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

Syed, Wajeeha; Liaqat, Nazia; Qazi, Qudsia; Yasmeen, Sumaira

doi:10.12669/pjms.36.7.2536

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…This is in accordance with the study by Syed et al who reported a strong correlation between low umbilical cord blood pH and a low APGAR score at five minutes. 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.…”

Section: Discussionsupporting

confidence: 90%

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

Aafreen

Dabral²,

Panwar³

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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Background: Meconium staining liquor (MSL) results from passage of meconium during labour and is used to diagnose fetal distress. Thick and granular meconium has been found to have a significant association with an abnormal cord pH and lactate and worst neonatal outcome. The aim of this study was to analyse and compare the mode of delivery, cord blood parameters and fetal outcomes in cases diagnosed with different degrees of meconium staining liquor.Methods: An observational study was carried out on 76 labouring patients presenting in the active stage of labour with term, singleton pregnancy with cephalic presentation diagnosed with either thin or thick MSL. The cases were followed up and compared in thin or thick MSL group for the mode of delivery (normal vaginal delivery, instrumental delivery or caesarean section), fetal cord blood parameter after birth (cord blood pH and lactate) and the neonatal outcome.Results: 39 cases were diagnosed with thin MSL. Of these, 74.4% delivered by a normal vaginal delivery. Maximum cases had normal cord blood parameters with a favourable neonatal outcome. 37 cases had thick MSL. Lower segment caesarean section (LSCS) rate was highest in this group (i.e. 48.6%). The neonatal outcomes were as follows- 24.3% had an APGAR score <7, 43.2% required assisted ventilation, 43.2% required NICU admission and 13.5% had an early neonatal death.Conclusions: Thin MSL should be closely monitored and can be followed up for normal vaginal delivery.

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Section: Discussionsupporting

confidence: 90%

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

Aafreen

Dabral²,

Panwar³

et al. 2022

Int J Reprod Contracept Obstet Gynecol

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“…Malin et al demonstrated that low arterial cord pH had powerful, temporal, and consistent connections with crucial neonatal outcomes, including HIE and cerebral palsy 32 . Moreover, on the condition that low UCB pH values happened together with a low 5‐min Apgar score, the neonatal morbidity and mortality risks were markedly increased 33 . Providing details on UCB gas analysis in neonates with a low Apgar score is useful to determine and exclude the diagnosis of birth asphyxia, as it was stated that most of the nonvigorous infants were not diagnosed as birth asphyxia if UCB gas analysis was accessible 7 .…”

Section: Discussionmentioning

confidence: 99%

“…32 Moreover, on the condition that low UCB pH values happened together with a low 5-min Apgar score, the neonatal morbidity and mortality risks were markedly increased. 33 Providing details on UCB gas analysis in neonates with a low Apgar score is useful to determine and exclude the diagnosis of birth asphyxia, as it was stated that most of the nonvigorous infants were not diagnosed as birth asphyxia if UCB gas analysis was accessible. 7 Thus, the Apgar score does not predict individual neonatal mortality and neurologic outcome and should not be utilized alone for this purpose.…”

Section: Discussionmentioning

confidence: 99%

The evaluation of the antepartum and intrapartum risk factors in predicting the risk of birth asphyxia

Tunç

Oğlak

Özköse

et al. 2022

J of Obstet and Gynaecol

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Purpose This study aimed to determine the related antepartum and intrapartum factors of birth asphyxia among neonates born in a tertiary referral hospital. Methods A total of 45 singleton pregnant women who delivered live births with a gestational age of ≥35 weeks and their neonates who suffered from birth asphyxia from June 2016 to June 2021 were included in this retrospective study. Data regarding maternal demographic features, maternal laboratory values, pregnancy complications, and obstetric and neonatal outcomes were collected. Results Significant risk factors associated with birth asphyxia were nulliparity (odds ratio [OR] = 5.357, 95% confidence interval [CI] = 2.169–24.950, p = 0.001), placental abruption (OR = 8.667, 95% CI = 2.223–33.784, p = 0.002), intrauterine growth restriction (OR = 1.394, 95% CI = 1.109–8.631, p = 0.012), the prolonged second stage of labor (OR = 6.121, 95% CI = 2.120–17.595, p = 0.001), meconium‐stained amniotic fluid (OR = 7.615, 95% CI = 2.394–24.223, p = 0.001), bloody amniotic fluid (OR = 9.423, 95% CI = 2.885–35.232, p = 0.001), the presence of FHR category II (OR = 12.083, 95% CI = 7.081–48.849, p <0.001) and FHR category III before labor (OR = 15.500, 95% CI = 8.394–56.176, p <0.001). Conclusion We identified that nulliparity, placental abruption, intrauterine growth restriction, the prolonged second stage of labor, meconium‐stained or bloody amniotic fluid, and FHR tracings categories II and III were significantly associated with birth asphyxia.

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Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section

et al. 2023

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Asphyxia during birth is one of the three leading causes of neonatal morbidity and mortality among newborns carried to term. The objective of this study was to evaluate the measurement of the foetal scalp blood pH as a measure of foetal status, evaluating: cord gases, meconium-stained fluid, APGAR score or the need for neonatal resuscitation in pregnant women undergoing caesarean sections. A cross-sectional study was carried out over a period of 5 years (2017–2021) at the Hospital de Poniente (southern Spain). A total of 127 pregnant women participated from whom a foetal scalp blood pH sample was taken and used to indicate the need for an urgent caesarean section. The results showed a correlation between the pH of the scalp blood and the pH of the umbilical cord artery, umbilical cord vein (Rho of Spearman arterial pH: 0.64, p < 0.001; Rho of Spearman venous pH: 0.58, p < 0.001) and the APGAR test one minute after delivery (Spearman’s Rho coefficient of 0.33, p < 0.01). These results suggest that the foetal scalp pH should not be considered a foolproof method to indicate an urgent caesarean section. Foetal scalp pH sampling can be used as a complementary test, in conjunction with cardiotocography, to indicate whether an emergency caesarean section is necessary due to loss of foetal well-being.

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

Cited by 3 publications

References 14 publications

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

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

The evaluation of the antepartum and intrapartum risk factors in predicting the risk of birth asphyxia

Determination of Foetal Scalp Blood Sampling pH as an Indicator of Loss of Foetal Well-Being in Women Undergoing Caesarean Section

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