Abstract
Intrapartum hypoxia can lead to perinatal asphyxia, acidosis, neuronal injury, long-term morbidity or even death. Intrapartum asphyxia and hypoxia can be predicated by fetal acidosis. Umbilical cord gases are used to evaluate a newborn�s acid-base status and the presence of hypoxia. Depending on what references are used, normal values for umbilical cord gases can wildly vary. Although most papers set a pH threshold of [7.2 for fetal acidosis / acidemia, some studies suggest that neonatal morbidity and mortality is increased only when the pH threshold is set below / cut-off value is 7.0. We did a retrospective study and evaluated all newborns from singleton term births in INSMC Alessandrescu Rusescu between 2010 - 2012. We found 83 cases of intrapartum asphyxia (IA) and 25 cases of hypoxic ischemic encephalopathy (HIE). Also a control group of 100 normal term newborns were randomly selected. The IA and HIE showed significant lower mean umbilical cord pH values compared to the control group (7.19, respectively 7.12 compared to 7.28). Using the Youden index we calculated pH a cutoff value of 7.25 for the prediction of IA and of 7.16 for the prediction of HIE. While a low Apgar score can be a predictor of neonatal outcome and may be determined by fetal hypoxia, it remains a subjective evaluation with variable intra-observer reliability. Thus it is important to have an objective test able to accurately diagnose perinatal asphyxia and predict the neonatal outcome.
Highlights
Intrapartum hypoxia can lead to perinatal asphyxia, acidosis, neuronal injury, long-term morbidity or even death
While a low Apgar score can be a predictor of neonatal outcome and may be determined by fetal hypoxia, it remains a subjective evaluation with variable intra-observer reliability
2010 - 2012, we found 83 cases that met our criteria for intrapartum asphyxia (IA), of which 25 cases met our criteria for hypoxic ischemic encephalopathy (HIE)
Summary
Umbilical cord gases are used to evaluate a newborn’s acid-base status and the presence of hypoxia. Most papers set a pH threshold of
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