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

Abstract

Predicting the severity of birth asphyxia-related brain injury in newborn infants is a difficult task. Cord blood gases can be useful indices in the assessment of the impact of peripartum events. Cord blood gas parameters are particularly important because, despite all the progress in fetal monitoring, the time gap between the onset of fetal heart rate (FHR) abnormalities and birth asphyxia-related brain injury has remained difficult to predict. In this paper, we have focused on cord blood gas values in understanding the degree of compromise. These data can help determine the timing of fetal compromise prior to labor, and whether these precipitating events were acute or prolonged. When combined with some adverse clinical markers, the accuracy of low-cord pH in predicting neonatal mortality and morbidity can be even higher. Low-cord pH or eucapnic neonatal pH can also help in the surveillance of at-risk infants and in timely institution of neuroprotective therapies. We present a detailed review on sampling, evaluation, and application of cord blood gas values for clinicians.