The effect of delayed umbilical cord clamping on cord blood gas analysis in vaginal and caesarean-delivered term newborns without fetal distress: a prospective observational study.
Acidosis
/ blood
Blood Gas Analysis
/ methods
Cesarean Section
/ adverse effects
Constriction
Delivery, Obstetric
/ adverse effects
Female
Fetal Blood
/ metabolism
Humans
Infant, Newborn
Italy
/ epidemiology
Male
Obstetric Labor Complications
/ diagnosis
Pregnancy
Pregnancy Outcome
/ epidemiology
Time-to-Treatment
Umbilical Cord
/ surgery
Anaemia
assisted vaginal delivery
caesarean section delivery
fetal monitoring
neonatal
obstetric haemorrhage
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
accepted:
15
11
2019
pubmed:
26
11
2019
medline:
29
1
2020
entrez:
26
11
2019
Statut:
ppublish
Résumé
To determine variations in cord blood gas (CBG) parameters after 3-minute delayed cord clamping (DCC) in vaginal deliveries (VDs) and caesarean deliveries (CDs) at term without fetal distress. Prospective observational study. University hospital. CBG from 97 VDs and 124 CDs without fetal distress. Comparison of paired arterial-venous CBG parameters drawn at birth from the unclamped cord and after 3-minutes DCC for VDs and CDs. Base excess, bicarbonate, haematocrit and haemoglobin from both arterial and venous cord blood, lactate, neonatal outcomes, partial pressure of oxygen (pO Arterial cord blood pH, bicarbonate ( After 3-minute DCC, the acid-base status shifted towards mixed acidosis in CDs and prevalent metabolic acidosis in VDs. CDs were associated with a more pronounced increase in arterial lactate, compared with VDs. By 3-minute DCC, acid-base status shifts towards mixed and metabolic acidosis in caesarean and vaginal delivery, respectively.
Identifiants
pubmed: 31762140
doi: 10.1111/1471-0528.16026
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
405-413Informations de copyright
© 2019 Royal College of Obstetricians and Gynaecologists.
Références
Armstrong L, Stenson BJ. Use of umbilical cord blood gas analysis in the assessment of the newborn. Arch Dis Child Fetal Neonatal Ed 2007;92:F430-4.
ACOG Committee on Obstetric Practice. ACOG Committee Opinion No. 348, November 2006: Umbilical cord blood gas and acid-base analysis. Obstet Gynecol 2006;108:1319-22.
South Australian Perinatal Practice Guidelines: Umbilical Cord Blood Gas Sampling (2014).
Delgado Nunes V, Gholitabar M, Sims JM, Bewley S. Intrapartum care of healthy women and their babies: summary of updated NICE guidance. BMJ [Internet] 2014;349:g6886.
Kellenberger F, Akladios CY, Sananes N, Gaudineau A, Langer B. The practice of neonatal umbilical blood gas analysis in the “Alsace” regional French perinatal network. J Gynecol Obstet Biol Reprod (Paris) 2016;45:835-40.
Ahlberg M, Elvander C, Johansson S, Cnattingius S, Stephansson O. A policy of routine umbilical cord blood gas analysis decreased missing samples from high-risk births. Acta Paediatr 2017;106:43-8.
Perlman JM. Intrapartum hypoxic-ischemic cerebral injury and subsequent cerebral palsy: medicolegal issues. Pediatrics 1997;99:851-9.
WHO. Delayed Umbilical Cord Clamping for Improved Maternal and Infant Health and Nutrition Outcomes [Internet]. Geneva: WHO.
Wyllie J, Bruinenberg J, Roehr CC, Rüdiger M, Trevisanuto D, Urlesberger B. European Resuscitation Council Guidelines for Resuscitation 2015: Section 7. Resuscitation and support of transition of babies at birth. Resuscitation 2015;95:249-63.
Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, et al. Part 13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015;132(18 Suppl 2):S543-560.
Committee on Obstetric Practice. Committee Opinion No. 684. Delayed umbilical cord clamping after birth. Obstet Gynecol 2017; 129:e5-10.
Committee on Obstetric Practice, American College of Obstetricians and Gynecologists. Committee Opinion No. 543: timing of umbilical cord clamping after birth. Obstet Gynecol 2012;120:1522-6.
Ghirardello S, Di Tommaso M, Fiocchi S, Locatelli A, Perrone B, Pratesi S, et al. Italian recommendations for placental transfusion strategies. Front Pediatr 2018;6:372.
Di Tommaso M, Vannuccini S. Is pulsating cord blood sampling a suitable and reliable method for cord gas analysis at birth? Acta Obstet Gynecol Scand 2018;97:1532.
Mokarami P, Wiberg N, Olofsson P. Hidden acidosis: an explanation of acid-base and lactate changes occurring in umbilical cord blood after delayed sampling. BJOG 2013;120:996-1002.
De Paco C, Herrera J, Garcia C, Corbalán S, Arteaga A, Pertegal M, et al. Effects of delayed cord clamping on the third stage of labour, maternal haematological parameters and acid-base status in fetuses at term. Eur J Obstet Gynecol Reprod Biol 2016;207:153-6.
Wiberg N, Källén K, Olofsson P. Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations. BJOG 2008;115:697-703.
Valero J, Desantes D, Perales-Puchalt A, Rubio J, Diago Almela VJ, Perales A. Effect of delayed umbilical cord clamping on blood gas analysis. Eur J Obstet Gynecol Reprod Biol 2012;162:21-3.
Andersson O, Hellström-Westas L, Andersson D, Clausen J, Domellöf M. Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstet Gynecol Scand 2013;92:567-74.
Boere I, Roest AAW, Wallace E, ten Harkel ADJ, Haak MC, Morley CJ, et al. Umbilical blood flow patterns directly after birth before delayed cord clamping. Arch Dis Child Fetal Neonatal Ed 2015;100:F121-5.
Westgate J, Garibaldi JM, Greene KR. Umbilical cord blood gas analysis at delivery: a time for quality data. Br J Obstet Gynaecol 1994;101:1054-63.
Tang J, Fullarton R, Samson S-L, Chen Y. Delayed cord clamping does not affect umbilical cord blood gas analysis. Arch Gynecol Obstet 2019;299:719-24.
Beyerlein A. Quantile regression-opportunities and challenges from a user’s perspective. Am J Epidemiol 2014;180:330-1.
Hillman N, Kallapur SG, Jobe A. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol 2012;39:769-83.
Jain L, Dudell GG. Respiratory transition in infants delivered by cesarean section. Semin Perinatol 2006;30:296-304.
Jain L, Eaton DC. Physiology of fetal lung fluid clearance and the effect of labor. Semin Perinatol 2006;30:34-43.
Robson SC, Boys RJ, Rodeck C, Morgan B. Maternal and fetal haemodynamic effects of spinal and extradural anaesthesia for elective caesarean section. Br J Anaesth 1992;68:54-9.
Reynolds F, Seed PT. Anaesthesia for Caesarean section and neonatal acid-base status: a meta-analysis. Anaesthesia 2005;60:636-53.
Chantry CJ, Blanton A, Taché V, Finta L, Tancredi D. Delayed cord clamping during elective cesarean deliveries: results of a pilot safety trial. Matern Health Neonatol Perinatol 2018;4:16.
Gandy GM, Adamsons K, Cunningham N, Silverman WA, James LS. Thermal environment and acid-base homeostasis in human infants during the first few hours of life. J Clin Invest 1964;43:751-8.
Trevisanuto D, Testoni D, de Almeida MFB. Maintaining normothermia: why and how? Semin Fetal Neonatal Med 2018;23:333-9.
Zhou YB, Li HT, Zhu LP, Liu JM. Impact of cesarean section on placental transfusion and iron-related hematological indices in term neonates: a systematic review and meta-analysis. Placenta 2014;35:1-8.
Yao AC, Moinian M, Lind J. Distribution of blood between infant and placenta after birth. Lancet 1969;2:871-3.
Askelöf U, Andersson O, Domellöf M, Fasth A, Hallberg B, Hellström-Westas L, et al. Wait a minute? An observational cohort study comparing iron stores in healthy Swedish infants at 4 months of age after 10-, 60- and 180-second umbilical cord clamping. BMJ Open [Internet] 2017;7:e017215.
Katheria A, Rich W, Finer N. Optimizing care of the preterm infant starting in the delivery room. Am J Perinatol 2016;33:297-304.
Kleinberg F, Dong L, Phibbs RH. Cesarean section prevents placenta-to-infant transfusion despite delayed cord clamping. Am J Obstet Gynecol 1975;121:66-70.
Ogata ES, Kitterman JA, Kleinberg F, Dong L, Willis M, Mates J, et al. The effect of time of cord clamping and maternal blood pressure on placental transfusion with cesarean section. Am J Obstet Gynecol 1977;128:197-200.
White CRH, Doherty DA, Kohan R, Newnham JP, Pennell CE. Evaluation of selection criteria for validating paired umbilical cord blood gas samples: an observational study. BJOG 2012;119:857-65.