scholarly journals THE CORRELATION OF ARTERIAL CORD BLOOD GAS VALUES AND APGAR SCORES IN TERM BABIES WITHOUT FETAL DISTRESS AND THEIR EFFECTS ON NICU ADMISSIONS

2021 ◽  
Author(s):  
ASLAN YILMAZ ◽  
Nesrin Kaya ◽  
Ipek Ulkersoy ◽  
Zeynep Alp Ünkar ◽  
Hazal Cansu ACAR ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Fetal Distress ◽  
Well Being ◽  
Blood Gas ◽  
Threshold Values ◽  
Apgar Scores ◽  
Nicu Admission ◽  
Two Parameters

Abstract Background Umbilical artery cord blood gas (UACG) values and Apgar scores (AS) are the two parameters that provide the fastest information about the well-being of a baby after birth. We hypothesized that AS may not be sufficient for a complete and correct evaluation of the newborns and UACG should be used routinely for all births even without any signs of fetal distress. Material-methods In this retrospective study, the data of 1781 babies born between January 2018 and December 2019 at Cerrahpasa Faculty of Medicine were analyzed. Newborn with fetal distress, congenital anomalies, severe and moderate acidemia (pH ≤7.1 at UACG), and pre and postterm newborns are excluded. The UACG and the 1 and 5-minute AS data of 1438 cases were evaluated. Mild acidemia was accepted as a pH between 7.1 and 7.2. Following UACG threshold values were accepted as abnormal pH <7.2, BE <-6 mmol/l, lactate ≥5 mmol/l, HCO3 <18 mmol/l, pCO2 ≥50 mmHg. We evaluated the correlation between UACG and 1 and 5-minute AS and their effects on admission to neonatal intensive care unit (NICU). Results There was a significant correlation between both 1 and 5-minute AS and UACG values such as pH, lactate, and pCO 2 (p<0.001). In addition, significant correlation was found between the 5-minute AS below 7 and some UACG abnormal threshold values (pH, HCO 3 , base excess) (p<0.001). We found that some cases with mild acidemia had a normal 1 and 5-minute Apgar scores (AS≥7) in %1.9 and %2 of cases, respectively. A significant correlation was found between admissions to NICU with 1 and 5-minute AS of <7 (p<0.001). Conclusions The 5-minute AS of 7 or higher may not be sufficient to verify the well-being of a newborn. Relying only on AS, may create the risk of missing some newborns with mild metabolic acidosis. 1 and 5-minute AS could be used as a predictive value for NICU admission. We propose that routine UACG should be evaluated for each birth at term, even without any signs of fetal distress and normal AS.

scholarly journals Maternal Body Mass Index Does Not Affect Neonatal Umbilical Artery Blood Gas Parameters

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Salam E. Chalouhi ◽  
Caroline Salafia ◽  
Magdy Mikhail ◽  
Robert Hecht
Keyword(s):  
Umbilical Artery ◽  
Maternal Obesity ◽  
Well Being ◽  
Maternal Body Mass Index ◽  
Blood Gas ◽  
Apgar Scores ◽  
Patients With Diabetes ◽  
Glucose Tolerant ◽  
Blood Gas Parameters ◽  
The Impact

This study was undertaken to assess the impact of obesity on fetal well-being in glucose-tolerant and nonhypertensive women. Medical charts of all patients admitted to the labor and delivery department at our institution between January, 2011 and July, 2011 were retrospectively reviewed. Patients with diabetes/impaired glucose tolerance or hypertension were excluded. A total of 100 women, 50 lean and 50 obese, were included. Umbilical artery blood gas parameters (BGPs) were compared in lean (<25 kg/m2) and obese (≥30 kg/m2) women. Obese and lean women were comparable with respect to all baseline characteristics. There was no difference in any of the BGP or Apgar scores between obese and lean patients. Pearson’s correlation coefficient found no significant correlation between BMI and BGP/Apgar scores. Maternal obesity does not seem to affect BGP and fetal well-being in glucose-tolerant and nonhypertensive women.

scholarly journals Maternal Exercise Uncovers Placental Insufficiency in Diabetic Mothers

2019 ◽  
pp. 91-93
Author(s):  
Petrikovsky BM ◽  
Zharov EV ◽  
Plotkin D ◽  
Petrikovsky E
Keyword(s):  
Gestational Diabetes ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Fetal Monitoring ◽  
Well Being ◽  
Adverse Outcomes ◽  
Exercise Regimen ◽  
Maternal Exercise ◽  
Nicu Admission ◽  
Diabetic Mothers

Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes, and enhances patient’s psychological well-being. We studied the possibility to use maternal exercise to test placental reserves in diabetic mothers. We used a motorized treadmill in a moderate exercise regimen (15-minute fast walk at a speed of 3 mph with an incline of 15-25 degrees). Fetal monitoring was provided by using standard Phillips equipment (Avalon CTS and FM40). Adverse fetal outcomes were considered if one or more of the following were present: Category III Fetal Heart Rate (FHR) tracing, 5-minute Apgar score of less than 7, admission to the neonatal intensive care nursery, fetal growth restriction, and fetal and early neonatal death. A total of 819 fetal assessments were performed: 160 patients had gestational diabetes, 80 had pregestational diabetes. The most common complication in fetuses with positive prenatal test results was abnormal FHR in labor (36%) followed by low Apgar score (21%) and need for NICU admission (19%). Most of the adverse outcomes had good correlation with positive results of the exercise test. In conclusion, it appears that maternal exercise causes changes in FHR, which may be used to assess placental and fetal reserves.

Liberal versus Indicated Maternal Oxygen Supplementation in Labor: A Before-and-After Trial

2018 ◽  
Vol 35 (11) ◽  
pp. 1057-1064 ◽  
Author(s):  
Sean Blackwell ◽  
Mesk Alrais ◽  
Farah Amro ◽  
Rachel Wiley ◽  
Patricia Heale ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Supplemental Oxygen ◽  
Oxygen Supplementation ◽  
Before And After ◽  
Clinically Significant ◽  
Nicu Admission ◽  
Singleton Pregnancies

Background Although supplemental oxygen (SO2) is routinely administered to laboring gravidas, benefits and harms are not well studied. Objective This article compares strategies of liberal versus indicated SO2 therapy during labor on cesarean delivery (CD) rate and neonatal outcomes. Study Design A controlled, before-and-after trial of laboring women with term, singleton pregnancies. During an initial 8-week period, maternal SO2 was administered at the discretion of the provider followed by an 8-week period where SO2 was to be given only for protocol indications. Results Our study included 844 women. There was no difference in number of women receiving SO2 (53% liberal vs. 50% indicated; p = 0.33). For those receiving SO2, there was no difference in SO2 duration (median, 89 minutes [interquartile range, 42–172] vs. 87 minutes [36–152]; p = 0.42). There were no differences in overall CD rate (20% vs. 17%; p = 0.70), CD for nonreassuring fetal status, or use of intrauterine resuscitative measures. There were more 5-minute APGAR < 7 in the indicated group, but no difference in umbilical artery pH < 7.1 or neonatal intensive care unit (NICU) admission. Conclusion Approximately half of women receive SO2 intrapartum regardless of a strategy of liberal or indicated oxygen use. There were no clinically significant differences in outcomes between strategies.

Association between Uterine Tachysystole during the Last Hour of Labor and Cord Blood Lactate in Parturients at Term Gestation

2018 ◽  
Vol 36 (11) ◽  
pp. 1171-1178 ◽  
Author(s):  
Arvind Palanisamy ◽  
Julia Lopez ◽  
Antonina Frolova ◽  
George Macones ◽  
Alison G. Cahill
Keyword(s):  
Cord Blood ◽  
Blood Lactate ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Secondary Analysis ◽  
Base Deficit ◽  
Admission Rates ◽  
Tertiary Care Institution ◽  
Umbilical Arterial Ph ◽  
Nicu Admission

Objective To assess whether uterine tachysystole (UT) in labor causes an increase in cord blood lactate. Study Design Secondary analysis of a prospective cohort study of all consecutive singleton gestations ≥ 37 weeks admitted for labor to a single tertiary care institution with universal cord gas policy. Patients with UT in the last hour (“always”) were compared with those without UT (“never”). Primary outcome of interest was cord blood lactate ≥ 4 mmol/L. Secondary outcomes included pH ≤ 7.10, base deficit ≥ 8 mmol/L, and admission to the neonatal intensive care unit (NICU). Multivariable logistic regression was used to estimate the risk for elevated cord blood lactate after adjusting for maternal age and body mass index. Results Of the 8,580 patients included in the analysis, 513 experienced UT 1 hour before delivery (5.9%). UT was significantly associated with elevated cord blood lactate in the “always” (33.5%) compared with the “never” group (26%) (adjusted odds ratio 1.47 [1.17, 1.86]; p < 0.01). However, there were no differences in either umbilical arterial pH, base deficit, or NICU admission rates. Conclusion UT in the last hour preceding delivery increases arterial cord blood lactate suggesting that UT proximate to delivery should be considered as a variable when interpreting cord blood gas values.

scholarly journals Oligohydramnios and Fetal Outcome: A Review

Med Phoenix ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Tarannum Khatun ◽  
Akhtar Alam Ansari ◽  
Irfan Hamid ◽  
Ravi Shankar Gupta ◽  
Md. Parwez Ahmad
Keyword(s):  
Intrauterine Growth Restriction ◽  
Neonatal Intensive Care ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Singleton Pregnancy ◽  
Safe Delivery ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Nicu Admission ◽  
Definition Of

Oligohydramnios is a threatening condition to fetal health and is associated with increased fetal morbidity. These conditions are often missed and patient may not seek appropriate treatment at appropriate time that often increases risk of numerous conditions. Early detection of oligohydramnios and its management may help in reduction of perinatal morbidity and mortality one side and decreased caesarean deliveries on the other side. A search in Google scholar, PubMed, Medline, EMBASE was performed using key words. Inclusion criteria for articles selection were singleton pregnancy, definition of olgohydramnios as AFI <5 cm, AF assessment at 37-42 gestational weeks. The searched revealed numerous research articles which is further refined. It is found that oligohydramnios is associated with Intrauterine Growth Restriction (IUGR), small for gestational age (SGA), prolonged labour, caesarian section (C/S) for fetal distress (FD), meconium stained liquor, Low Apgar score and Neonatal Intensive Care Unit (NICU) admission. Women with oligohydramnios are associated with higher fetal risk but can expect a safe delivery and good outcome for which proper fetal surveillance and regular Antenatal care (ANC) visits are required. MED Phoenix Volume (1), Issue (1) July 2016, page: 23-30

scholarly journals The effect of maternal parameters on umbilical artery blood gas values and neonatal well-being in singleton pregnancies

2016 ◽  
Vol 0 (0) ◽  
Author(s):  
Huseyin Bilgin ◽  
Aydin Kosus ◽  
Nermin Kosus ◽  
Semra Kara ◽  
Abdulkadir Eren ◽  
...  
Keyword(s):  
Umbilical Artery ◽  
Well Being ◽  
Blood Gas ◽  
Singleton Pregnancies

scholarly journals Correlation of nucleated red blood cell count with neonatal intensive care unit admission

2020 ◽  
Vol 7 (11) ◽  
pp. 2225
Author(s):  
Sambedna . ◽  
Amit Kumar ◽  
Rita Chakore
Keyword(s):  
Cord Blood ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Health Centre ◽  
Tertiary Care ◽  
Control Group ◽  
Study Group ◽  
Cord Blood Sample ◽  
Nicu Admission ◽  
Retrospective Comparative Study

Background: Perinatal asphyxia should be diagnosed, when baby goes on to develop hypoxic ischemic encephalopathy which has shown to be much more reliable indicator of long term handicap than any other perinatal markers like non reassuring FHR, Apgar score, meconium stained amniotic fluid and blood acid base status of fetus. Since NRBC is related to hematopoietic response to hypoxia it predicts the chance of neurological sequelae and NICU admission. The aim of our study to analyze the significant relationship of NRBC count and NICU admission.Methods: This was a retrospective comparative study conducted in department of OBG, Patna medical college and Hospital between December 2013 to November 2015 in tertiary care health centre. Umbilical cord blood samples were collected from 100 newborns with asphyxia at birth out of which 56 were admitted in NICU taken as study group and rest 44 asphyxiated babies were not admitted in NICU were taken as control group. NRBC per 100 WBC was counted in Cord blood sample from all babies.Results: This shows that average count of NRBC/100 WBC in the study with NICU admission was 27.37+7.25. Average count in the study group with no NICU admission was 23.93+6.04. The difference was statistically significant (p<0.05).Conclusions: This study concludes that NRBC count correlate well with fetal asphyxia and finally NICU admission. Early detection leads to decrease neurological morbidity and mortality among survivors.

scholarly journals Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses

2016 ◽  
Vol 33 (1) ◽  
pp. 12-17
Author(s):  
Zakia Afroze ◽  
Rokeya Begum
Keyword(s):  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Perinatal Death ◽  
Fetal Distress ◽  
Accurate Method ◽  
Doppler Velocimetry ◽  
Average Birth Weight ◽  
Diastolic Flow ◽  
Doppler Study ◽  
Gestational Age At Delivery

Objectives: To study pregnancy outcomes in growth restricted fetuses with normal umbilical artery velocimetry, low end-diastolic umbilical flow, and absent or reversed diastolic flow. Methods: Fifty pregnant women with growth restricted fetuses were evaluated by umbilical artery velocimetry between 28 and 39 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n=17; 34%), the low end diastolic flow group (n=23; 46%), the group with absent diastolic flow (n=8; 16%) and the group with reversed diastolic flow (n=2; 4%). Results: The average birth weight, diagnosis to delivery interval and gestational age at delivery were comparatively lower in case of abnormal umbilical Doppler velocimetry group. Again there was higher incidence of LSCS for fetal distress, Apgar score <7 at 1 minute, admission to neonatal intensive care unit and perinatal death with those of the abnormal umbilical Doppler velocimetry. Conclusion: Doppler study of umbilical artery allows a noninvasive assessment of uteroplacental insufficiency and is an accurate method for diagnosis and management of fetal growth retardation.J Bangladesh Coll Phys Surg 2015; 33(1): 12-17

scholarly journals Relation between immediate postpartum APGAR score with umblical cord blood pH and fetal distress

2019 ◽  
Vol 8 (12) ◽  
pp. 4690
Author(s):  
Varuna Pathak ◽  
Deep Shikha Sahu
Keyword(s):  
Cesarean Section ◽  
Cord Blood ◽  
Apgar Score ◽  
Ph Value ◽  
Fetal Distress ◽  
Well Being ◽  
Emergency Cesarean Section ◽  
Medical Disorders ◽  
Blood Ph ◽  
Emergency Cesarean

Background: The one-minute Apgar score, proven useful for rapid assessment of the neonate, is often poorly correlated with other indicators of intrauterine well-being. Fetal asphyxia is directly associated with neonatal acidosis. Umbilical cord pH is best indicator of fetal hypoxemia and hypoxemia leads to neonatal acidosis. In today scenario, fetal distress is the leading indication of emergency cesarean section.Methods: A observational cross-sectional study conducted of one year between march 2017 to February 2018; of full-term obstetric patients undergoing emergency cesarean section for fetal distress as an indication. All patients included are term gestation with low risk pregnancy excluding medical disorders and other complications of pregnancy. Immediately after delivery umbilical artertial cord blood from placental site collected and sent for pH determination and Apgar score calculated of newborn.Results: Emergency cesarean section was being done for fetal distress diagnosed based on guidelines for Intermittent auscultation; maximum patients had fetal bradycardia (240) followed by fetal tachycardia (12) and irregular rhythm (18). Relation between pH value and the fetal outcome babies who had low pH value. i.e. <7.1; had maximum referrals with poor Apgar score at 1 min (<3) and at 5 min (<3). Out of 270 babies 18 had Apgar score <3 at 1 min, out of which 10 continued to have Apgar score <3 at 5 mins. These babies were referred to department of pediatrics and were not alive beyond day 2-4.Conclusions: The values of mean Apgar score and cord blood pH decreases, which is inversely proportion to duration and severity of intrauterine/intra partum asphyxia. Umbilical arterial cord blood pH correlation was found to be significant with Apgar score in neonates delivered with indication as fetal distress.

Amniotic-Umbilical-to-Cerebral Ratio – A Novel Ratio Combining Doppler Parameters and Amniotic Fluid Volume to Predict Adverse Perinatal Outcome in SGA Fetuses At Term

2020 ◽  
Author(s):  
Florian Matthias Stumpfe ◽  
Florian Faschingbauer ◽  
Sven Kehl ◽  
Jutta Pretscher ◽  
Julius Emons ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Predictive Accuracy ◽  
Area Under The Curve ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Adverse Perinatal Outcome ◽  
Adverse Perinatal Outcomes ◽  
Nicu Admission ◽  
Singleton Pregnancies

Abstract Purpose Introduction of a novel ratio – the amniotic-umbilical-to-cerebral ratio (AUCR) – to predict adverse perinatal outcome in SGA fetuses at term and comparison of its predictive accuracy with established parameters. Materials and Methods This retrospective cohort study included 165 singleton pregnancies with SGA fetuses (birth weight < 10th percentile) at term. Cases with planned vaginal delivery and documented pulsatility indices (PI) of the umbilical artery (UA), middle cerebral artery (MCA), and single deepest pocket (SDP) were included. CPR was calculated as the ratio between MCA PI and UA PI, UCR as the ratio between UA PI and MCA PI. AUCR was defined as follows: SDP/(UA PI/MCA PI). Adverse perinatal outcomes were defined as operative intervention (OI), OI due to fetal distress, admission to the neonatal intensive care unit (NICU), and composite adverse perinatal outcome (CAPO). Associations between Doppler parameters and these outcomes were estimated using regression analyses. Results OI was statistically significantly associated with UCR, SDP, and AUCR, whereas no association was observed for UA PI, MCA PI, and CPR. Fetuses requiring OI due to fetal distress revealed a significantly higher UA PI and UCR as well as a lower MCA PI, CPR, and AUCR. With regard to NICU admission and CAPO, a significantly higher UA PI and lower CPR were found. Furthermore, a significant association was shown for SDP, UCR, and AUCR. AUCR achieved the best area under the curve for all outcome parameters. Conclusion AUCR leads to an improvement in the prediction of unfavorable outcome in SGA fetuses at term. Furthermore, results of our study show that UCR might be superior to CPR.

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