Di Tommaso Mariarosaria, Seravalli Viola, Martini Irene, La Torre Pasquale, Dani Carlo
Department of Health Sciences, University of Florence, Florence, Italy.
Department of Health Sciences, University of Florence, Florence, Italy.
Early Hum Dev. 2014 Sep;90(9):523-5. doi: 10.1016/j.earlhumdev.2014.03.010. Epub 2014 Apr 29.
To determine the reliability of the cord blood gas analysis on the unclamped cord compared to the standard technique of sampling on double clamped cord.
Prospective observational study conducted on 46 singleton neonates vaginally delivered at term. Matched pairs of umbilical artery and vein blood samples were collected from unclamped cord within 90s after birth and from the same cord after clamping, with the clamping occurring immediately after the first blood collection. A blood gas analysis was performed on each collected sample.
Arterial and venous blood samples were analyzed for pH, PO2, pCO2, SaO2, hemoglobin concentration (ctHb) and base excess (BE). The values were compared between the two groups (clamped vs unclamped) using a Wilcoxon test.
No significant difference was found in pH, PO2, pCO2, SaO2 and ctHb values on arterial blood between unclamped and clamped cord. The only significant difference was related to BE (p<0.001). For the venous blood, the values of pH, PO2, pCO2 were comparable between unclamped and clamped cord, while the values of SaO2, ctHb and BE were significantly different (p<0.05).
No significant difference was found in almost all the arterial blood gas parameters and in the main venous blood gas parameters between unclamped and clamped cord. Sampling of cord blood for gas analysis may be performed on the unclamped cord right after birth without reducing the accuracy of the analysis.
与双钳夹脐带的标准采样技术相比，确定未钳夹脐带时脐血气分析的可靠性。
对46例足月阴道分娩的单胎新生儿进行前瞻性观察研究。在出生后90秒内从未钳夹的脐带采集配对的脐动脉和静脉血样本，并在首次采血后立即钳夹脐带，然后从同一脐带采集血样。对每个采集的样本进行血气分析。
分析动脉和静脉血样本的pH值、PO2、pCO2、SaO2、血红蛋白浓度（ctHb）和碱剩余（BE）。使用Wilcoxon检验比较两组（钳夹组与未钳夹组）的值。
未钳夹和钳夹脐带的动脉血pH值、PO2、pCO2、SaO2和ctHb值无显著差异。唯一显著差异与BE有关（p<0.001）。对于静脉血，未钳夹和钳夹脐带的pH值、PO2、pCO2值相当，而SaO2、ctHb和BE值有显著差异（p<0.05）。
未钳夹和钳夹脐带的几乎所有动脉血气参数和主要静脉血气参数均无显著差异。出生后可立即在未钳夹的脐带上采集脐血气分析样本，而不会降低分析的准确性。
