ACID-BASE BALANCE AND GAS COMPOSITION OF THE UMBILICAL CORD BLOOD IN THE FULL-TERM NEWBORNS WITH A LOW APGAR SCORE
https://doi.org/10.34822/2304-9448-2022-3-32-39
Abstract
The study aims to determine the relation between the indicators of acid-base balance and umbilical cord blood gases in full-term newborns with a low Apgar score. Materials and methods. A retrospective cohort study of 273 newborns in the Perinatal Center of the Khanty-Mansiysk was conducted by random selection for the period of 2015–2018. The main group consisted of 63 full-term newborns with a low Apgar score of < 7 at the 1st
minute of life. The comparison gr oup consisted of 210 full-term newborns with an Apgar score of > 7 at the 1st minute after birth. Born at 38–42 weeks from single pregnancies, all newborns showed no malformations. As soon as the umbilical cord was clamped and cut, the blood samples were taken from the umbilical vein to be analyzed with an automated EASYSTAT analyzer (Medica, USA). Results. A low Apgar score at the 1st minute refl ects the state of acidosis at birth in 62 % of cases, at the 5th minute – in 81 %. Signifi cant cord blood acidosis (pH ≤ 7.1) was observed 2 times more often in newborns with a low Apgar score at the 5th minute of life than at the 1st minute (33.3 and 68.8 %, p = 0.010). The frequency of neonatal acidosis, even with a normal Apgar score at the 5th minute, was detected in 4.3 % of cases (pH ≤ 7.1), and severe case of acidosis (pH ≤ 7.0) in 0.8 %. An Apgar score correlated more closely with pH of blood than with acid-base balance and umbilical cord blood gases. It is recommended to determine the pH of umbilical cord blood as it refl ects the condition of the newborn more accurately than other
indicators.
About the Authors
T. N. Ugleva
Khanty-Mansiysk State Medical Academy, Khanty-Mansiysk
Russian Federation
Russian Federation
Doctor of Sciences (Medicine), Associate Professor
E-mail: tatjana.ugleva@yandex.ru
V. G. Tarabrina
District Clinical Hospital, Khanty-Mansiysk
Russian Federation
Russian Federation
Neonatologist-Resuscitator
E-mail: valy19894@mail.ru
L. A. Alekseenko
District Clinical Hospital, Khanty-Mansiysk
Russian Federation
Russian Federation
Neonatologist-Resuscitator
E-mail: allexa33@mail.ru
References
1. Apgar V. A Proposal for a New Method of Evaluation of the Newborn Infant // Curr Res Anesth Analg. 1953. Vol. 32, Is. 4. P. 260–267.
2. Антонов А. Г., Буров А. А., Володин Н. Н., Горев В. В., Дегтярев Д. Н. Реанимация и стабилизация состояния новорожденных детей в родильном зале: метод. письмо // Неонатология: Новости. Мнения. Обучение. 2020. № 1 (27). С. 34–52.
3. Committee Opinion No. 644: The Apgar Score // Obstet Gynecol. 2015. Vol. 126, Is. 4. P. e52–e55.
4. Simon L. V., Hashmi M. F., Bragg B. N. APGAR Score // StatPearls. 2022.
5. Gillam-Krakauer M., Gowen Jr C. W. Birth Asphyxia // StatPearls. 2021.
6. Armstrong L., Stenson B. J. Use of Umbilical Cord Blood Gas Analysis in the Assessment of the Newborn // Arch Dis Child Fetal Neonatal Ed. 2007. Vol. 92, Is. 6. P. F430–F434.
7. Yeh P., Emary K., Impey L. The Relationship between Umbilical Cord Arterial pH and Serious Adverse Neonatal Outcome: Analysis of 51,519 Consecutive Validated Samples // BJOG. 2012. Vol. 119, Is. 7. P. 824–831.
8. Manomayangkul K., Siriussawakul A., Nimmannit A. et al. Reference
9. Values for Umbilical Cord Blood Gases of Newborns Delivered by Elective Cesarean Section // J Med Assoc Thai. 2016. Vol. 99, Is. 5. P. 611–617.
10. Vesoulis Z. A., Liao S. M., Rao R. et al. Re-examining the Arterial Cord
11. Blood Gas pH Screening Criteria in Neonatal Encephalopathy //
12. Arch Dis Child Fetal Neonatal Ed. 2018. Vol. 103, Is. 4. P. F377–F382.
13. Bailey E. J., Frolova A. I., López J. D. et al. Mild Neonatal Acidemia is Associated with Neonatal Morbidity at Term // Am J Perinatol. 2021. Vol. 38, Is. S 01. P. e155–e161.
14. Raghuraman N., Temming L. A., Stout M. J. et al. Umbilical Cord Oxygen Content and Neonatal Morbidity at Term // Am J Perinatol. 2018. Vol. 35, Is. 4. P. 331–335.
15. Malin G. L., Morris R. K., Khan K. S. Strength of Association between
16. Umbilical Cord pH and Perinatal and Long Term Outcomes: Systematic Review and Meta-Analysis // BMJ. 2010. Vol. 340. P. c1471.
17. Sabol B. A., Caughey A. B. Acidemia in Neonates with a 5-Minute Apgar Score of 7 or Greater – What Are the Outcomes? // Am J Obstet Gynecol. 2016. Vol. 215, Is. 4. P. 486.E1–486.E6.
18. Locatelli A., Incerti M., Ghidini A. et al. Factors Associated with Umbilical Artery Acidemia in Term Infants with Low Apgar Scores at 5 Min // Eur J Obstet Gynecol Reprod Biol. 2008. Vol. 139, Is. 2. P. 146–150.
19. Syed W., Liaqat N., Qazi Q., Yasmeen S. Relationship between Immediate Postpartum Umbilical Cord pH, Fetal Distress and Neonatal Outcome // Pak J Med Sci. 2020. Vol. 36, Is. 7. P. 1529–1532.
Review
For citations:
Ugleva T.N., Tarabrina V.G., Alekseenko L.A. ACID-BASE BALANCE AND GAS COMPOSITION OF THE UMBILICAL CORD BLOOD IN THE FULL-TERM NEWBORNS WITH A LOW APGAR SCORE. Vestnik SurGU. Meditsina. 2022;(3 (53)):32-39. (In Russ.) https://doi.org/10.34822/2304-9448-2022-3-32-39
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