Umbilical Cord Blood Gases: Sampling, Evaluation, and Application for Clinicians

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

ABSTRACT

Predicting the severity of birth asphyxia-related brain injury in newborn infants is a difficult task. Cord blood gases can be useful indices in the assessment of the impact of peripartum events. Cord blood gas parameters are particularly important because, despite all the progress in fetal monitoring, the time gap between the onset of fetal heart rate (FHR) abnormalities and birth asphyxia-related brain injury has remained difficult to predict. In this paper, we have focused on cord blood gas values in understanding the degree of compromise. These data can help determine the timing of fetal compromise prior to labor, and whether these precipitating events were acute or prolonged. When combined with some adverse clinical markers, the accuracy of low-cord pH in predicting neonatal mortality and morbidity can be even higher. Low-cord pH or eucapnic neonatal pH can also help in the surveillance of at-risk infants and in timely institution of neuroprotective therapies. We present a detailed review on sampling, evaluation, and application of cord blood gas values for clinicians.

How to cite this article

Hiranandani M, Kaur I, Grover S. Umbilical Cord Blood Gases: Sampling, Evaluation, and Application for Clinicians. Newborn 2023;2(3):214–221.

Related collections

Most cited references 74

Record: found
Abstract: found
Article: not found

Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy.

Jennifer J. Kurinczuk, Melanie White-Koning, Nadia Badawi (2010)

Neonatal encephalopathy (NE) is the clinical manifestation of disordered neonatal brain function. Lack of universal agreed definitions of NE and the sub-group with hypoxic-ischaemia (HIE) makes the estimation of incidence and the identification of risk factors problematic. NE incidence is estimated as 3.0 per 1000 live births (95%CI 2.7 to 3.3) and for HIE is 1.5 (95%CI 1.3 to 1.7). The risk factors for NE vary between developed and developing countries with growth restriction the strongest in the former and twin pregnancy in the latter. Potentially modifiable risk factors include maternal thyroid disease, receipt of antenatal care, infection and aspects of the management of labour and delivery, although indications for some interventions were not reported and may represent a response to fetal compromise rather than the cause. It is estimated that 30% of cases of NE in developed populations and 60% in developing populations have some evidence of intrapartum hypoxic-ischaemia. Copyright 2010 Elsevier Ltd. All rights reserved.

0 comments Cited 311 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy.

Ernest M Graham, Kristy A Ruis, Adam L Hartman … (2008)

The object of this review was to determine the incidence, morbidity, and mortality of an umbilical arterial pH < 7.0; the incidence of hypoxic-ischemic encephalopathy; and the proportion of cerebral palsy associated with intrapartum hypoxia-ischemia in nonanomalous term infants. A systematic review of the English language literature on the association between intrapartum hypoxia-ischemia and neonatal encephalopathy was conducted by using Pubmed and Embase. For nonanomalous term infants, the incidence of an umbilical arterial pH < 7.0 at birth is 3.7 of 1000, of which 51 of 297 (17.2%) survived with neonatal neurologic morbidity, 45 of 276 (16.3%) had seizures, and 24 of 407 (5.9%) died during the neonatal period. The incidence of neonatal neurologic morbidity and mortality for term infants born with cord pH < 7.0 was 23.1%. The incidence of hypoxic-ischemic encephalopathy is 2.5 of 1000 live births. The proportion of cerebral palsy associated with intrapartum hypoxia-ischemia is 14.5%. The vast majority of cases of cerebral palsy in nonanomalous term infants are not associated with intrapartum hypoxia-ischemia.

0 comments Cited 132 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Neonatal encephalopathy: an inadequate term for hypoxic-ischemic encephalopathy.

Joseph J Volpe (2012)

This Point of View article addresses neonatal encephalopathy (NE) presumably caused by hypoxia-ischemia and the terminology currently in wide use for this disorder. The nonspecific term NE is commonly utilized for those infants with the clinical and imaging characteristics of neonatal hypoxic-ischemic encephalopathy (HIE). Multiple magnetic resonance imaging studies of term infants with the clinical setting of presumed hypoxia-ischemia near the time of delivery have delineated a topography of lesions highly correlated with that defined by human neuropathology and by animal models, including primate models, of hypoxia-ischemia. These imaging findings, coupled with clinical features consistent with perinatal hypoxic-ischemic insult(s), warrant the specific designation of neonatal HIE. Copyright © 2012 American Neurological Association.

0 comments Cited 118 times – based on 0 reviews      Review now

All references

Author and article information

Journal

Journal ID (publisher-id): JNB

Title: Newborn

Abbreviated Title: JNB

Publisher: Jaypee Brothers Medical Publishers

ISSN (Electronic): 2769-514X

Publication date (Print): July-September 2023

Volume: 2

Issue: 3

Pages: 214-221

Affiliations

[1 ]Department of Pediatrics and Neonatology, Cloudnine Hospital, Chandigarh, India

Author notes

Mahesh Hiranandani, Department of Pediatrics and Neonatology, Cloudnine Hospital, Chandigarh, India, Phone: +91 9876608322, e-mail: mhiranandani@ 123456yahoo.com

Article

DOI: 10.5005/jp-journals-11002-0074

SO-VID: 250d4831-5f50-45e1-8d3e-2e3e276ca911

License:

© The Author(s). 2023 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 10 August 2023

Date accepted : 05 September 2023

Date: 25 September 2023

Custom metadata

file-pdf jnb-02-214.pdf

ScienceOpen disciplines: Pediatrics

Keywords: Universal cord blood gas analysis,Arterio-venous difference,‘20,30,40,50 rule’,Maternal hypoxemia,Base deficit,Birth asphyxia,Brain injury,Rectal temperature,Respiratory acidosis,Stillbirth,Surveillance,Umbilical arteries,Umbilical venous blood,Regional anesthesia,Carbonic acid,Cerebral palsy,Cord blood gas,Eucapnic pH,pH qu 40,Hypercapnia,Hypoxic–ischemic encephalopathy,Maternal positioning,Neonatal encephalopathy,Nuchal cord,Organic acids,Oxygen-carrying capacity,Peripartum events,Placenta,Vascular zone

Comments

Comment on this article

Cited by 1

Correlation of cardiotocography with combined APGAR scores and diagnostic performance of umbilical cord parameters in predicting low combined APGAR scores – A prospective Cohort study
Authors: Soumyashree Paikaray, Saubhagya Kumar Jena, Deepthy Balakrishnan …

See all cited by

Most referenced authors 551

See all reference authors

Jaypee Content relevant to SDG 03 - Good Health & Wellbeing. To subscribe to Jaypee Journals, please click here

Want to submit a manuscript? Please click here for Instructions