DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20160145

The strength of correlation between umbilical cord pH and early neonatal outcome

R. Prasanna, P. Karthikeyan, M. Mani, P. Paramanantham, P. Sekar

Abstract


Background: Umbilical artery gas parameters have been used reliably to detect intrauterine asphyxia.

Methods: We analyzed umbilical arterial gas parameters in depressed children and compared it with normal children.

Results: Nearly one third of depressed babies had low pH. Umbilical cord acidosis correlated with increased incidence in seizures (P=0.000), incidence of HIE (P=0.000), risk of intubation (0.001) and thrombocytopenia (0.008). Overall mortality was one fourth, but a significant association could not be ascertained. Also we can confirm that pH less than 7.00 is significant as per AAP and NNF rather than 7.20, defined by ACOG.

Conclusions: We conclude that a decrease in umbilical arterial pH among cases was significantly associated with increased risk of intubation and need for mechanical ventilation, seizures, Hypoxic ischemic encephalopathy.


Keywords


Umbilical arterial pH, Perinatal asphyxia, Early neonatal outcome

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References


Arora S, Evan YS. Manual of neonatal care. In John P Cloherty, C Eichenwald and Ann R Stark (Ed.) 5th Edition, Lippincott Williams& Wilkins, 2004:536-55.

National Neonatal and Perinatal Database Report 2002-2003.1-58.

Saade ARL, Gilstrap G, Wilkins LC, Zlatnik I, Hankins FGV. Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal academia. Am J Obstet and Gynaecol: 1999;181(4):867-71.

Low JA, Panagiotopoulos C, Derrick EJ. Newborn complications after intrapartum asphyxia with metabolic acidosis in the term fetus. Am J Obstet and Gynaecol. 1994;170(4):1081-7.

Goodwin TM, Belai I, Heranandez P, Durnand M, Paul RH. Asphyxial complications in the term newborn with severe umbilical acidemia. Am J Obstet and Gynaecol. 1992;167(6):1506-12.

American Academy of Pediatrics, American College of Obstetrician and Gynecologist. Use and Abuse of Apgar score. Pediatrics.1996;98:141-2.

Winkler CL, Hauth JC, Tucker JM, Owen J, Brumfield CG. Neonatal complications at term related to the degree of umbilical artery acidemia. Am J Obstet & Gynaecol. 1991;164(2):637-41.

Belai Y, Godwin MT, Durand M, Greenspoon J. Umbilical arteriovenous PO2 & PCO2 differences & neonatal morbidity in term infants with severe metabolic acidosis. Am J Obstet & Gynaecol. 1998;178(8):13-9.

Suidan JS, Young BK. Acidosis in vigorous newborn. Obstet Gynaecol. 1985;65(3):361-4.

Armstrong L, Stenson BJ. Use of umbilical cord blood gas analysis in assessment of the newborn. Arch Dis Child Fetal Neonatal Ed. 2007;92(6): F430- 4.

Thayyil S, Costello A, Shankaran S, Robertson NJ. Therapeutic Hypothermia for Neonatal Encephalopathy: Implications for Neonatal Units in India. Indian Pediatrics. 2009;46.

Naegel HTC, Vandenbussche FP, Oepkes, Dick HA, Jennekens SA, Laura AEM, Bennebroek JG. Follow up of children born with an umbilical arterial blood pH<7. Am J Obstet & Gynaecol. 1995;173(6):1758-64.

Perlman JM, Risser R. Can asphyxiated infants at risk for neonatal seizures be rapidly identified by current high risk markers? Pediatrics. 1996; 97(4):456-62.

Goldaber KG, Gilstrap III LC, Lenovo KJ, Dax JS, Mclntire DD. Pathological fetal acidemia. Obstet Gynaecol. 1991;78(6):1103-7.

Vandenberg PP, Willianne NLM, Jongsma HW, Nijland R, Kolle AA, Nijhus J, et al. Neonatal complications in newborns with an umbilical artery pH <7.00. Am J Obstet & Gynaecol. 1996;175(5):1154-7.

Oren H, Irken G, Oren B, Olgun N, Ozkan H. Assessment of clinical impact and predisposingfactors for neonatal thrombocytopenia. Indian J Pediatr. 1994;61:551-8.

Gunn AJ, Gluck man PD, Gunn TR. Selective head cooling in newborn infants after perinatal asphyxia: asafety study. Pediatrics. 1998;102:885-92.

Gluck man PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM, et al. Selective head cooling withmild systemic hypothermia after neonatalencephalopathy: multicentrerandomized trial. Lancet. 2005;365(9460):663-70.

Williams KP, Singh A. The correlation of seizures in newborn infants with significant acidosis at birth with umbilical artery cord gas values. Am J Obstet & Gynaecol. 2002;100(3):557-9.