Goodlin R C, Freedman W L, McFee J G, Winter S D
Department of Obstetrics and Gynecology, Denver General Hospital, University of Colorado Medical School.
J Reprod Med. 1994 Feb;39(2):97-100.
We attempted to determine the etiology and clinical significance of unexpected acidemia in otherwise healthy neonates. A retrospective review was performed of the umbilical cord pH in 11,203 deliveries performed at Denver General Hospital, with an umbilical artery pH < 7.13 (3 SD below the mean) selected as the definition of neonatal acidemia. Among those neonates weighing > 2.5 kg with umbilical artery pH < 7.13, 76 were expected to have acidemia because of signs of severe fetal distress. There were 59 neonates with unexpected acidemia, having umbilical artery pH < 7.13, with no definite etiology found. In 96% of cases of unexpected acidemia, the neonates were discharged with their mothers, while 84% of the expected cases went home with their mothers. In excess of $880,000 was spent performing routine umbilical blood pH determinations without any apparent clinical or legal benefit. Routine umbilical blood gas studies on all neonates does not appear to be indicated for either clinical or legal reasons.
我们试图确定健康新生儿意外发生酸血症的病因及临床意义。对丹佛总医院进行的11203例分娩的脐带血pH值进行了回顾性研究，将脐动脉pH值<7.13（低于均值3个标准差）定义为新生儿酸血症。在那些体重>2.5kg且脐动脉pH值<7.13的新生儿中，76例因严重胎儿窘迫迹象而被认为会发生酸血症。有59例新生儿出现意外酸血症，其脐动脉pH值<7.13，但未发现明确病因。在96%的意外酸血症病例中，新生儿与母亲一同出院，而84%的预期酸血症病例也是与母亲一起回家。花费超过88万美元进行常规脐血pH值测定，但未获得任何明显的临床或法律效益。基于临床或法律原因，对所有新生儿进行常规脐血气检查似乎并无必要。
