Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography
OBJECTIVES: Electronic fetal monitoring (EFM) is used to identify early signs of fetal deterioration. However, caution is advised when interpreting cardiotocographic parameters. A promising alternative is umbilical cord blood sampling. The analysis of blood gases and lactate levels in the cord with...
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Medical Network
2024-08-01
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| Series: | Gynecology Obstetrics & Reproductive Medicine |
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| Online Access: | https://gorm.com.tr/index.php/GORM/article/view/1458 |
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| author | Indrani Mukhopadhyay Sanjay Singh Sushila Kachatti |
| author_facet | Indrani Mukhopadhyay Sanjay Singh Sushila Kachatti |
| author_sort | Indrani Mukhopadhyay |
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OBJECTIVES: Electronic fetal monitoring (EFM) is used to identify early signs of fetal deterioration. However, caution is advised when interpreting cardiotocographic parameters. A promising alternative is umbilical cord blood sampling. The analysis of blood gases and lactate levels in the cord within the ini-tial minutes of life is a recommended approach.
STUDY DESIGN: This prospective cohort study, conducted over eighteen months from June 2021 to December 2022, enrolled 70 patients with non-reactive and 70 with reactive cardiotocograph (CTG) pat-terns. APGAR scores were recorded at 1 and 5-minute intervals. 1 ml of umbilical artery blood was as-sessed in an arterial blood gas machine and fetal acidosis was defined as pH <7.0 and a lactate con-centration exceeding 4 mmol/L.
RESULTS: In the non-reactive CTG group, 35.7% had early decelerations, 37.1% had variable decel-erations, and 17.1% had late decelerations (p<0.001). The mean cord blood lactate was 5.220±1.970 mmol/L in the non-reactive CTG group and 3.400±0.228 mmol/L in the reactive CTG group. Similarly, the mean cord blood pH was 7.030±0.007 in the non-reactive CTG group and 7.170±0.076 in the reac-tive CTG group (p<0.001). 14.3% of cases in the non-reactive CTG group had a 5-minute APGAR <7, with a higher APGAR score in the reactive group.
CONCLUSION: The study suggests that abnormal or indeterminate CTG readings are linked to a higher risk of intrapartum fetal acidosis. Non-reactive CTG results were associated with higher mean cord blood lactate and pH levels and more number of Neonatal Intensive Care Unit (NICU) admissions. There is a definite correlation between abnormal CTG patterns and poorer neonatal outcomes.
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| institution | Kabale University |
| issn | 1300-4751 2602-4918 |
| language | English |
| publishDate | 2024-08-01 |
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| series | Gynecology Obstetrics & Reproductive Medicine |
| spelling | doaj-art-fc4f531dfa4746379e1565ce9eb1760c2025-02-11T21:18:39ZengMedical NetworkGynecology Obstetrics & Reproductive Medicine1300-47512602-49182024-08-0130210.21613/GORM.2023.1458Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal CardiotocographyIndrani Mukhopadhyay0Sanjay Singh1Sushila Kachatti2AFMC, PuneAFMC,Pune, IndiaAFMC, Pune OBJECTIVES: Electronic fetal monitoring (EFM) is used to identify early signs of fetal deterioration. However, caution is advised when interpreting cardiotocographic parameters. A promising alternative is umbilical cord blood sampling. The analysis of blood gases and lactate levels in the cord within the ini-tial minutes of life is a recommended approach. STUDY DESIGN: This prospective cohort study, conducted over eighteen months from June 2021 to December 2022, enrolled 70 patients with non-reactive and 70 with reactive cardiotocograph (CTG) pat-terns. APGAR scores were recorded at 1 and 5-minute intervals. 1 ml of umbilical artery blood was as-sessed in an arterial blood gas machine and fetal acidosis was defined as pH <7.0 and a lactate con-centration exceeding 4 mmol/L. RESULTS: In the non-reactive CTG group, 35.7% had early decelerations, 37.1% had variable decel-erations, and 17.1% had late decelerations (p<0.001). The mean cord blood lactate was 5.220±1.970 mmol/L in the non-reactive CTG group and 3.400±0.228 mmol/L in the reactive CTG group. Similarly, the mean cord blood pH was 7.030±0.007 in the non-reactive CTG group and 7.170±0.076 in the reac-tive CTG group (p<0.001). 14.3% of cases in the non-reactive CTG group had a 5-minute APGAR <7, with a higher APGAR score in the reactive group. CONCLUSION: The study suggests that abnormal or indeterminate CTG readings are linked to a higher risk of intrapartum fetal acidosis. Non-reactive CTG results were associated with higher mean cord blood lactate and pH levels and more number of Neonatal Intensive Care Unit (NICU) admissions. There is a definite correlation between abnormal CTG patterns and poorer neonatal outcomes. https://gorm.com.tr/index.php/GORM/article/view/1458Cord blood pHElectronic fetal monitoringFetal distressIntrapartum; Lactate |
| spellingShingle | Indrani Mukhopadhyay Sanjay Singh Sushila Kachatti Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography Gynecology Obstetrics & Reproductive Medicine Cord blood pH Electronic fetal monitoring Fetal distress Intrapartum; Lactate |
| title | Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography |
| title_full | Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography |
| title_fullStr | Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography |
| title_full_unstemmed | Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography |
| title_short | Cord Blood pH and Lactate- A Step Ahead in Diagnosis of Fetal Acidaemia in Patients with Abnormal Cardiotocography |
| title_sort | cord blood ph and lactate a step ahead in diagnosis of fetal acidaemia in patients with abnormal cardiotocography |
| topic | Cord blood pH Electronic fetal monitoring Fetal distress Intrapartum; Lactate |
| url | https://gorm.com.tr/index.php/GORM/article/view/1458 |
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