Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome

Abstract

Objective To analyze if umbilical artery pH (pHua) ≤7.00 and umbilical artery blood deficit (BDua) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes. Methods This was an observational, longitudinal and retrospective cohort study, conducted at the department of obstetrics and gynecology of Centro Hospitalar Tondela Viseu between September 2013 and September 2015. Total cohort and subgroup analysis were performed: group A—women with umbilical cord blood gas analysis (UCBGA) performed for non-reassuring fetal cardiotocographic patterns, placental abruption, or shoulder dystocia; and group B—all the others. Assays were made with the software SPSS for Windows, Versions 20.0 and 21.0 (IBM Corp., Armonk, NY, USA). Results A total of 428 UCBGAs met the inclusion criteria. The group analysis revealed an association between group A and pHua ≤7.00, as well as between BDua ≥12.00 mmol/L and 1st minute Apgar score ≤4 (p = 0.011). After the application of the logistic regression models in the total cohort analysis, pHua ≤7.00 had an impact in the occurrence of acute neonatal hypoxia (odds ratio [OR]: 6.71; 95% confidence interval [CI]: 1.21–37.06; p = 0.029); multiparous women had a higher risk of delivering a newborn with first minute Apgar score ≤4 and acute neonatal hypoxia (OR: 5.38; 95% CI: 1.35–21.43; p = 0.017; and OR: 2.66; 95% CI: 1.03–6.89, p = 0.043, respectively); women who had urologic problems during pregnancy had a higher risk of delivering a newborn with 5th minute Apgar score ≤7 (OR: 15.17; 95% CI: 1.29–177.99; p = 0.030); and shoulder dystocia represented a 15 times higher risk of acute neonatal hypoxia (OR: 14.82; 95% CI: 2.20–99.60; p = 0.006). Conclusion The pHua and the BDua are predictors of adverse neonatal outcome, and UCBGA is a useful tool for screening newborns at risk. Universal UCBGA should be considered for all deliveries, as it is an accurate screening test for neonatal hypoxia.

Umbilical Cord Blood Gases: Sampling, Evaluation, and Application for Clinicians

“…Also, multiparous women had higher risks of low Apgar score and NE as compared with nulliparas. 54 Shoulder dystocia and women with urological problems had a statistically higher risk of delivering a baby with a low 5-min Apgar score. 34 In their series of 3506 infants, Goldaber et al 55 observed neonatal death to be more likely at pH <7, and seizures as more likely at pH <7.05.…”

Плодово-Материнский Газовый Транспорт При Преждевременных Родах

“…Исследования нормальной биохимии и КЩР пуповинной крови благодаря цифровой глобализации стали доступны за многие, в том числе отдаленные, годы из исследовательских центров любой страны. Большинство ранних и современных исследований посвящены изменениям у доношенных новорожденных в состоянии гипоксии или без нее [6,7,16], предсказанию, ранним и отдаленным последствиям интранатальной асфиксии [2,4,5,12]. Показано, что параметры изменяются зависимо от очередности родов, предлежания, массы плодов, особенностей родовой деятельности, применения средств обезболивания родов, других факторов.…”

Effect of cord blood double collection method on cord blood hematopoietic stem cell transplantation-related indices and blood gas analysis

“…The UC-ABG analysis is a practical technology for screening high-risk newborns. [4] UC-ABG obtained at the time of delivery allows for the CYS and WYR contributed equally to this work.…”

“…The UC-ABG analysis is a practical technology for screening high-risk newborns. [4] UC-ABG obtained at the time of delivery allows for the assessment of fetal acid-base status. A meta-analysis showed that fetal acidemia at delivery is associated with adverse neonatal and long-term outcomes.…”