Examination of Systole/Diastole Ratio of Umbilical Artery in the third Trimester Gestational Pregnancy and its Correlation with Lactate Acid Level in Fetal Cord

Abstract

BACKGROUND: Fetal distress is a serious complication of perinatal infants and refers to fetal hypoxia in the uterus and asphyxia immediately after the baby is born. The occurrence of uteroplacental disorders is related to various factors, including maternal and fetal factors. When fetal distress occurs, umbilical cord blood flow and fetal blood flow decrease, which in turn causes fetal circulation and respiratory dysfunction in the womb. Evaluating cord blood flow characteristics with ultrasound can provide a reference for prediction and diagnosis of fetal distress, especially by conducting an ultrasound examination of the Doppler S/D ratio of the umbilical arteries especially at gestational age >30 weeks.
 OBJECTIVE: The objective of the study was to assess the correlation between umbilical artery SD ratio examinations with lactate acid levels in the umbilical
 METHODS: This study was an observational analytic study with a cross-sectional study design. The research was conducted in Haji Adam Malik General Hospital Medan and Satellite Hospital. The sample was pregnant women who meet the inclusion and exclusion criteria, we found 38 of pregnant women from January to December 2019.
 Results: The average age of patients in this study was 30 (5) years, the majority of multiparous patients were 25 (47.2), the average gestational age was 38 (2) weeks. Most births in this study were SC 38 (71.7) with an average S/D ratio in the study of 2.81 (0.52) and a mean lactic acid level of 2.7 (0.4). The average Apgar score in this study was 8/9 as many as 29 (54.7), the average S/D ratio is obtained with the average Apgar score of the patient. From this study, it is known that the higher the Apgar score, the higher the average S/D ratio value in patients. The mean patients with poor Apgar outcomes (5/6) have an S/D ratio of 2.5. From the analysis using ANNOVA also obtained p < 0.28. This shows that there is no significant relationship between Apgar score and S/D ratio. Increasing in lactic acid was found in infant outcomes with an Apgar score of 9/10 with a mean value of 2.9 (0.5). From the ANNOVA analysis, a p = 0.99 was also found. This showed that there was no significant relationship between the levels of lactic acid and Apgar score for infants. Lactic acid has a very weak positive correlation with Apgar score for infants with an R value of 0.274 (p = 0.047), this shows that lactic acid does not have a strong relationship with infant outcomes.
 CONCLUSION: There was no correlation between umbilical cord S/D ratio and lactic acid with Apgar score. Lactic acid has a very weak positive correlation with the infant Apgar score with an R value of 0.274.