Chauhan S P, Meydrech E F, Morrison J C, Magann E F, Rock W A, Martin J N
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Am J Perinatol. 1997 Jan;14(1):39-43. doi: 10.1055/s-2007-994094.
It is not always possible or feasible to perform routine umbilical artery blood sampling at birth. This study was undertaken to assess the accuracy of selective remote umbilical arterial blood analysis to retrospectively predict the original birth pH of any newborn. Umbilical arterial blood samples were obtained in two preheparinized syringes immediately following 1007 deliveries. One sample was analyzed within 60 minutes of delivery. The other was placed on ice and later analyzed at variable time intervals up to 180 hours postpartum. The results of each remote analysis were adjusted using a previously published regression equation to accurately identify which newborns had pH values < 7.00, < or = 7.10, or < 7.20 at birth. Among the 1007 newborns, there were 14 (1.3%), 44 (4.3%), and 187 (18.5%) who had pH values < 7.00, < or = 7.10, and < 7.20, respectively, at birth. Remote umbilical arterial samples analyzed within 72 hours of delivery correctly identified newborns with an original pH < 7.00, < or = 7.10, or < 7.20 with: (1) a sensitivity of 100, 82, and 84%, respectively; (2) positive predictive values of 100, 93, and 66%, respectively; and (3) a test efficiency of 100, 99, and 89%, respectively. Up to 72 hours after delivery, remote umbilical arterial blood pH analysis can be reliably used to accurately identify the newborn that was acidotic at birth.
出生时进行常规脐动脉血采样并非总是可行或切实可行的。本研究旨在评估选择性远程脐动脉血分析回顾性预测任何新生儿出生时原始pH值的准确性。在1007例分娩后立即用两个预肝素化注射器采集脐动脉血样本。一个样本在分娩后60分钟内进行分析。另一个样本置于冰上，随后在产后长达180小时的不同时间间隔进行分析。使用先前发表的回归方程对每次远程分析的结果进行调整，以准确识别哪些新生儿出生时pH值<7.00、≤7.10或<7.20。在1007例新生儿中，分别有14例（1.3%）、44例（4.3%）和187例（18.5%）出生时pH值<7.00、≤7.10和<7.20。在分娩后72小时内分析的远程脐动脉样本正确识别出原始pH<7.00、≤7.10或<7.20的新生儿，其：（1）敏感性分别为100%、82%和84%；（2）阳性预测值分别为100%、93%和66%；（3）检测效率分别为100%、99%和89%。分娩后长达72小时，远程脐动脉血pH分析可可靠地用于准确识别出生时酸中毒的新生儿。
