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Acidosis in Newborns with Nuchal Cords and Normal Apgar Scores

Journal of Perinatology volume 25, pages 162–165 (2005)Cite this article

Abstract

OBJECTIVE:

Apgar scores and cord blood gases (BG) and pH were compared between a group of babies with nuchal cords and a group without nuchal cords and uncomplicated deliveries.

STUDY DESIGN:

We collected umbilical arterial (UA) and umbilical venous (UV) blood samples from the placentas of term infants from both normal deliveries (NORM, n=29) and nuchal cords (NUCH, n=33). BG/pH and hematocrit were measured; base deficits and oxygen contents were calculated; and a member of the study assigned Apgar scores and demographic data were collected from the babies’ charts.

RESULTS:

Median Apgar scores in the NUCH babies at 1 and 5 minutes were 9 and 9 respectively, which did not differ from the NORM infants. The pH, PCO2, and oxygen content obtained from UV of the NUCH infants was not statistically different from the NORM. The pH and oxygen content of the NUCH UA was significantly lower than that of the NORM. The UA PCO2 in the NUCH was greater than the NORM. Veno-arterial (VA) differences (ΔVA) in pH and PCO2 of the NUCH infants were greater than that of the NORM.

CONCLUSION:

The Apgar score is not a sensitive indicator of acid-base changes in nuchal cord patients; UV samples alone may be misleading. UA must be sampled to detect the hypercapnia and diminished oxygen content that is a result of the nuchal cord.

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References

  1. Casey BM, McIntire DB, Leveno KJ . The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med 2001;344:467–471.

    Article  CAS  Google Scholar 

  2. Yeomans ER, Hauth JC, Gilstrap LC, Strickland DM . Umbilical cord pH PCO2, and bicarbonate following uncomplicated term vaginal deliveries. Am J Obstet Gynecol 1985;151:798–800.

    Article  CAS  Google Scholar 

  3. Casey BM, Goldaber KG, McIntire DB, Leveno KJ . Outcomes among term infants when two-hour postnatal pH is compared with pH at delivery. Am J Obstet Gynecol 2001;184:447–450.

    Article  CAS  Google Scholar 

  4. Low JA, Pickersgill H, Killen H, Derrick J . The prediction and prevention of intrapartum fetal asphyxia in term pregnancies. Am J Obstet Gynecol 2001;184:724–730.

    Article  CAS  Google Scholar 

  5. West JB, Wagner PD . Pulmonary gas exchange. In: West JB, editor. Bioengineering Aspects of the Lung. New York (NY): Marcel Dekker; 1977. p. 363–366.

    Google Scholar 

  6. Nelson NM . Respiration and circulation before birth. In: Smith CA, Nelson NM, editors. Physiology of The Newborn Infant. Springfield: Charles C Thomas Press; 1976. p. 23.

    Google Scholar 

  7. Pomerance J . When cord gases do not reflect fetal condition. In: Pomerance J, editor. Interpreting Umbilical Cord Blood Gases. Pasadena: BNMG; 2004. p. 6.

    Google Scholar 

  8. Pomerance J . When cord gases do not reflect fetal condition. In: Pomerance J, editor. Interpreting Umbilical Cord Blood Gases. Pasadena: BNMG; 2004. p. 8–9.

    Google Scholar 

  9. Belai Y, Goodwin TM, Durand M, Greenspoon JS, Paul RH, Walther F . Umbilical arteriovenous PO2 and PCO2 differences and neonatal morbidity in term infants with severe acidosis. Am J Obstet Gynecol 1998;178:13:9.

    Article  Google Scholar 

  10. Clapp JF, Lopez B, Simonean S . Nuchal cord and neurodevelopmental performance at 1 year. J Soc Gynecol Invest 1999;6:268–272.

    Google Scholar 

  11. Sornes T . Umbilical cord encirclements and fetal growth restriction. Obstet Gynecol 1995;86:725–728.

    Article  CAS  Google Scholar 

  12. Weber T . The influence of cord complications on fetal pH, neonatal apgar score, and the acid base state and oxygenation of the umbilical artery and vein. J Perinatal Med 1981;9:134–139.

    Article  CAS  Google Scholar 

  13. Waugh J, Johnson A, Farkas A . Analysis of cord blood gas at delivery: questionnaire study of practice in the United Kingdom. BMJ 2001;323:727.

    Article  CAS  Google Scholar 

  14. Pomerance J . Umbilical cord blood gas casebook. J Perinatol 1997;17:503–505.

    CAS  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Pediatrics, Division of Newborn Medicine, Mount Sinai Medical Center, New York, NY, USA

    Gregory C Martin MD, Robert S Green MD & Ian R Holzman MD

Authors
  1. Gregory C Martin MD
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  2. Robert S Green MD
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  3. Ian R Holzman MD
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Martin, G., Green, R. & Holzman, I. Acidosis in Newborns with Nuchal Cords and Normal Apgar Scores. J Perinatol 25, 162–165 (2005). https://doi.org/10.1038/sj.jp.7211238

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  • DOI: https://doi.org/10.1038/sj.jp.7211238

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