Umbilical Cord Arterial Blood Gas Study and Cord Blood Lactate Predictability for Unfavorable Neonatal Outcomes

Volume 1 - Issue 5

E Eltaieb¹* and H Elkholy²

Received: April 12, 2018;   Published: April 18, 2018

DOI: 10.32474/IGWHC.2018.01.000123

Full Text PDF

To view the Full Article   Peer-reviewed Article PDF

Abstract

Background: Prenatal asphyxia is a cornerstone issue influencing neonatal morbidity and mortality with long term health impact. Foetal electronic monitoring is clinically performed in a routine manner to reflect the fetal clinical status throughout intra partum period of time. Normal cardiotocography trace is in powerful correlation with absent academia occurrence at delivery of the neonate. Abnormality of cardiotocographic trace on the other hand trace requires extra clinical evaluation and research implementation. To reflect the metabolic pathways of the neonate, umbilical artery lactate have been analyzed and evaluated. Aim of this research study is to verify the clinical power and value of umbilical cord lactate level in predictability of the unfavorable early onset neonatal outcomes in clinical scenarios of fetal distress in intra partum period and to statistically compare and contrast the clinical value of umbilical cord lactate and umbilical artery pH in predictability undesirable neonatal clinical outcomes having intra partum foetal distress issues.

Methodology: 295 gestations with abnormalities of cardiotocographic traces in active stage of labor have undergone analysis and measurement of umbilical cord blood lactate levels and umbilical artery pH measurements straight away after birth and have been compared statistically for predictability of unfavorable newborn outcomes.

Results: In the current research study statistically calculated specificity of cord serum lactate (97.7%) and umbilical cord arterial pH (95.97%) was displayed clearly to be almost similar in neonates with Apgar scores <7 at 1 minute and 5 minutes, but the statistically obtained sensitivity of umbilical cord serum lactate levels (23.14%) and umbilical cord ph (31.4%) was less in neonates with Apgar scores ≤7 at 1 minute. Area under ROC displayed and demonstrated that serum lactate levels are much more precise in forecasting unfavorable neonatal outcomes in comparison to umbilical cord artery pH.

Conclusions: Umbilical blood lactate levels are more statistically specific than umbilical artery pH measurements in forecasting unfavorable neonatal clinical outcomes. The area under ROC curve (at 95th percentile) have displayed that serum lactate levels is more precise in forecasting unfavorable newborn clinical outcomes in comparison to umbilical cord artery pH at delivery.

Abstract| Introduction| Methods| Results| Discussion| Restrictions of the Current Research Study| Conclusion| Conflict of interest| References|