Khan S N, Ahmed G S, Abutaleb A M, Hathal M A
Department of Pediatrics, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
J Perinatol. 1995 Jan-Feb;15(1):39-42.
Umbilical cord arterial blood gas (UCABG) analysis is recommended in addition to Apgar scoring for assessing newborns. A prospective study was performed to determine whether UCABG values should be obtained in all deliveries, or only in selected deliveries in which the UCABG values are likely to be informative. During a predefined study period, maternal and neonatal data were collected for all live births (n = 604). UCABG test results were available for 505 births. Of these, 98 (19.4%) had UCABG pH < 7.2 (acidotic group), and they were compared with the other 407 live births (nonacidotic group). There were significantly more primiparous women in the acidotic group, whereas grandmultiparity (parity > 7) was significantly lower. The first and second stages of labor were significantly prolonged and there were more assisted births in the acidotic group. Fetal distress and the incidence of Apgar scores < 3 were significantly higher in the acidotic group. The selective determination of UCABG values in primiparous pregnancies, prolonged labors, assisted deliveries. or in the presence of fetal distress may be more informative than universal UCABG determination. Although these factors were highly sensitive, their specificity was poor; thus we cannot recommend criteria for the selective determination of UCABG values.
除阿氏评分外，建议进行脐动脉血气（UCABG）分析以评估新生儿。开展了一项前瞻性研究，以确定是应在所有分娩中获取UCABG值，还是仅在UCABG值可能提供有用信息的特定分娩中获取。在预定的研究期间，收集了所有活产（n = 604）的母亲和新生儿数据。505例分娩有UCABG检测结果。其中，98例（19.4%）的UCABG pH < 7.2（酸中毒组），并将其与其他407例活产（非酸中毒组）进行比较。酸中毒组初产妇明显更多，而多产（产次>7）明显更低。酸中毒组第一产程和第二产程明显延长，助产分娩更多。酸中毒组胎儿窘迫和阿氏评分<3的发生率明显更高。在初产妇、产程延长、助产分娩或存在胎儿窘迫的情况下选择性测定UCABG值可能比普遍测定UCABG更具信息价值。尽管这些因素敏感性很高，但其特异性较差；因此，我们不能推荐选择性测定UCABG值的标准。
