Acidosis in newborns with nuchal cords and normal apgar scores

被引：29
作者：
Martin G.C. [1 ,2 ]
Green R.S. [1 ]
Holzman I.R. [1 ]
机构：
[1] Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Medical Center, New York, NY
[2] Pediatrix Medical Group, Sunrise Children's Hospital, Las Vegas, NV 89109
来源：
Journal of Perinatology | 2005年 / 25卷 / 3期
关键词：
D O I：
10.1038/sj.jp.7211238
中图分类号：
学科分类号：
摘要：
Objective: Apgar scores and blood gases (BG) and pH were compared between a group of babies with nuchal cords and a group without nuchal cords and uncomplicated deliveries. Study design: We collected umbilical arterial (UA) and umbilical venous (UV) blood samples from the placentas of term infants from both normal deliveries (NORM, n = 29) and nuchal cords (NUCH, n = 33). BG/pH and hematocrit were measured; base deficits and oxygen contents were calculated; and a member of the study assigned. Apgar scores and demographic data were collected from the babies' charts. Results: Median Apgar scores in the NUCH babies at 1 and 5 minutes were 9 and 9 respectively, which did not differ from the NORM infants. The pH, PCO2, and oxygen content obtained from UV of the NUCH infants was not statistically different from the NORM. The pH and oxygen content of the NUCH UA was significantly lower than that of the NORM. The UA PCO2 in the NUCH was greater than the NORM. Veno-arterial (VA) differences (ΔVA) in pH and PCO2 of the NUCH infants were greater than that of the NORM. Conclusion: The Apgar score is not a sensitive indicator of acid-base changes in nuchal cord patients; UV samples alone may be misleading. UA must be sampled to detect the hypercapnia and diminished oxygen content that is a result of the nuchal cord. © 2005 Nature Publishing Group. All rights reserved.
引用
收藏
页码：162 / 165
页数：3
相关论文
共 14 条
  • [1] Casey B.M., McIntire D.B., Leveno K.J., The continuing value of the Apgar score for the assessment of newborn infants, N. Engl. J. Med., 344, pp. 467-471, (2001)
  • [2] Yeomans E.R., Hauth J.C., Gilstrap L.C., Strickland D.M., Umbilical cord pH PCO<sub>2</sub>, and bicarbonate following uncomplicated term vaginal deliveries, Am. J. Obstet. Gynecol., 151, pp. 798-800, (1985)
  • [3] Casey B.M., Goldaber K.G., McIntire D.B., Leveno K.J., Outcomes among term infants when two-hour postnatal pH is compared with pH at delivery, Am. J. Obstet. Gynecol., 184, pp. 447-450, (2001)
  • [4] Low J.A., Pickersgill H., Killen H., Derrick J., The prediction and prevention of intrapartum fetal asphyxia in term pregnancies, Am. J. Obstet. Gynecol., 184, pp. 724-730, (2001)
  • [5] West J.B., Wagner P.D., Pulmonary gas exchange, Bioengineering Aspects of the Lung, pp. 363-366, (1977)
  • [6] Nelson N.M., Respiration and circulation before birth, Physiology of The Newborn Infant, (1976)
  • [7] Pomerance J., When cord gases do not reflect fetal condition, Interpreting Umbilical Cord Blood Gases, (2004)
  • [8] Pomerance J., When cord gases do not reflect fetal condition, Interpreting Umbilical Cord Blood Gases, pp. 8-9, (2004)
  • [9] Belai Y., Goodwin T.M., Durand M., Greenspoon J.S., Paul R.H., Walther F., Umbilical arteriovenous PO2 and PCO2 differences and neonatal morbidity in term infants with severe acidosis, Am. J. Obstet. Gynecol, 178, 13, (1998)
  • [10] Clapp J.F., Lopez B., Simonean S., Nuchal cord and neurodevelopmental performance at 1 year, J. Soc. Gynecol. Invest., 6, pp. 268-272, (1999)
12