Xodo Serena, Xodo Luigi, Berghella Vincenzo
Department of Gynecology and Obstetrics, School of Medicine, University of Udine, Udine, Italy.
Department of Medical and Biological Sciences, School of Medicine, University of Udine, Udine, Italy.
Acta Obstet Gynecol Scand. 2018 Jan;97(1):7-12. doi: 10.1111/aogs.13233. Epub 2017 Nov 1.
Delayed cord clamping for at least 60 s in both term and preterm babies is a major recent change in clinical care. Delayed cord clamping has several effects on other possible interventions. One of these is the effect of delayed cord clamping on umbilical artery gas analysis. When indicated, umbilical artery gas analysis can safely be done either with early cord clamping or, probably most of the times it is necessary, during delayed cord clamping with the cord still unclamped. Paired blood samples (one from the umbilical artery and one from the umbilical vein) can be taken from the pulsating and unclamped cord, immediately after birth, during delayed cord clamping, without any effect on either the accuracy of umbilical artery gas analysis or the transfusion of blood through delayed cord clamping. Umbilical artery gas analysis should instead not be done after delayed cord clamping, since delayed cord clamping alters several acid-based parameters and lactate values.
近期临床护理的一项重大变化是,足月儿和早产儿的脐带延迟结扎至少60秒。延迟脐带结扎对其他可能的干预措施有多种影响。其中之一是延迟脐带结扎对脐动脉血气分析的影响。如有必要,脐动脉血气分析既可以在早期脐带结扎时安全地进行,也可以在大多数需要延迟脐带结扎的情况下,在脐带仍未结扎时进行。出生后立即在延迟脐带结扎期间,可从搏动且未结扎的脐带上采集配对血样(一份来自脐动脉,一份来自脐静脉),这对脐动脉血气分析的准确性或通过延迟脐带结扎输血均无影响。相反,不应在延迟脐带结扎后进行脐动脉血气分析,因为延迟脐带结扎会改变多个酸碱参数和乳酸值。