How to assess fetal metabolic acidosis front cord samples

Rosén, Karl G.; Murphy, Karl W.

doi:10.1515/jpme.1991.19.3.221

Cited by 43Renal function and acid-base balanceNeonatal and fetal brain pathologyPregnancy and preeclampsia studies

How to assess fetal metabolic acidosis front cord samples

Rosén, Karl G., Murphy, Karl W.·1991·jpme

DOI 10.1515/jpme.1991.19.3.221

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Abstract

The degree of metabolic acidosis at birth has been calculated in cord artery and vein samples from 21 term fetuses with cord artery pH less than 7.20. The aim of the study was to compare base deficit values calculated from either Siggaard-Andersen alignment nomogram (BD blood) or the Acid-Base chart (BD extra cellular fluid, BDecf). BDblood was found to be consistently higher in the cord artery as compared with BDecf, 13.2 +/- 3.5 and 9.9 +/- 2.9 mmol/l (Mean +/- SD), respectively. A significant correlation was found between cord artery PCO2 and BDblood whereas BDecf appeared unaffected by PCO2. In cases with cord entanglement BDecf a-v differences were increased to 3.4 +/- 2.3 mmol/l as compared with the small a-v difference noted in acidotic cases without cord entanglement, 1.1 +/- 1.25 mmol/l. It is speculated that with acutely emerging, intermittent asphyxia due to cord compression, a cord artery and vein difference in metabolic acidosis may exist and where the vein captures the basal level and the artery the acute changes. It is concluded that BDecf in both cord artery and vein add valuable information on the mechanisms behind metabolic acidosis.

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Base deficit in extracellular fluid is advocated for fetal blood because high partial pressure of CO2 is common in newborns without concomitant hypoxia, and hypercapnia has a strong influence on pH.
“Base deficit in extracellular fluid is advocated for fetal blood because a high partial pressure of CO 2 (hypercapnia) is common in newborns without concomitant hypoxia, and hypercapnia has a strong influence on the pH value, then termed respiratory acidosis.”
From Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. (2023) · cites this paper as [26]

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Reply
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LETTER TO THE EDITOR: REPLY
Valenzuela, P. L., & Guijarro, R. (2007) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340701212005
An overlooked aspect on metabolic acidosis at birth: blood gas analyzers calculate base deficit differently
MOKARAMI, P., WIBERG, N., & OLOFSSON, P. (2012) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2011.01364.x · Cited by 28 · see citing works
LETTER TO THE EDITOR
Kessler, J., & Albrechtsen, S. (2007) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340701211932
Umbilical cord blood gas analysis at delivery: a time for quality data
Westgate, J., Garibaldi, J. M., & Greene, K. R. (1994) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1994.tb13581.x · Cited by 244 · see citing works
Obstetric factors associated with cord blood gas values at birth
Yudkin, P., Johnson, P. A., & Redman, C. W. G. (1987) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0028-2243(87)90015-3 · Cited by 33 · see citing works

Authors: Rosén, K. G., & Murphy, K. W.
Affiliations: University of Gothenburg (SE)
ORCID: Rosén, Karl G.
Venue: jpme
Publisher: Walter de Gruyter GmbH
Published: 1991
Volume: 19
Issue: 3
Pages: 221-226
ISSN: 0300-5577 (ISSN-L)
1619-3997
DOI: 10.1515/jpme.1991.19.3.221
OpenAlex: W2041835480
Cited by: 43
References: 13
Citations by year: 2023: 1 · 2021: 1 · 2019: 1 · 2018: 1 · 2016: 3 · 2014: 1 · 2013: 1 · 2012: 3
FWCI: 1.70
Type: journal article
Language: en
Open access: closed
Locations: Journal of Perinatal Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Nephrology › Renal function and acid-base balance
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords: umbilical cord blood, base deficit, arteriovenous differences, cord compression, fetal asphyxia, fetal acid-base status
MeSH terms: Acidosis, Lactic, Carbon Dioxide, Fetal Blood, Humans, Hydrogen-Ion Concentration, Infant, Newborn, Umbilical Arteries, Umbilical Veins

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How to assess fetal metabolic acidosis front cord samples

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