery (vertebro-placental ratio, VPR), supplying 30% of the cerebral flow. Methods: We studied term fetuses classified into groups according to birth weight (BW), CPR and VPR. BW was expressed in centiles and ratios in multiples of the median (MoM). Subsequently, associations with neonatal pH values were evaluated by means of regression curves and Mann-Whitney tests. Results: VPR MoM correlated with BW centiles (p < 0.0001, R² = 0.042) and its distribution resembled that of CPR MoM (p < 0.001). When both arteries were compared, adequate-for-gestational-age (AGA) fetuses with either low CPR or low VPR had lower neonatal venous pH values (p < 0.05, p < 0.01, respectively). However, in case of small-for-gestational-age (SGA) fetuses, only those with low VPR had significantly lower neonatal arterial and venous pH values (p < 0.05). Conclusions: Blood flow in the vertebral artery mimics that in the middle cerebral artery supporting the FRGP model. Both CPR and VPR identify AGA fetuses with lower neonatal pH values, but only VPR identifies SGA with lower pH values. Hypoxemia might be reflected as a generalized cerebral vasodilation demonstrated as low CPR and VPR.

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Section: Summary Of the Resultsmentioning

confidence: 63%

Neonatal Acid-Base Status in Fetuses with Abnormal Vertebro- and Cerebro-Placental Ratios

et al. 2015

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“…Another control method -fetal electrocardiography (ECG)-, in a multicenter randomized controlled study (20) On the other hand, 2 / 3 of newborn babies with umbilical artery pH <7.0 don't have brain dysfunction and its clinical signs ;even occurs, it may be temporary (21,22) . and it is known that, electronic heart rate monitoring can still have great importance in legal perspective.…”

Section: Discussionmentioning

confidence: 99%

The role of non-stress test to decision-making procedure in pregnant women with cesarean delivery "outcomes of our clinic and literature review"

Erğun¹,

Sen²,

Kilic³

et al. 2012

J Turk Soc Obstet Gynecol

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“…In the current definition of fetal asphyxia that can lead to hypoxic-ischemic encephalopathy, umbilical arterial pH is required to be lower than 7.0 (Goldaber et al 1991;Andres et al 1999). It is well known that neonatal seizures and other morbidities, and even neonatal death, are more common in neonates with umbilical artery pH < 7.0 (Low et al 1988;Thorp et al 1989;Winkler et al 1991;Nagel et al 1995).…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that neonatal seizures and other morbidities, and even neonatal death, are more common in neonates with umbilical artery pH < 7.0 (Low et al 1988;Thorp et al 1989;Winkler et al 1991;Nagel et al 1995). Andres et al (1999) suggested that pathologic fetal acidemia should be pH < 7.0 in arterial blood with a metabolic component. On the other hand, several authors defined significant acidemia as the range of pH from 7.10 to 7.18 that is 2 standard deviations below the mean for a given population (Yeomans et al 1985;Ruth and Raivio 1988).…”

Section: Discussionmentioning

confidence: 99%

Appearance of Abnormal Electrocorticogram Patterns during Umbilical Cord Compression in Sheep Fetus

Takahashi

Sugawara

Chisaka

et al. 2006

Tohoku J. Exp. Med.

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A frequent cause of fetal acidemia, which sometimes results in hypoxic-ischemic encephalopathy, is umbilical cord compression associated with uterine contraction. Using a sheep model of fetal acidemia, we examined the changes in electrocorticogram (ECoG), carotid artery blood flow, arterial blood pressure and fetal heart rate during cord compression. A characteristic burst of ECoG spikes emerged during cord compression at fetal arterial pH 7.18 even before the pH went down to severe fetal acidemia (less than 7.10). The administration of a neuromuscular blocking agent to the fetus did not abolish the appearance of the spikes. These results suggest that cord compression may cause abnormal brain excitement even in the absence of severe fetal acidemia and that this abnormal excitement can lead to fetal brain dysfunction, if cord compression is repeated or prolonged.fetal heart rate; cord compression; fetal electrocorticogram; fetal acidemia

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Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal acidemia

Cited by 131 publications

References 18 publications

Neonatal Acid-Base Status in Fetuses with Abnormal Vertebro- and Cerebro-Placental Ratios

Neonatal Acid-Base Status in Fetuses with Abnormal Vertebro- and Cerebro-Placental Ratios

The role of non-stress test to decision-making procedure in pregnant women with cesarean delivery "outcomes of our clinic and literature review"

Appearance of Abnormal Electrocorticogram Patterns during Umbilical Cord Compression in Sheep Fetus

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