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Comparison of umbilical arterial versus umbilical venous blood PH correlated with arterio-venous glucose difference and cardiotocographic score

  • Neonatology
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Abstract

The value of clinical parameters and umbilical arterial blood pH as indicator of prenatal hypoxia is disputed. In a prospective study of 86 vaginally delivered full-term infants, cardiotocographic (CTG) findings obtained 0–30 min and 30–60 min before birth were compared to pH values, O2 and CO2 partial pressures and glucose difference in umbilical arterial and venous blood. CTG findings were expressed as a score, higher values indicating fetal hypoxia. The venous but not the arterial blood pH was significantly related to the later (0–30 min) CTG score. The arterio-venous glucose difference was significantly related to both CTG scores. There was a significant statistical relationship between glucose difference and venous but not arterial blood pH. The later CTG score (0–30 min) also correlated significantly with O2 and CO2 partial pressures and base excess in the umbilical vein of all vaginally born infants. If CTG is accepted as an objective indicator of fetal hypoxia before birth, the arterio-venous glucose difference, and in the investigated range of pH-values, umbilical venous blood pH are more suitable than the arterial blood pH to ascertain the peripartal situation of the newborn.

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Abbreviations

BE:

base excess

CTG:

cardiotocography

SG:

serum glucose

VE:

vacuum extraction

References

  1. Apgar V (1953) A proposal for a new method for evaluation of the newborn infant. Anesth Analg Curr Res 32:260–267

    Google Scholar 

  2. Boehm FH, Fields LM, Entman SS, Vaughn WK (1986) Correlation of the one-minute Apgar-Score and umbilical cord acid-base status. South Med J 79:429–431

    PubMed  Google Scholar 

  3. Bohm S (1978) Significance of a general umbilical-cord pH for the evaluation of acidosis morbidity. Zentralbl Gynäkol 100: 842–846

    Google Scholar 

  4. Bretscher J, Saling E (1967) pH values in the human fetus during labor. Am J Obstet Gynecol 97:906–911

    PubMed  Google Scholar 

  5. Breuker KH, Kriebel I, Haase W, Bolte A (1980) Cardiotocographic Scores with Acid Base Status, Apgar Scores and Umbilical Blood Gas Levels. Arch Gynecol 229:45–55

    PubMed  Google Scholar 

  6. Breuker KH, Kusche M, Müller U, Bolte A (1986) The importance of antepartum cardiotokographie. J Perinat Med 14: 171–179

    PubMed  Google Scholar 

  7. Dennis J, Johnson A, Mutch L, Yudkin P, Johnson P (1989) Acid base status at birth and neurodevelopmental outcome at four and one-half years. Am J Obstet Gynecol 161:213–220

    PubMed  Google Scholar 

  8. Dijxhoorn MJ, Visser GH, Fidler VJ, Touwen BC, Huisjes HJ (1986) Apgar score, meconium and acidaemia at birth in relation to neonatal neurological morbidity in term infants. Br J Obstet Gynecol 93:217–222

    Google Scholar 

  9. D'Souza SW, Black P, Cadman J, Richards B: Umbilical venous blood pH (1983) a useful aid in the diagnosis of asphysia at birth. Arch Dis Child 58:15–19

    PubMed  Google Scholar 

  10. Fields LM, Entman SS, Boehm FH (1983) Correlation of the one-minute Apgar score and the pH value of umbilical arterial blood. South Med J 76:1477–1479

    PubMed  Google Scholar 

  11. Fischer WM, Fendel MD, Schultze-Mosgau H (1976) Fetal heart rate pattern (FHRP) in the second stage of labour and the perinatal outcome. In: Stembera Z, Polacek K, Sabata V (ed) Perinatal medicine. Thieme, Stuttgart, pp 79

    Google Scholar 

  12. Hammacher K, Brun Del Re R, DeGrandhi P, Richter R (1974) Kardiotokographischer Nachweis einer fetalen Gefährdung mit einem CTG-Score. Gynäk Rdsch 14:61

    Google Scholar 

  13. Huisjes HJ, Aarnoudse JG (1979) Arterial or venous umbilical pH as a measure of neonatal morbidity. Early Hum Dev 3: 155–161

    PubMed  Google Scholar 

  14. Josten BE, Johnson TR, Nelson JP (1978) Umbilical cord blood pH and Apgar scores as an index of neonatal health. Am J Obstet Gynecol 157:843–848

    Google Scholar 

  15. Marrin M, Paes BA (1988) Birth asphyxia: does Apgar score have diagnostic value? Obstet Gynecol 72:120–123

    PubMed  Google Scholar 

  16. Nikischin W, Weisner D, Oldigs HD (1990) Perinatal glucose metabolism as an indicator for stress and hypoxia during different forms of delivery. J Perinat Med 18:209–213

    PubMed  Google Scholar 

  17. Oksefjell H, Ipsen HE, Okland O (1990) Acid-base equilibrium in umbilical cord blood. Apgar score and acid-base equilibrium in umbilical cord blood as control parameters during labor. Tidsskr Nor Laegeforen 110:209–212

    PubMed  Google Scholar 

  18. Roemer VM, Heinzl S (1979) Zur Frage der Quantifizierung von Oszillationsfrequenz und Oszillationsamplitude in der direkten Kardiotokographie. Z Geburtsh Perinat 183:396–404

    Google Scholar 

  19. Ross Milley J (1988) Uptake of exogeneous substrates during hypoxia in fetal lambs. Am J Physiol Soc E572–E578

  20. Rüttgers H, Kubli F (1971) Effect of labour on fetomaternal exchange. In: Huntingford PJ, Beard RW, Hytten FE, Scopes JW (ed) Perinatal medicine. Karger, Basel, pp 48

    Google Scholar 

  21. Ruth VJ, Raivio KO, (1988) Perinatal brain demage: predictive value of metabolic acidosis and the Apgar score. BMJ 297:24–27

    PubMed  Google Scholar 

  22. Saling E (1971) The measurement of fetal heart-rate and acid-base balance. In: Huntingford PJ, Beard RW, Hytten FE, Scopes JM (ed) Perinatal medicine. Karger, Basal, pp 13

    Google Scholar 

  23. Thorp JA, Sampson JE, Parisi VM, Creasy RK (1989) Routine umbilical cord blood gas determinations? Am J Obstet Gynecol 161:600–605

    PubMed  Google Scholar 

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Nikischin, W., Lehmann-Willenbrock, E., Weisner, D. et al. Comparison of umbilical arterial versus umbilical venous blood PH correlated with arterio-venous glucose difference and cardiotocographic score. Eur J Pediatr 152, 840–843 (1993). https://doi.org/10.1007/BF02073383

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  • DOI: https://doi.org/10.1007/BF02073383

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