Determination of umbilical cord blood acid-base status. Indications and techniques
Objective. To carry out a systems analysis of the data available in the current literature to assess the relationship between blood gases and pH values in a newborn infant and his/her status. Material and methods. The review includes the data of foreign and Russian articles published in the past 10 years and found in Pubmed on this topic. Results. The optimal solution is to apply two clamps to the umbilical cord and to take blood from the artery and vein, as this gives a more comprehensive idea of the cause and nature of hypoxia. A test should be carried out in the shortest possible time after blood collection, within one hour in some situations. Umbilical cord blood pH <7.0 and base deficit ≥12 mmol/l in combination with lactate >4.1 mmol/l are unfavorable prognostic factors for neonatal morbidity and long-term neurological disorders. Conclusion. The normal pH level excludes a causal relation between the course of labor and the subsequent development of hypoxic brain damage. Determination of umbilical cord blood gases is the most objective method to assess the baby’s status at birth.Prikhodko A.M., Baev O.R.
Keywords
fetal hypoxia
neonatal asphyxia
umbilical cord blood gases
blood acid-base status
acidosis
References
1. Beecher C.W. Metabolomic studies at the start and end of the life cycle. Clin. Biochem. 2011; 44(7): 518-9.
2. Graça G., Duarte I.F., Barros A.S., Goodfellow B.J., Diaz S., Carreira I.M. et al. (1)H NMR based metabonomics of human amniotic fluid for the metabolic characterization of fetus malformations. J. Proteome Res. 2009; 8(8): 4144-50.
3. Caliskan E., Cakiroglu Y., Corakci A., Ozeren S. Reduction in caesarean delivery with fetal heart rate monitoring and intermittent pulse oximetry after induction of labour with misoprostol. J. Matern. Fetal Neonatal Med. 2009;22(5): 445-51.
4. Roza S.J., Steegers E.A., Verburg B.O., Jaddoe V.W., Moll H.A., Hofman A. et al. What is spared by fetal brain-sparing? Fetal circulatory redistribution and behavioral problems in the general population. Am. J. Epidemiol. 2008; 168(10): 1145-52.
5. Martin R.J., Fanaroff A.A., Walsh M.C. Fanaroff and Martin’s neonatal-perinatal medicine. Diseases of the fetus and infant. 10th ed. Elsevier; 2015. 1883p.
6. Володин Н.Н., ред. Неонатология. Национальное руководство. Краткое издание. М.: ГЭОТАР-Медиа; 2014. [Volodin N.N., ed. Neonatology. National guideline. Short edition. Moscow: GEOTAR-Media; 2014. (in Russian)]
7. Ginosar Y., Reynolds F., Halpern S.H., Weiner C., eds. Anesthesia and the fetus. John Wiley & Sons; 2012. 424p.
8. Zimmerman R.A., Gibby W.A., Carmody R.F., eds. Neuroimaging: сlinical and physical principles. Springer; 2012. 1640p.
9. Graham E.M., Ruis K.A., Hartman A.L., Northington F.J., Fox H.E. A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy. Am. J. Obstet. Gynecol. 2008; 199(6): 587-95.
10. Kanani N., Makwana A.M., Parikh Y.N., Kalathia M.B., Hapani P.T., Shah Z. Study of umbilical cord arterial blood gas analysis in high risk newborn Study of umbilical cord arterial blood gas analysis in high risk newborn. IOSR J. Dent. Med. Sci. 2016; 15(12): Ver. IV: 45-50.
11. Maron J.L., Arya M.A., Seefeld K.J., Peter I., Bianchi D.W., Johnson K.L. pH but not hypoxia affects neonatal gene expression: relevance for housekeeping gene selection. J. Matern. Fetal Neonatal Med. 2008; 21(7): 443-7.
12. Wiberg N., Kallen K., Olofsson P. Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations. BJOG. 2008; 115(6): 697-703.
Received 07.06.2017
Accepted 22.06.2017
About the Authors
Prikhodko Andrey Mikhailovich, PhD, physician of maternity department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954383047. E-mail: a_prikhodko@oparina4.ru
Baev Oleg Radomirovich, MD, Professor, Head of maternity department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381188. E-mail: o_baev@oparina4.ru
For citations: Prikhodko A.M., Baev O.R. Determination of umbilical
cord blood acid-base status. Indications and techniques.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (5): 127-31. (in Russian)
https://dx.doi.org/10.18565/aig.2018.5.127-131
Similar Articles
