Correlation of umbilical blood pH and outcome in meconium stained deliveries

Abstract

Background: Umbilical cord blood analysis is assumed to give a picture of acid base balance of the infant at the moment of birth when umbilical circulation is arrested by clamping of the cord. Meconium stained deliveries often cause anxiety in the minds of clinicians attending such newborn.Aims and Objectives: To study the correlation of umbilical cord pH with apgar and outcome and predict a model to help us to detect cases of meconium that need active monitoring and intervention.Materials and Methods: This was a prospective observational study.86 newborn born to mothers with meconium at artificial rupture of membranes was enrolled for the study All newborn had arterial blood gas analysis from umbilical cord.Results: The pH of umbilical blood showed positive correlation with apgar scores at 1minute (r=0.46) and negative correlation with thick meconium(r=-0.35) and outcome (r=0.36).Conclusion: The correlation though not strong are suggestive of the fact that meconium deliveries with poor apgar and thick meconium should be monitored before discharge.Asian Journal of Medical Sciences Vol.7(4) 2016 113-115

Relationship between immediate postpartum umbilical cord pH, fetal distress and neonatal outcome

“…Similar short-term outcome association of APGAR score and cord blood pH was reported by other authors. [16][17][18] Association between intrapartum fetal distress, cord acidemia and neonatal hypoglycemia in babies admitted to NICU has been found out by Durrani and colleagues. 19 Apgar score for neonatal assessment at birth is a universal practice while cord blood gas analysis is reserved for high risk situations or where there is low APGAR score at birth.…”

“…Similar short-term outcome association of APGAR score and cord blood pH was reported by other authors. 16 - 18 Association between intrapartum fetal distress, cord acidemia and neonatal hypoglycemia in babies admitted to NICU has been found out by Durrani and colleagues. 19 …”

Cord blood parameters and fetal outcome in neonates with fetal distress due to meconium staining liquor- an observational study

“…This is comparable to the studies by Samiyappa et al, Fernadez et al and Misra et al where the caesarean section rate was higher with thick MSL. [10][11][12] Our study also found that the study population operated by LSCS for thick MSL were most commonly associated with persistent late decelerations. This is comparable to the study by Kumar In our study, thick MSL and cord blood pH<7 was associated with abnormal cord blood lactate, maximum neonates requiring assisted ventilation, intubation, NICU admission, APGAR score less than seven and early NND, while thin MSL was associated with the best cord blood parameters and best neonatal outcomes.…”

“…13 The number of neonates with a low APGAR score in our study was comparable to the study by Gandhi et al and Misra et al where 10% and 12.9% of newborns respectively had an APGAR score of less than seven. 6,12 On the other hand, Tolu et al and Espinheira et al observed that the APGAR score in MAS was less than seven at five minutes in 36.8% and 23.6% newborns respectively. 3,8 Incidence of acidaemia seen in the above mentioned neonates is comparable to the study by Gandhi et al and Kacho et al 6,14 A similar study can be conducted with a larger sample size.…”