The effect of labor on the acid‐base status of the newborn

Hagelin, Anders; Leyon, Jan

doi:10.1034/j.1600-0412.1998.770810.x

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…[1213141516] Huckabee et al . [17] (1962) stated that the placenta and mother serve as large hydrogen depositories for the fetus and help it to withstand anaerobic metabolism.…”

Section: Methodsmentioning

confidence: 99%

“…[411161920] However, it should be noted that moderate hyperventilation could be beneficial as it can improve feto-maternal gradients at placental sites, but may rapidly become associated with adverse maternal and fetal consequences as it gets more pronounced. Usually when a maternal pCO 2 of 15 mmHg and pH of 7.650 is approached there is a fall in fetal blood oxygen saturation; maternal muscle cramps and fetal heart irregularities in rate and rhythm appear.…”

Section: Methodsmentioning

confidence: 99%

“…Biochemical monitoring revealed that during labor all patients showed a gradual fall in fetal pH and an increase in pCO 2 and base deficit, especially in the second stage of labor and during delivery. [16] These biochemical changes were more marked in high-risk fetuses. At birth and during the 1 st h of life the neonates of high-risk mothers were more acidotic and recovered more slowly than neonates of normal mothers.…”

Section: Methodsmentioning

confidence: 99%

“…A lower pH in cases of uterine inertia is not unexpected as progressive retraction of the uterus would jeopardize the placental circulation. [1624] …”

Section: Methodsmentioning

confidence: 99%

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Maternal and fetal acid-base chemistry: A major determinant of perinatal outcome

Omo‐Aghoja¹

2014

Ann Med Health Sci Res

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Very small changes in pH may significantly affect the function of various fetal organ systems, such as the central nervous system, and the cardiovascular system with associated fetal distress and poor Apgar score. Review of existing data on maternal-fetal acid-base balance in pregnancy highlight the factors that are associated with derangements of the acid-base status and the impact of the derangements on fetal outcome. Extensive search of electronic databases and manual search of journals for relevant literature on maternal and fetal acid chemistry, clinical studies and case studies were undertaken. There is a substantial reduction in the partial pressure of carbon dioxide (pCO2) in pregnancy. Adequate buffering prevents significant changes in maternal arterial pH. Normal fetal metabolism results in the production of acids which are buffered to maintain extracellular pH within a critical range. Fetal hypoxia can occur when maternal oxygenation is compromised, maternal perfusion of the placenta is reduced, or delivery of oxygenated blood from the placenta to the fetus is impeded. When adequate fetal oxygenation does not occur, metabolisms proceed along with an anaerobic pathway with production of organic acids, such as lactic acid. Accumulation of lactic acid can deplete the buffer system and result in metabolic acidosis with associated low fetal pH, fetal distress and poor Apgar score. There is a significant reduction in pCO2 in pregnancy. This change, however, does not result in a corresponding significant reduction in maternal arterial pH, because of adequate buffering. Very small changes in pH may cause significant derangement in fetal function and outcome.

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“…[1213141516] Huckabee et al . [17] (1962) stated that the placenta and mother serve as large hydrogen depositories for the fetus and help it to withstand anaerobic metabolism.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…A lower pH in cases of uterine inertia is not unexpected as progressive retraction of the uterus would jeopardize the placental circulation. [1624] …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Maternal and fetal acid-base chemistry: A major determinant of perinatal outcome

Omo‐Aghoja¹

2014

Ann Med Health Sci Res

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“…A normal second stage of labour changes it by around 1 mmol/l per h 37. In contrast, base excess changes by around 1 mmol/l per 30 min during prolonged periods when there are repeated fetal heart rate decelerations 38.…”

Section: Other Factors Which Influence Cord Blood Valuesmentioning

confidence: 98%

Use of umbilical cord blood gas analysis in the assessment of the newborn

Armstrong

Stenson

2007

Archives of Disease in Childhood - Fetal and Neonatal Edition

181

109

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Prolonged second stage of labor is associated with low Apgar score

et al. 2015

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There is no consensus on the effects of a prolonged second stage of labor on neonatal outcomes. In this large Swedish population-based cohort study, our objective was to investigate prolonged second stage and risk of low Apgar score at 5 min. All nulliparous women (n = 32,796) delivering a live born singleton infant in cephalic presentation at ≥37 completed weeks after spontaneous onset of labor between 2008 and 2012 in the counties of Stockholm and Gotland were included. Data were obtained from computerized records. Exposure was time from fully retracted cervix until delivery. Logistic regression analyses were used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Adjustments were made for maternal age, height, BMI, smoking, sex, gestational age, sex-specific birth weight for gestational age and head circumference. Epidural analgesia was included in a second model. The primary outcome measure was Apgar score at 5 min <7 and <4. We found that the overall rates of 5 min Apgar score <7 and <4 were 7.0 and 1.3 per 1000 births, respectively. Compared to women with <1 h from retracted cervix to birth, adjusted ORs of Apgar score <7 at 5 min generally increased with length of second stage of labor: 1 to <2 h: OR 1.78 (95% CI 1.19-2.66); 2 to <3 h: OR 1.66 (1.05-2.62); 3 to <4 h: OR 2.08 (1.29-3.35); and ≥4 h: OR 2.71 (1.67-4.40). We conclude that prolonged second stage of labor is associated with an increased risk of low 5 min Apgar score.

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The effect of labor on the acid‐base status of the newborn

Cited by 9 publications

References 14 publications

Maternal and fetal acid-base chemistry: A major determinant of perinatal outcome

Maternal and fetal acid-base chemistry: A major determinant of perinatal outcome

Use of umbilical cord blood gas analysis in the assessment of the newborn

Prolonged second stage of labor is associated with low Apgar score

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