Cai Yu, Zhang Xiaojuan, Wu Xiaozhi, Liu Honglan, Qi Lianfeng, Liu Xiaoyun
Department of Obstetrics and Gynecology, Third Affiliated Hospital of Zunyi Medical University (Zunyi First People's Hospital) Zunyi 563000, Guizhou, China.
Am J Transl Res. 2022 Jul 15;14(7):4821-4829. eCollection 2022.
To explore the diagnostic specificity and clinical application of neonatal umbilical cord blood gas analysis in the prognosis of fetal distress, and to provide theoretical basis for neonatal rescue. Clinical data of a total of 240 singleton pregnant women and their neonates who delivered in the Obstetrics Department of our hospital from January 2021 to December 2021 were retrospectively analyzed. The pregnant women and their newborns were divided into an acute group (acute fetal distress), a chronic group (chronic fetal distress) and a control group (no fetus distress), with 80 cases in each. The umbilical artery blood gas analysis values including power of hydrogen (PH), partial pressure of carbon dioxide (PCO), partial pressure of oxygen (PO), bicarbonate radical (HCO ), buffer excess (BE) and the Apgar score, as well as the neonatal asphyxia outcome after birth were recorded. There were statistically significant differences in fetal condition, PH and BE between newborns with asphyxia and normal newborns (P<0.05). The incidence of neonatal distress was 1.25% in the control group and 19.38% in the fetal distress group (including acute and chronic groups). Logistic regression analysis found that fetal distress was a risk factor for neonatal asphyxia (Odds Ratio (OR)=11.064, P=0.012). The specificity and sensitivity of neonatal cord blood gas analysis in diagnosing neonatal asphyxia were 95.69% and 80.65%, respectively. The specificity of Apgar score in the diagnosis of neonatal asphyxia was 94.74%, and the sensitivity was 70.97%. The rate of neonatal asphyxia in the chronic fetal distress group (26.25%) was higher than that in the acute fetal distress group (12.5%). The proportion of neonatal severe asphyxia in the chronic fetal distress group (66.67%) was higher than that in the acute group (20%). The PH and BE levels in the chronic fetal distress group were lower than those in the control group and acute fetal distress group (P<0.05). Cord blood gas analysis can help to improve the accuracy of fetal distress diagnosis. Cord blood gas is closely related to neonatal prognosis. Compared with acute fetal distress, chronic fetal distress is more likely to lead to neonatal acidosis and asphyxia.
探讨新生儿脐血气分析对胎儿窘迫预后的诊断特异性及临床应用价值，为新生儿救治提供理论依据。回顾性分析2021年1月至2021年12月在我院产科分娩的240例单胎孕妇及其新生儿的临床资料。将孕妇及其新生儿分为急性组（急性胎儿窘迫）、慢性组（慢性胎儿窘迫）和对照组（无胎儿窘迫），每组80例。记录脐动脉血气分析值，包括酸碱度（PH）、二氧化碳分压（PCO）、氧分压（PO）、碳酸氢根（HCO）、缓冲碱（BE）及Apgar评分，以及出生后新生儿窒息结局。窒息新生儿与正常新生儿在胎儿状况、PH及BE方面差异有统计学意义（P<0.05）。对照组新生儿窘迫发生率为1.25%，胎儿窘迫组（包括急性组和慢性组）为19.38%。Logistic回归分析发现胎儿窘迫是新生儿窒息的危险因素（比值比（OR）=11.064，P=0.012）。新生儿脐血气分析诊断新生儿窒息的特异性和敏感性分别为95.69%和80.65%。Apgar评分诊断新生儿窒息的特异性为94.74%，敏感性为70.97%。慢性胎儿窘迫组新生儿窒息率（26.25%）高于急性胎儿窘迫组（12.5%）。慢性胎儿窘迫组新生儿重度窒息比例（66.67%）高于急性组（20%）。慢性胎儿窘迫组PH及BE水平低于对照组和急性胎儿窘迫组（P<0.05）。脐血气分析有助于提高胎儿窘迫诊断的准确性。脐血气与新生儿预后密切相关。与急性胎儿窘迫相比，慢性胎儿窘迫更易导致新生儿酸中毒和窒息。
