Correlation between Intrapartum Cardiotocogram findings and cord blood pH in term and preterm labors

2021 ◽  
Vol 17 ◽  
Author(s):  
Shubha Rao ◽  
Himanshi Jain ◽  
Anjali Suneel ◽  
Roopa Padavagodu Shivananda ◽  
Akhila Vasudeva
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Preterm Labor ◽  
Fetal Monitoring ◽  
Cord Blood Sample ◽  
Arterial Blood ◽  
Blood Ph ◽  
Preterm Group ◽  
Fetal Acidosis

Background: The purpose of intrapartum fetal monitoring by cardiotocograph (CTG) is to identify early signs of developing hypoxia so that appropriate action can be taken to improve the perinatal outcome. Although CTG findings are well known to monitor the progress of the labor due to the paucity of recommendations, there has always been a clinical dilemma as the term fetuses respond differently than a preterm fetus. However, umbilical cord blood pH can distinguish the infant at high risk for asphyxia and related sequel. Therefore, because of differences in fetal physiology in term and preterm fetuses, CTG findings vary, and hence the validity of CTG to determine fetal acidosis should be different. Aims and Objectives: This study aimed to correlate abnormal intrapartum CTG findings with umbilical cord blood pH in term and preterm labor and thus evaluate the success of CTG in predicting fetal acidosis during labor. Methods: The present study included 210 women in labor (70 preterm and 140 term) with abnormal intrapartum CTG that was classified as per 2015 revised International Federation of Gynecologists and Obstetrician (FIGO) guidelines. Immediately after delivery 2 ml Umbilical artery cord blood sample was taken in a pre-heparinized syringe for analysis, pH <=7.2 was taken as acidosis and pH >7.2 was taken as normal. The measured data were maternal general characteristics which included gravida status, associated comorbidities, method of induction and character of liquor, the intrapartum CTG tracings recorded the cord arterial blood pH and the neonatal characteristics such as APGAR score and neonatal outcome. Results: Data from 70 preterm labor was compared with 140 term labor. In this study, 20.9 % of the babies had acidosis. Suspicious CTG due to decreased variability were more common in the preterm group than in the term group (21.4% vs. 8.6% p<0.05). Positive predictive value (PPV) of abnormal CTG for fetal acidosis in the preterm group was found to be higher than that in term group, PPV of pathological CTG being even higher than suspicious CTG. Women with suspicious CTG had 82 % less risk of fetal acidosis as compared to pathological CTG. Women with Bradycardia had 5.9 times the risk of fetal acidosis as compared with normal and tachycardia. Conclusion: Abnormal CTG should be managed appropriately without any delay to prevent acidosis and cord blood pH should be done in all labors with abnormal CTG. However, our findings of a higher incidence of lower cord blood pH and suspicious CTG due to decreased variability alone, highlight the limitation of criteria currently used for interpretation of CTG in preterm labors.

scholarly journals Study of intrapartum fetal distress with the help of cardiotocography and its correlation with umbilical cord blood sampling

2020 ◽  
Vol 9 (4) ◽  
pp. 1580
Author(s):  
S. Neeraja ◽  
Sugathi Parimala ◽  
Naima Fathima
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Risk Groups ◽  
Normal Vaginal Delivery ◽  
Arterial Blood ◽  
Blood Ph ◽  
Fetal Acidosis

Background: Even in low risk mothers, fetal acidosis occurs as in high risk groups. Aim of fetal monitoring is to detect early response to intrauterine hypoxia and prevent irreversible neurological damage and death. Objective of this study was to correlate the intrapartum fetal distress with the help of cardiotocography CTG with umbilical cord blood sampling.Methods: A total 100 consecutive patients attending the labor ward were studied. Immediately at birth, before the baby’s first breath and before delivery of the placenta, the umbilical cord blood was collected as per the standard guidelines laid down in the standard textbooks. Fetal acidosis was assessed by umbilical cord arterial blood pH. Fetal acidosis was considered when umbilical artery pH <7.2. Cardiotocography features were used to clinically diagnose fetal distress.Results: Most of the mothers were multigravida. They belonged to the age group of 20-25 years. Only 18% had abnormal CTG. Out of 50 mothers with normal vaginal delivery, all had normal CTG. Out of 43 mothers who were delivered by LSCS, no one had normal CTG, 25 had indeterminate CTG and 18 had abnormal CTG. As CTG became abnormal, proportion of mothers with the thick meconium increased. NICU admission proportion increased as CTG changed from normal to the abnormal. There was a significant association between the abnormal CTG and the umbilical cord blood pH being acidic.Conclusions: CTG is a simple test, easy to perform and can alert obstetrician for necessary interventions in case of an abnormal CTG. It can detect fetal distress in labor thus helping to reduce neonatal morbidity by early intervention in cases of abnormal tracing.

scholarly journals Intrapartum cardiotocography and its correlation with umbilical cord blood pH in term pregnancies: a prospective study

2017 ◽  
Vol 6 (7) ◽  
pp. 2745 ◽  
Author(s):  
Chandrima Ray ◽  
Alokananda Ray
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gas Analysis ◽  
Fetal Monitoring ◽  
Gas Analysis ◽  
Arterial Blood ◽  
Blood Ph ◽  
Electronic Fetal Monitoring ◽  
A Prospective Study

Background: The purpose of intra-partum fetal monitoring is to identify early signs of developing hypoxia. Electronic fetal monitoring is performed using cardiotocograph, which is a paper record of the fetal heart rate (FHR) patterns plotted simultaneously in relation to uterine activity. In low resource settings umbilical cord artery blood gas analysis can provide important information about the foetuses exposed to intrapartum hypoxaemic events and can distinguish the infant at high risk for asphyxia and related sequelae. The aim of this study was to correlate intrapartum CTG findings with umbilical cord blood pH at birth in term pregnancies in labour and thus evaluate the success of CTG in predicting fetal acidosis during labour.Methods: The present study included 301 consecutive women with term singleton pregnancies in labour. Intrapartum CTG was taken and classified into normal (category I trace), indeterminate (category II trace) and abnormal (category III trace) according to NICHD 2008 Classification (Adapted by ACOG 2013). Umbilical cord arterial blood was taken immediately after birth, in a pre-heparinised syringe and sent to the laboratory for pH study to detect acidosis. Cord blood pH <7.2 was taken as acidosis and cord blood pH ≥7.2 was taken as normal.Results: In this study, 50.2% of the women had normal CTG, 36.5% had indeterminate CTG and 13.3% had abnormal CTG. 18.3 % of the babies had acidosis. Out of the subjects with abnormal intrapartum CTG, 52.5% had acidosis, of the subjects with normal intrapartum CTG trace, 7.3% had acidosis and of the 110 subjects with indeterminate intrapartum CTG, 22.7% had acidosis. A statistically significant association was found between intrapartum CTG and umbilical cord arterial pH (p <0.001).Conclusions: From the analysis of this study, it can be concluded that an abnormal CTG should be managed appropriately, without delay, in order to prevent acidosis in the neonate and adverse long-term sequelae. The obstetrician should be more vigilant in cases of indeterminate CTG tracings and monitor such labours closely.

scholarly journals TO STUDY THE CATEGORY II CARDIOTOCOGRAPHY AND ITS CORRELATION WITH UMBILICAL CORD PH

2020 ◽  
Vol 8 (10) ◽  
pp. 1086-1091
Author(s):  
Sonal Behra ◽  
◽  
Namita Agarwal ◽  
Mridu Sinha ◽  
J.K Goel ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Blood Gas Analysis ◽  
Fetal Monitoring ◽  
Gas Analysis ◽  
Arterial Blood ◽  
Blood Ph ◽  
Electronic Fetal Monitoring ◽  
Paper Record ◽  
Fetal Acidosis

Introduction: The purpose of intra-partum fetal monitoring is to identify early signs of developing hypoxia. Electronic fetal monitoring is performed using cardiotocograph, which is a paper record of the fetal heart rate (FHR) patterns plotted simultaneously in relation to uterine activity. In low resource settings umbilical cord artery blood gas analysis can provide important information about the fetuses exposed to intrapartum hypoxaemic events and can distinguish the infant at high risk for asphyxia and related sequelae. The aim of this study was to correlate intrapartum CTG findings with umbilical cord blood pH at birth in term pregnancies in labour and thus evaluate the success of CTG in predicting fetala cidosis during labour. Methods:The present study included 100 women with term singleton pregnancies in labour and with Category II according to NICHD 2008 Classification (Adapted by ACOG 2013). Umbilical cord arterial blood was taken immediately after birth, in a pre-heparinised syringe and sent to the laboratory for pH study to detect acidosis. Cord blood pH <7.2 was taken as acidosis and cord blood pH ≥7.2 was taken as normal Results: Among 100 patients, 78 had normal cord pH and 22 had abnormal cord pH(<7.20). On intrapartum CTG, maximum patients in our study group had variable decelerations,followed by decreased variability(<5bpm) and absent induced acceleration on fetal stimulation. Late decelerations and fetal bradycardia were observed to have most significant correlation with fetal acidosis. Conclusions: From the analysis of this study, it can be concluded that an abnormal CTG should be managed appropriately, without delay, in order to prevent acidosis in the neonate. The obstetrician should be more vigilant in cases of Cat II CTG tracings with bradycardia and late decelerations and monitor such labours closely.

Discovery of a novel HLA class I allele, HLA‐B*38:75 , in an Indian umbilical cord blood sample

HLA ◽  
2019 ◽  
Vol 94 (5) ◽  
pp. 442-443 ◽  
Author(s):  
Satyen Y. Sanghavi ◽  
Tripti U. Gaunkar ◽  
Vinayak V. Kedage
Keyword(s):  
Cord Blood ◽  
Blood Sample ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Hla Class I ◽  
Class I ◽  
Cord Blood Sample ◽  
Umbilical Cord Blood Sample

scholarly journals Associations between piglet umbilical blood hematological criteria, birth order, birth interval, colostrum intake, and piglet survival

2020 ◽  
Vol 98 (10) ◽  
Author(s):  
Kiah M Gourley ◽  
Joel M DeRouchey ◽  
Mike D Tokach ◽  
Steve S Dritz ◽  
Robert D Goodband ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Birth Weight ◽  
Cord Blood ◽  
Birth Order ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Birth Interval ◽  
Blood Ph ◽  
Umbilical Cords ◽  
Piglet Survival

Abstract A total of 656 pigs (623 live-born and 33 stillborn) from 43 sows were used to evaluate hematological criteria at birth and their association with piglet survival. At birth of each piglet, birth time and order within the litter, weight, umbilical cord status (intact or ruptured) and whether the pig was live-born or stillborn were recorded. A 200µL sample of blood from the umbilical cord was collected and immediately analyzed for concentrations of glucose, oxygen partial pressure (pO2), carbon dioxide partial pressure (pCO2), pH, base excess (BE), bicarbonate (HCO3), saturated oxygen (sO2), total carbon dioxide (TCO2), sodium, potassium, ionized calcium (iCa), hematocrit (Hct), and hemoglobin (Hb) on a hand held iStat portable clinical analyzer (iStat Alinity, Abbott Point of Care Inc., Princeton, NJ). Piglets were categorized into quartiles based on birth order and cumulative birth interval (CumBI). Live-born pigs had higher (P &lt; 0.01) umbilical cord blood pH, HCO3, BE, sO2, TCO2, and birth weight compared with stillborn pigs, but lower (P &lt; 0.01) pCO2, K, iCa, and glucose compared with stillborn pigs. Pigs with intact umbilical cords at birth were associated with higher (P &lt; 0.01) blood pH, HCO3, BE, and TCO2 compared with piglets born with a ruptured umbilical cord. Pigs with intact umbilical cords were associated with lower (P &lt; 0.01) Hct and Hb concentrations and born earlier (P &lt; 0.01) in the birth order compared with pigs born with a ruptured umbilical cord. Pigs that did not survive to weaning had lower (P &lt; 0.01) umbilical cord blood pH, HCO3, BE, sO2, TCO2, Na, glucose, and birth weight, and 24 hr weight compared with pigs alive at weaning. Pigs born in the first quartile for CumBI had higher (P &lt;0.05) pH compared with pigs in the other three quartiles. Umbilical cord blood HCO3, BE, and TCO2 decreased (P &lt;0.05) with each change in CumBI quartile from first to last. Blood glucose was lowest (P &lt;0.05) in pigs born before 44 min and highest in pigs born after 164 min. Umbilical cord blood pH, HCO3, BE, TCO2, Na, glucose, Hct, and Hb were positively associated (P &lt;0.001) with colostrum intake, indicating increased blood values resulted in higher colostrum intake. Although a pig may be live-born, their survival to 24 hr and to weaning is reduced when blood pH, HCO3, BE, and sO2 are lower reiterating the importance of management practices that can reduce the birth interval between pigs and the number of pigs experiencing moderate to severe hypoxia.

Questioning the Practice of Routine Umbilical Cord Blood pH Sampling at Delivery

1993 ◽  
Vol 2 (4) ◽  
pp. 191-196 ◽  
Author(s):  
Richard P. Perkins ◽  
Patricia A. Weaver ◽  
William J. Sweeney
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Ph

scholarly journals A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome

2020 ◽  
Vol 8 (2) ◽  
pp. 30-35
Author(s):  
Nutan Singh ◽  
Asheesh Kumar Gupta ◽  
Ajay Kumar Arya
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Outcome ◽  
Outcome Measurement ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Arterial Blood ◽  
Blood Ph

Background: Perinatal asphyxia is one of the major causes of neonatal morbidity & mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia & early neonatal outcome. Subjects and Methods: A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST & there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed & encephalopathy (sarnat & sarnat stage). Results: In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH <7.1 (ROC=0.998) is very significant in predicting the adverse outcome. Conclusion: Cord blood pH is very sensitive and specific & has good correlation in predicting the birth asphyxia & adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.

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