The Correlation of Seizures in Newborn Infants With Significant Acidosis at Birth With Umbilical Artery Cord Gas Values

Williams, Keith Philip; Singh, Avash

doi:10.1097/00006250-200209000-00025

Cited by 26 publications

(28 citation statements)

References 15 publications

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“…A correlation between decreased pH and base excess with seizures has been reported in neonates (7). Profound changes of these parameters, particularly for creatine kinase, may be related to the intensity of muscular activity (3) …”

Section: Ammonia Generated In the Gut From Protein Digestion And Deammentioning

confidence: 96%

Hyperammonemia is Associated with Generalized Convulsion

2008

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Section: Ammonia Generated In the Gut From Protein Digestion And Deammentioning

confidence: 96%

Hyperammonemia is Associated with Generalized Convulsion

2008

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“…One can therefore argue that there is benefit in testing for acidosis in all deliveries; to review and audit acidaemic cases leading to identification of areas where quality of care across the perinatal period can be improved. 13,26,27 If one considers widespread assessment of acidosis at birth, one may want to consider a method that is effective but inexpensive and simple to implement. Commonly used measurements are pH and BE, both of which are assessed using a blood gas analyser, requiring up to 90 ll of blood.…”

Section: Introductionmentioning

confidence: 99%

Umbilical lactate as a measure of acidosis and predictor of neonatal risk: a systematic review

Allanson

Waqar

White

et al. 2016

BJOG

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Background Umbilical cord lactate is one approach to measuring acidosis and intrapartum hypoxia, knowledge of which may be helpful for clinicians involved in the care of women and newborns.Objective To synthesise the evidence on accuracy of umbilical cord lactate in measuring acidosis and predicting poor neonatal outcome.Search strategy Studies published and unpublished between 1990 and 2014 from PubMed/Medline, EMBASE, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov were assessed.Selection criteria Cross-sectional and randomised studies that assessed fetal acidosis (using lactate as the index test) with or without an assessment of neonatal outcome.Data collection and analysis Correlations between index and reference test(s) were recorded, as were the raw data to classify the predictive ability of umbilical lactate for neonatal outcomes. Metaanalysis of correlation was performed. We plotted estimates of the studies' observed sensitivities and specificities on Forest plots with 95% confidence intervals (CI). Where possible, we combined data using meta-analysis, applying the hierarchical summary receiver operating characteristics model and a bivariate model.Main results Twelve studies were included. Umbilical lactate correlated with pH [pooled effect size (ES) À0.650; 95% CI À0.663 to À0.637, P < 0.001], base excess (ES À0.710; 95% CI À0.721 to À0.699, P < 0.001), and Apgar scores at 5 minutes (ES 0.300; 95% 0.193-0.407, P < 0.001). Umbilical lactate had pooled sensitivity and specificity for predicting neonatal neurological outcome including hypoxic ischaemic encephalopathy of 69.7% (95% CI 23.8-94.4%) and 93% (95% CI 86.8-96.3%).Authors' conclusion Umbilical cord lactate is a clinically applicable, inexpensive and effective way to measure acidosis and is a tool that may be used in the assessment of neonatal outcome.

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“…17 Williams KP et al suggest that severe fetal academia identified by a pH less than 7.0 was the most umbilical blood gas variable for predicting early onset of worst outcome e.g., seizures or mortality. 18 Goodwin TM et al stated with worsening acidosis, mortality increases. They found that at pH<7.00 mortality occurs in 12%, 33% with cord pH<6.9,60% with pH <6.8, 80% with pH <6.7.…”

Section: Discussionmentioning

confidence: 99%