Obwegeser R, Böhm R, Gruber W
II. Univ. Frauenklinik Wien.
Z Geburtshilfe Perinatol. 1993 Mar-Apr;197(2):59-64.
In a retrospective study data from more than 9000 live births were analyzed. Our aim was to compare the significance of Apgar-Score and umbilical artery pH in predicting the condition and development of the newborn. We were particularly interested in three groups of patients: "Group A" included patients with a 5 minute Apgar-Score < or = 7 and a normal pH > 7,2. In "Group P" the pH was < 7,10 combined with a normal Apgar-Score (8 to 10). Both groups were compared with a "normal group" (pH > 7,20 and Apgar-Score between 8 and 10). There was a higher percentage of operative deliveries in group A (38%) and group P (20%) compared to the normal group (15%). The only predictor of a low Apgar-Score was meconium stained amniotic fluid (Group A 16%). A poor condition of the newborn correlated much better with a low Apgar-Score than with a low umbilical artery pH. In group A the rate of newborns transferred to the neonatology unit was 43% and the perinatal mortality rate was 50%. The poor correlation of a low umbilical artery pH and the fetal outcome is partly explainable by the standard cut off level of 7,20 for acidosis, which seems to be too high.
在一项回顾性研究中，分析了9000多例活产的数据。我们的目的是比较阿氏评分和脐动脉pH值在预测新生儿状况和发育方面的意义。我们特别关注三组患者：“A组”包括5分钟阿氏评分≤7且pH值正常（>7.2）的患者。“P组”的pH值<7.10且阿氏评分正常（8至10）。将这两组与“正常组”（pH值>7.20且阿氏评分在8至10之间）进行比较。与正常组（15%）相比，A组（38%）和P组（20%）的手术分娩率更高。低阿氏评分的唯一预测因素是羊水胎粪污染（A组为16%）。新生儿状况不佳与低阿氏评分的相关性比与低脐动脉pH值的相关性更好。在A组中，转入新生儿科的新生儿比例为43%，围产儿死亡率为50%。低脐动脉pH值与胎儿结局的相关性较差，部分原因可解释为酸中毒的标准临界值7.20似乎过高。
