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TitleUmbilical Cord Blood Gas Analysis
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Brian M. Lappas

April 26, 2013

Umbilical Cord Blood Gas Analysis

Umbilical cord blood gas is the most objective way of assessing a newborns metabolic condition at birth.

Specifically, arterial cord pH and base deficit can determine perinatal hypoxia/asphyxia (potential causes

of hypoxic-ischemic encephalopathy or cerebral palsy) and give insight into causes of intrapartum fetal


When are cord blood gases indicated? including but not limited to:

High risk pregnancies -C-section for fetal compromise

-Abnormal fetal heart rate patterns -

-Intrapartum fever >100.4 C -Multifetal gestation

Why do neonates get hypoxic/asphyxia?

3 main etiologies:

-Maternal oxygen compromised

-Maternal perfusion of placenta reduced

Preeclampsia, chronic hypertension, hypotension/hypovolemia, cyanotic heart disease

-Delivery of oxygenated blood from placenta to fetus is impaired

Placental abruption, cord prolapse, repetitive cord occlusion

How should it be collected and stored?

-10 to 20cm section of cord double clamped and put on ice

- Assessed accurately up to 60min, pH fall 0.05 at 30min, 0.087 at 60min, and 0.112 at 90min.

-Sample via venous sample recommended (artery < 0.09 venous)

What do the blood gases tell us?

Mean umbilical artery blood pH and gas in pre-term & term infants are similar

Pre-Term Term

pH 7.21 -7.29 7.27 -7.28

pCO2 (mmHg) 49.2 -51.6 49.2 -50.3

HCO3 (mEq/L) 22.4-23.9 22.0-23.1

Base deficit (mEq/L) 2.5 - 3.3 2.7 - 3.6

Results of hypoxia/asphyxia on infants?

ith mortality, hypoxic ischemic

encephalopathy, intraventricular hemorrhage, or cerebral palsy.

Severity of Deficit Amount of base deficit Motor/Cognitive deficits 4-8 yo

Mild 4-8 mmol/L None

Moderate 8-12 mmol/L

Severe 10% had moderate/severe

40% had moderate/severe

-Only 4% of neonatal encephalopathic patients had hypoxia in absence of antepartum risk factors

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