Clinical analysis of neonatal umbilical artery blood gas analysis at delivery: 320 cases

Abstract

Objective To investigate the clinical application value of neonatal umbilical artery blood gas analysis. Methods The umbilical artery blood samples of 320 newborns, who were born in Peking University Shenzhen hospital, were obtained from October 23rd 2013 to May 13rd 2014. The relations between umbilical artery blood gas analysis with Apgar score, character of amniotic fluid and newborn outcome were analyzed. Results (1)The level of pH value, PaCO2, PaO2, HCO3-, and base excess(BE) value in Apgar score of 4 to 7 at 1 min group were (7.15±0.11)、(64.21±21.62)mmHg, (9.21±4.69)mmHg, (21.12±6.98)mmol/L, (-9.06±7.07)mmol/L; and the datum in Apgar score ≥8 at 1 min group were (7.28±0.10), (43.16±15.06)mmHg, (20.38±9.21)mmHg, (19.59±5.31)mmol/L, (-6.79±4.92)mmol/L, respectively. There were significant differences of pH value, PaO2 and PaCO2 between the two groups; t=2.914, -2.764, 2.501, all P value <0.05. (2) The level of pH value, PaCO2, PaO2, HCO3-, BE value in normal amniotic fluid group were (7.29±0.10), (43.64±15.35)mmHg, (20.40±7.85)mmHg, (19.81±5.28)mmol/L, (-6.59±4.85)mmol/L; In meconium-staining amniotic fluid Ⅰ group, the datum were (7.29±0.06), (43.88±15.79)mmHg, (21.41±9.61)mmHg, (20.20±6.92)mmol/L, (-6.24±5.55)mmol/L, respectively; In meconium-staining amniotic fluid Ⅱ group, the datum were (7.24±0.14), (40.36±14.70)mmHg, (17.38±4.75)mmHg, (16.55±4.13)mmol/L, (-10.09±4.98)mmol/L, respectively. There were no significant differences of the indicators in the three groups. Conclusions Umbilical artery blood gas analysis is the objective indicator to diagnose neonatal asphyxia. Meconium-staining amniotic fluid Ⅰ and Ⅱ are not the indicators to diagnose fetal distress. Key words: Blood gas analysis; Apgar score; Asphyxia neonatorum; Acidosis; Umbilical arteries; Amniotic fluid