Article Text

PDF
Cord and placenta arterial gas analysis: the accuracy of delayed sampling
  1. Adrienne Lynn1,
  2. Philip Beeby2
  1. 1RPA Newborn Care, The Royal Prince Alfred, Hospital, Sydney, Australia
  2. 2RPA Newborn Care, The Royal Prince Alfred, Hospital, Sydney, Australia, and The University of Sydney, Australia
  1. Correspondence to:
    Adrienne Lynn
    RPA Newborn Care, The Royal Prince Alfred Hospital, Missenden Rd, Camperdown NSW 2050, Australia; adielynn{at}optusnet.com.au

Abstract

Aim: To determine the accuracy of delayed arterial gas sampling (1) from the umbilical cord and (2) from the placental surface at room temperature.

Methods: Term deliveries were classified a priori into three groups: normal vaginal deliveries, elective caesarean sections and high risk deliveries. The cord was double clamped and paired arterial samples were taken from the cord and the placenta at 0, 30, 60 and 90 min.

Results: 90 placentas were sampled with 30 cases per group. At time 0 the mean cord pH 7.207 (±0.08) was significantly lower than the placenta pH 7.240 (±0.08). The cord pH dropped significantly: by 0.050 (95% CI 0.036 to 0.063) at 30 min, 0.087 (95% CI 0.069 to 0.105) at 60 min, and 0.112 (95% CI 0.086 to 0.138) at 90 min. The placenta pH fell at twice the rate of the cord pH over 90 min. At time 0 the mean cord base excess –7.0 mmol/l (±4.1) was significantly lower than the placenta base excess –6.3 mmol/l (±3.6). The cord base excess fell at 30 min by 4.1 mmol/l (95% CI 3.4 to 4.7), at 60 min by 7.1 mmol/l (95% CI 6.1 to 8.0), and at 90 min by 9.0 mmol/l (95% CI 7.9 to 10.0). The pH and base excess rate of fall was similar for each of the three delivery groups despite differing starting values.

Conclusion: Arterial blood gases should be taken as soon as possible after delivery from the umbilical cord. However, when this is not possible, the arterial pH and base excess from a delayed sample from a clamped cord at room temperature can be used to estimate the values at birth.

Statistics from Altmetric.com

Footnotes

  • Published Online First 27 October 2006

  • Competing interests: None.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Fantoms
    Martin Ward Platt