State of acidity as an indicator of quality care in obstetrics.

Abstract

Increasingly, excellence in obstetric care is not just measured by perinatal mortality but also by the ratio of the infants born with acidosis [5, 6, 7]. The values published by SALING and WULF [21] according to which pH values below 7.20 are termed acidotic, have been generally accepted and permit comparisons. The value of determining the degree of acidity has been confirmed among others by LlTSCHGI and coworkers [12], even though the severity of acidosis and clinical depression may differ [9] and the pH in the umbilical artery blood may not inform adequately about the correction of the acidosis [10]. Since the introduction of cardiotocography (CTG) and fetal blood gas analysis as routines the risk for acidosis has become estimable. Thus the rate of infants with acidosis may be influenced by including operative deliveries which assess the actual fetal condition in maternal as well as fetal distress. In combination with the degree of prematurity, acidosis is an important indicator because neonatal adaptation and the development of respiratory distress syndrome show a correlation with the degree of acidosis [18,24].