scholarly journals Maternal arterial blood values during delivery: effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood

2020 ◽  
Author(s):  
Mehreen Zaigham ◽  
Sara Helfer ◽  
Karl Heby Kristensen ◽  
Per-Erik Isberg ◽  
Nana Wiberg
Keyword(s):  
Vaginal Delivery ◽  
Epidural Anesthesia ◽  
Umbilical Cord Blood ◽  
Mode Of Delivery ◽  
Blood Gas ◽  
Acid Base ◽  
Maternal Characteristics ◽  
Arterial Blood ◽  
Vaginal Deliveries ◽  
Synthetic Oxytocin

AbstractObjectiveTo determine a reference interval for maternal arterial blood values during vaginal delivery and to elucidate the effect of common maternal characteristics and obstetric interventions on maternal acid base values during vaginal and planned cesarean section (CS).DesignProspective, observational study of randomly selected women undergoing vaginal deliveries and planned CS at Skåne University Hospital, Malmö, Sweden.ResultsTwo hundred and fifty women undergoing vaginal delivery (VD) and fifty-eight women undergoing planned CS were recruited. We found significant differences for gestational age, parity, artery pH, pCO2, pO2, sO2 and cord venous pH, pCO2 and lactate between the two study groups (P < 0.005). For women undergoing vaginal delivery, we found significant changes in base deficit, hemoglobin, bilirubin, potassium, glucose and lactate values as compared to women with planned CS (P < 0.02). Maternal characteristics did not significantly affect acid base parameters however, multiple regression showed significant associations for the use of epidural anesthesia on maternal pH (P < 0.05) and pO2 (P < 0.01); and synthetic oxytocin on pCO2 (P = 0.08), glucose (P < 0.00) and lactate (P < 0.02) in maternal blood. Maternal arterial pH, pCO2 and lactate correlated significantly to values in venous umbilical cord blood (P < 0.000).ConclusionsReference values for maternal arterial blood gases in vaginal deliveries for term pregnancies were outlined and we found that most arterial blood gas parameters varied significantly according to mode of delivery. The use of different obstetrical interventions like epidural anesthesia or synthetic oxytocin, resulted in significant changes in blood gas values.

scholarly journals Effect of Chorionicity on Umbilical Cord Blood Acid-Base Analysis of the Second Twin

2020 ◽  
Vol 23 (3) ◽  
pp. 178-183
Author(s):  
Matthew J. Blitz ◽  
Burton Rochelson ◽  
Nontawan Benja-Athonsirikul ◽  
Weiwei Shan ◽  
Meir Greenberg ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Tertiary Hospital ◽  
Chronic Hypertension ◽  
Acid Base ◽  
Arterial Ph ◽  
Vaginal Deliveries ◽  
Twin Pregnancies ◽  
Second Twin

AbstractOur objective was to determine whether chorionicity affects umbilical cord blood acid-base parameters of the second twin. This was a retrospective cohort of twin pregnancies delivered at ≥23 weeks of gestation at a tertiary hospital from 2010 to 2016. Patients were included if arterial and venous umbilical cord gas results were available for both newborns and chorionicity was confirmed histologically. Exclusion criteria included intrauterine fetal demise of either twin prior to labor, major fetal anomalies, monoamnionicity, uncertain chronicity and twin-to-twin transfusion syndrome. The primary outcome evaluated was the umbilical artery (UA) pH of the second twin. A total of 593 dichorionic (DC) and 86 monochorionic (MC) twin pregnancies were included. No difference in UA pH was observed between MC and DC twins. Among vaginal deliveries (n = 97), the UA pH of the first twin was higher than the second twin (7.26 vs. 7.24; p = .01). Twin-to-twin delivery interval (TTDI) ≥20 min was associated with a higher UA pH in the first twin compared to the second twin (7.25 vs. 7.16, respectively; p = .006). Multivariable logistic regression was used to predict arterial pH < 7.20 for the second twin; the most predictive factors were arterial pH < 7.20 for the first twin, chronic hypertension and prolonged TTDI. Chorionicity was not associated with any acid-base parameter of umbilical cord blood in either the first or second twin. No differences in neonatal outcomes were observed based on chorionicity or birth order. Populations with a lower cesarean delivery rate may yield different findings.

Blood gas analysis

2018 ◽  
Author(s):  
Richard Paul ◽  
Paul Grant
Keyword(s):  
Ph Value ◽  
Fluid Management ◽  
Disease Process ◽  
Blood Gas Analysis ◽  
Underlying Disease ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base ◽  
Electrolyte Disorders ◽  
Arterial Blood

Acid-base homeostasis is vital for the maintenance of normal tissue and organ function, as both acidosis and alkalosis can have harmful and potentially life-threatening effects. Arterial blood gas analysis, combined with routine clinical history and examination, can provide useful information for the management of the critically ill cardiac patient. Most acid-base derangements are reversed by treatment of the underlying disease process, rather than simple correction of the abnormal pH, and prognosis is determined by the nature of the underlying disease, rather than the extent of pH value deviation. Within this chapter, a six-step approach is presented for prompt and accurate acid-base interpretation. Water and electrolyte disorders are common in the intensive cardiac care unit, particularly in patients with cardiac failure. Prompt recognition and treatment is required to prevent cardiovascular and neurological compromise. Therapeutic strategies range from simple electrolyte substitution and fluid management to extracorporeal filtration of excess fluid and electrolytes. These are discussed within this chapter.

Blood gas analysis: acid–base, fluid, and electrolyte disorders

2015 ◽  
Author(s):  
Richard Paul ◽  
Pavlos Myrianthefs ◽  
George Baltopoulos ◽  
Shaun McMaster
Keyword(s):  
Ph Value ◽  
Fluid Management ◽  
Disease Process ◽  
Blood Gas Analysis ◽  
Underlying Disease ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base ◽  
Electrolyte Disorders ◽  
Arterial Blood

Acid-base homeostasis is vital for the maintenance of normal tissue and organ function, as both acidosis and alkalosis can have harmful and potentially life-threatening effects. Arterial blood gas analysis, combined with routine clinical history and examination, can provide useful information for the management of the critically ill cardiac patient. Most acid-base derangements are reversed by treatment of the underlying disease process, rather than simple correction of the abnormal pH, and prognosis is determined by the nature of the underlying disease, rather than the extent of pH value deviation. Within this chapter, a six-step approach is presented for prompt and accurate acid-base interpretation. Water and electrolyte disorders are common in the intensive cardiac care unit, particularly in patients with cardiac failure. Prompt recognition and treatment is required to prevent cardiovascular and neurological compromise. Therapeutic strategies range from simple electrolyte substitution and fluid management to extracorporeal filtration of excess fluid and electrolytes. These are discussed within this chapter.

scholarly journals Association between Acid-Base Balance and Asphyxia in Newborn Infants

2018 ◽  
Vol 34 (1-2) ◽  
pp. 38-43
Author(s):  
Sari Leyli Harahap ◽  
Chairul Adillah Harahap ◽  
Sri Sulastri ◽  
Chairul Yoel ◽  
Noersida Raid
Keyword(s):  
Apgar Score ◽  
Newborn Infants ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Acid Base ◽  
Apgar Scores ◽  
Arterial Blood ◽  
Base Balance

We performed a prospective study on the association between acid-base balance and asphyxta based on Apgar scores in 45 newborn babies admitted to the Division of Perinatology, Pirngadi Hospital, Medan, from January 1 to February 28, 1993. Blood gas analysis was done on blood obtained from umbilical artery. Based on 1st and 5th minutes Apgar scores, 40 (88.9%) and 21 babies (46.7%}, respectively, had asphyxia. Relation to acid-base balance was determined with the sensitivity of the 5th minute Apgar score in predicting acidotic states. It was found that Apgar score had sensitivity of 57.7% and specificity of 68.4% in predicting the acidotic states. Apgar score of > 7 was unable to. exclude the possible acidosis in 45% of cases (negative predictive value 54.1%). Gestational age had no influence on Apgar Scores. Apgar score was more sensitive to eliminate suspected acidosis in term neonates than in preterms. We recommend to perform umbilical arterial blood gas analysis to determine acidotic state in high risk newborn infants.

Umbilical cord blood acid-base balance and gas composition in relation to the use of epidural analgesia in vaginal delivery

2019 ◽  
Vol 5_2019 ◽  
pp. 70-76
Author(s):  
Tysyachnyy O.V. Tysyachnyy ◽  
Baev O.R. Baev ◽  
Evgrafova A.V. Evgrafova ◽  
Prikhodko A.M. Prikhodko ◽  
Pismensky S.V. Pismensky S ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Cord Blood ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Gas Composition ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance
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