Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Halochamim 62, Holon, Tel Aviv, Israel.
Faculty of Medicine, Tel Aviv University, 69978, Ramat Aviv, Tel Aviv, Israel.
Arch Gynecol Obstet. 2024 Feb;309(2):523-531. doi: 10.1007/s00404-023-06965-2. Epub 2023 Feb 19.
There is no clear correlation between abnormal umbilical cord blood gas studies (UCGS) and adverse neonatal outcome in low-risk deliveries. We investigated the need for its routine use in low-risk deliveries.
We retrospectively compared maternal, neonatal, and obstetrical characteristics among low-risk deliveries (2014-2022) between "normal" and "abnormal" pH groups: A:normal pH ≥ 7.15; abnormal pH < 7.15; B: normal pH ≥ 7.15 and base excess (BE) > - 12 mmol/L; abnormal pH < 7.15 and BE ≤ We retrospectively compared 12 mmol/L; C: normal pH ≥ 7.1; abnormal pH < 7.1; D: normal pH > 7.1 and BE > - 12 mmol/L; abnormal pH < 7.1 and BE ≤ - 12 mmol/L.
Of 14,338 deliveries, the rates of UCGS were: A-0.3% (n = 43); B-0.07% (n = 10); C-0.11% (n = 17); D-0.03% (n = 4). The primary outcome, composite adverse neonatal outcome (CANO) occurred in 178 neonates with normal UCGS (1.2%) and in only one case with UCGS (2.6%). The sensitivity and specificity of UCGS as a predictor of CANO were high (99.7-99.9%) and low (0.56-0.59%), respectively.
UCGS were an uncommon finding in low-risk deliveries and its association with CANO was not clinically relevant. Consequently, its routine use should be considered.
在低危分娩中，脐带血血气分析（UCGS）异常与新生儿不良结局之间并无明确相关性。本研究旨在探讨 UCGS 在低危分娩中的常规应用价值。
本研究回顾性比较了 2014 年至 2022 年低危分娩中“正常”和“异常”pH 组的产妇、新生儿和产科特征：A：正常 pH≥7.15；异常 pH<7.15；B：正常 pH≥7.15 且碱剩余（BE）>-12mmol/L；异常 pH<7.15 且 BE≤-12mmol/L；C：正常 pH≥7.1；异常 pH<7.1；D：正常 pH>7.1 且 BE>-12mmol/L；异常 pH<7.1 且 BE≤-12mmol/L。
在 14338 例分娩中，UCGS 的检出率分别为：A-0.3%（n=43）；B-0.07%（n=10）；C-0.11%（n=17）；D-0.03%（n=4）。在 UCGS 正常的 178 例新生儿中，主要结局复合不良新生儿结局（CANO）的发生率为 1.2%，而在 UCGS 异常的 1 例新生儿中，CANO 的发生率为 2.6%。UCGS 预测 CANO 的敏感性和特异性均较高（99.7%-99.9%和 0.56%-0.59%）。
UCGS 在低危分娩中并不常见，与 CANO 之间也无临床相关性。因此，UCGS 不应常规用于低危分娩。
