Cord blood oxygen saturation in vigorous infants at birth: what is normal?

Abstract

Objective To define the normal ranges of umbilical cord blood oxygen saturation (SaO,) and acid-base status at birth and to evaluate the effect of gestational age on cord blood values in vigorous newborn infants following spontaneous vaginal birth from a vertex position.Design Prospective study.Setting Department of Obstetrics and Gynaecology, University of Graz, Austria.Sample Cord blood samples from 1281 vigorous newborn infants.Methods Cord blood sampling was performed following on newborn infants following spontaneous vaginal birth in a vertex position. SaO, was measured directly by a spectrophotometer and pH, base excess, pC0, and PO, by a pH/blood-gas analyser. Infants with a 5-minute Apgar score 2 7 were considered vigorous. Subgroups were classified according to the gestational age: preterm, term and postterm (< 37,3742 and > 42 weeks, respectively). ResultsThe median umbilical artery SaO, was 24.3% and the 2.5th centile was as low as 2.7%. The median umbilical artery values were pH = 7-25, base excess = -4.3 mmol/L and PO, = 16 mmHg. The 2.5th centiles were 7.08, -1 1.1 mmol/L and 5 mmHg, respectively. The median umbilical artery pC0, was 50 mmHg and the 97.5th centile was 75 mmHg. The mean umbilical artery and vein SaO, values were not significantly influenced by gestational age. The umbilical artery SaO, and base excess values were strongly skewed. The mean umbilical artery pH values in preterm infants were higher than in other subgroups. The mean umbilical artery and vein base excess values were lower in post-term newborn infants than in other subgroups.Conclusions The physiological range of oxygen saturation in umbilical cord of vigorous newborn infants at birth is wide and skewed. In contrast to pH and base excess, umbilical cord blood oxygen saturation is not influenced significantly by gestational age at birth.

Cord blood sampling at delivery: do we need to always collect from both vessels?

“…This approach that we propose strikes a balance from costly over-investigation of thousands of normal deliveries (with extra burden on staff), while acknowledging the considerable error rate in sampling that we and others 3,4 have now consistently found. …”

“…We then determined the proportion of invalid samples using criteria described by Westgate et al 3 and adopted by others 4 . Specifically, for samples to be valid, the pH in the vein should be > 0.02 relative to the artery, and CO 2 < À4 mmHg.…”

Effects of hypoxia on proliferation of human cord blood-derived mesenchymal stem cells

“…Very little attention was given to the oxygen concentration present in culture media. Oxygen concentrations in human body vary from 3 to 11 % (Goossens et al 2011) and the stem cells reside in the most hypoxic areas (Roemeling-van et al 2013;Danet et al 2003), thus, hUCB-MSCs reside in anatomical sites that are relatively oxygen-deficient (Arikan et al 2000). Studies in vitro have shown that culture in 2-3 % O 2 stimulated human mesenchymal stem cells (hMSC) proliferation (Estrada et al 2012).…”

Validation des gazométries au cordon ombilical : étude au sein d’une maternité française

“…Dans les autres é tudes ré alisé es concernant la validation des gazomé tries, ce pourcentage varie entre 6 % pour Arikan et al [15], 13 % pour Victory et al [7], 14 % pour Kro et al [11], 18,3 % pour Tong et al [16], et 19,4 % pour Westgate et al [10]. Une diffé rence est cependant à noter concernant notre é tude ; nous avons utilisé des critè res plus restrictifs que Westgate et al [10], Arikan et al [15], Victory et al [7] et Tong et al [16], ce qui pourrait expliquer que nous avons un pourcentage de gazomé tries non fiables un peu plus é levé que la moyenne.…”

“…Premiè rement, nous avons é tabli leur faisabilité , dé finie par le rapport de gazomé tries complè tes sur le nombre d'accouchements d'enfants né s vivants. Deuxiè mement, nous avons é tabli leur fiabilité , dé finie par le rapport des gazomé tries qui remplissaient les critè res de qualité initialement dé finis par Westgate 3] ; p < 0,0001) aboutissaient à des gazomé tries non valides, alors que seulement 11,3 % des cé sariennes prophylactiques (IC 95 % [4,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]2] ; p < 0,0001) donnaient lieu à des gazomé tries non valides. Faisabilité et fiabilité é taient donc significativement plus faibles lors des cé sariennes en urgence.…”