Abstract
Objectives:To determine relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcomeMethods:This descriptive cross-sectional study was conducted in the department of Gynaecology, Lady Reading Hospital Peshawar, Pakistan, from January 2019 to July 2019. This study included 27 full-term pregnant women who had abnormal CTG during the active or latent phase of labour. Data were analyzed by IBM SPSS Statistics for Windows, Version 23.0.Results:Out of 27, most patients 13 (48.14%) were in the age group 20-25 years,11 (40.74%) to 26-30 years and 3 (11.11%) belonged to 31-35 years of age group. CTG abnormalities were severe bradycardia, late deccelerations and persistent variable deccelerations with loss of baseline variability. Of all delivered babies, 21 (77%) babies had birth weight<3.5 kg and 6 (22%) had >3.5 kg birth weight. 20 (74.07%) had acidosis (pH <7.2) at the time of birth, of which one had severe hypoxemia and acidosis with pH 6.85. APGAR score at 0 minutes showed a strong positive correlation (r=0.818, p= <0.001) with cord pH, while APGAR at five minutes was also strongly correlated (r= 773, p=<0.001). Of all babies 18(66.66%) with PH less than 7.2 were admitted in NICU while only 2 babies with PH more than 7.2 were admitted. (p value= 0.005).Conclusion:Low umbilical cord pH values of babies born by cesarean section (for fetal distress) are strongly correlated with low APGAR score at birth and higher rates of NICU admission.
Highlights
Birth asphyxia is one of the top three causes of neonatal morbidity and mortality in structurally normal term babies
Out of all patients 13 (48.14%) women belonged to 20-25 years age group, 11 (40.74%) to 26-30 years and 3 (11.11%) belonged to 31-35 years of age group. (Table-I) Of all included women, 17 (62.69%) were primigravida
In this study neonatal acidemia at birth was present in 20(74.07%) cases
Summary
Birth asphyxia is one of the top three causes of neonatal morbidity and mortality in structurally normal term babies. The other two causes are neonatal sepsis and respiratory distress syndrome.[1] Perinatal asphyxia can be the cause of hypoxicischemic encephalopathy, cerebral palsy, seizure disorder and developmentally delayed child.[2] APGAR scoring practice has been ordinarily formulated to quickly summarize the condition of newborn against infant mortality.[3] Shortly after birth the APGAR score is done at 1 and 5 minutes of age to evaluate the newborn status. This is widely used and is universally accepted technique Yet, this practice is not appropriate for the evaluation of birth asphyxia because it could be affected by various
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