Acid-base evaluation of umbilical cord blood: relation to delivery mode and Apgar scores
Open accessAbstract
Acid-base status of umbilical artery and vein blood was measured immediately after delivery in 300 cases. A slight acidosis of mixed respiratory/metabolic type was found in newborns delivered following a second stage of 10-30 min duration. After a second stage of more than 30 min the metabolic contribution to the acidosis was predominating. With Apgar scores lower than 10 the pH was found to decrease and carbon dioxide tension to increase. Induction or augmentation of labor by oxytocin did not influence the acid-base status of umbilical cord blood. Delivery by vacuum extraction or low forceps resulted in lower pH and higher carbon dioxide tension in umbilical cord blood, but the changes were associated with the indication for instrumental delivery and not with mode of delivery. A large arterio-venous difference between the acid-base parameters was usually connected to vigorous newborns and a small difference to depressed infants. The carbon dioxide tension was usually increased in newborns with decreased pH, and a close correlation between these parameter was found. No case of acidosis (pH below 7.15) was found in this population at carbon dioxide tensions below 7.2 kPa; at higher Pco2 values only 25% of the newborns were acidotic. A Pco2 level of 7.7 kPa might be used at transcutaneous carbon dioxide monitoring during labor, although the sensitivity and specificity of this parameter will have to be decided in a prospective study.
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- Authors
- Nickelsen, C., & Weber, T.
- Affiliations
- University of Copenhagen (DK)
- ORCID
- Weber, Tom
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 1987-03
- Volume
- 24
- Issue
- 3
- Pages
- 153-165
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W2031629448
- Cited by
- 30
- References
- 15
- Citations by year
- 2026: 1 · 2023: 1 · 2018: 1 · 2013: 1 · 2012: 2
- FWCI
- 5.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Keywords
- umbilical cord blood, acid-base status, acidosis, second stage of labor, Apgar score, carbon dioxide tension, arteriovenous differences, vacuum extraction, forceps delivery, oxytocin induction, transcutaneous carbon dioxide monitoring, fetal acidosis
- MeSH terms
- Acid-Base Equilibrium, Apgar Score, Carbon Dioxide, Cesarean Section, Female, Fetal Blood, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Labor Stage, Second, Obstetrical Forceps, Oxygen, Pregnancy, Umbilical Arteries, Umbilical Veins, Vacuum Extraction, Obstetrical, Delivery, Obstetric
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