Journal Name:
- Cerrahpaşa Tıp Dergisi
Keywords (Original Language):
| Author Name | University of Author | Faculty of Author |
|---|---|---|
Abstract (2. Language):
Analysis of umbilical cord blood acid-base status at birth could give some information
about the fetal intrapartal condition retrospectively. Normally umbilical cord arterial blood reflects fetal acid-base
balance and umbilical cord venous blood reflects a combination of maternal acid-base status and placental
function. In this study we aimed to demonstrate the relationship between the umbilical cord gas parameters and
fetal well-being as well as to assess the usefulness of routine umbilical cord blood sampling. During a 12-month
period we made the umbilical cord arterial and venous blood gas analysis of 199 healthy pregnant women
between the 37th and 42nd week of gestation. During the trial all samples were taken by the same trained
midewife and nurse. Immediately after each birth, the umbilical cord was clamped twice about 10 cm apart.Blood
was taken first from the artery and from the vein using preheparinised syringes. Analysis was achieved within 30
minutes of delivery. Tracings indicative of fetal acidosis were defined as persistent late decelerations and severe
variable decelerations (heart rate dropping to <70 beats/min and lasting >60 seconds).
Results.- We classified the deliveries as normal (head or breech presentation with or without induction) and
operative (Cesarean section, vacuum and forceps deliveries) to compare the fetal blood parameters. Each group
was evaluated for the existence of intra-uterine growth retardation and fetal weight at delivery separately.
Umbilical cord arterial pH, PO2 and venous pH, pCO2, pO2 difference between normal deliveries and operative
deliveries done for fetal distress were statistically significant (p<0.05).
Conclusion.- We conclude that umbilical cord blood pH and gases should be obtained only in cases of high risk
pregnancies and in depressed newborns so that the diagnosis of neonatal asphyxia could be excluded in 80% of
the cases.
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Abstract (Original Language):
Umbilikal kordon pH ve gaz değerleri yüksek
riskli doğumlarda ve düşük apgar skorlu
yenidoğanlarda düşünülmeli ve öncelikle UA
pH alınmalıdır. Böylelikle gerçek hipoksemik
ve asidemik bebekler ayrılmış olacaktır. Bu
sayede böyle bebeklere klinik yardım ve yaklaş
ımın doğru , yeterli ve öncelikli olarak uygulanmas
ı sağlanacaktır. Aynı zamanda düşük
apgar skorlu doğan bebeklerde gerçek doğum
asfiksi tanısı %80 dışlanabilecektir. Bu sonuç-
lar doğrultusnda, ACOG (American College of
Obstetrics and Gynecologists )önerisine paralel
olarak, her yenidoğanda olmasa bile, riskli gebeliklerde,
özellikle antepartum fetal asfiksi
saptanan ve intrapartum fetal distres belirlenen
vakalarda umbilikal kordon kan gazları tetkiklerinin,
neonatal yardım ve girişimlerin doğru
ve zamanında yapılması bakımından faydalı
olacağı görüşüne varılmıştır.
- 4
236-244