Neacsu Adrian, Herghelegiu Cătălin Gabriel, Voinea Silviu, Dimitriu Mihai Cornel Traian, Ples Liana, Bohiltea Roxana Elena, Braila Anca Daniela, Nastase Leonard, Bacalbasa Nicolae, Chivu Laura Ioana, Furtunescu Florentina, Ioan Raluca Gabriela
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Obstetrics and Gynecology, 'Sf. Ioan' Emergency Clinical Hospital, 042122 Bucharest, Romania.
Exp Ther Med. 2021 Jan;21(1):80. doi: 10.3892/etm.2020.9513. Epub 2020 Nov 26.
Despite advances in fetal monitoring during labor, one of the most critical causes of neonatal death and neurologic injuries remains intrapartum asphyxia. Umbilical cord gases can be used to detect acidosis and fetal distress. We conducted a retrospective, multicenter study to evaluate umbilical cord blood pH and lactate as a mean of evaluating the degree of intrapartum hypoxia and also to establish which of the two is more reliable in predicting morbidity in term neonates. The present study utilized a total of 124 cases that met the criteria for intrapartum asphyxia and 150 normal term newborns that were randomly selected as case control. Both umbilical cord lactate and pH proved to be accurate predictors of neonatal morbidity caused by intrapartum hypoxia. Lactate proved to be superior to pH in predicting adverse neonatal outcome. The greatest sensibility and specificity in predicting intrapartum asphyxia were achieved in our study by using a cutoff value of 3.75 mmol/l for lactate and 7.24 for pH.
尽管分娩期间胎儿监测取得了进展，但新生儿死亡和神经损伤的最关键原因之一仍然是产时窒息。脐血气可用于检测酸中毒和胎儿窘迫。我们进行了一项回顾性多中心研究，以评估脐血pH值和乳酸水平，作为评估产时缺氧程度的一种手段，并确定两者中哪一个在预测足月儿发病率方面更可靠。本研究共纳入了124例符合产时窒息标准的病例，并随机选择150例正常足月儿作为病例对照。脐血乳酸和pH值均被证明是产时缺氧所致新生儿发病的准确预测指标。在预测不良新生儿结局方面，乳酸被证明优于pH值。在我们的研究中，通过使用乳酸临界值3.75 mmol/l和pH值临界值7.24，在预测产时窒息方面实现了最高的敏感性和特异性。
