4.4 Article

Umbilical cord blood gases sampling in low-risk vaginal deliveries as a predictor of adverse neonatal outcome

Journal

ARCHIVES OF GYNECOLOGY AND OBSTETRICS
Volume -, Issue -, Pages -

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00404-023-06965-2

Keywords

Umbilical cord pH; Adverse neonatal outcome; Low-risk deliveries; Fetal acidemia

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There is no significant correlation between abnormal umbilical cord blood gas studies (UCGS) and adverse neonatal outcome in low-risk deliveries. Therefore, the routine use of UCGS in low-risk deliveries should be reconsidered.
IntroductionThere 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.MethodsWe 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.ResultsOf 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.ConclusionUCGS were an uncommon finding in low-risk deliveries and its association with CANO was not clinically relevant. Consequently, its routine use should be considered.

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