Sabol and Caughey evaluated outcomes for neonates. Measuring pH and base excess in the umbilical cord can help to identify a neonate who is likely to have problems despite a 5-minute Apgar score >= 7. The authors are from Oregon Health and Science University in Portland.
Patient selection: neonate with 5-minute Apgar score >= 7
Parameters:
(1) umbilical cord blood pH
(2) umbilical cord blood base excess in mmol/L (a negative base excess indicates acidemia)
Umbilical cord blood lactate was not reported.
Cutoffs for pH: <= 7.0 and <= 7.1
Cutoffs for base excess: <= -12 and <= -10 mmol/L
The presence of umbilical cord pH <= 7.1 and base excess <= -10 mmol/L were associated with increased risk for:
(1) neonatal ICU admission
(2) neonatal sepsis
(3) respiratory distress syndrome
(4) meconium aspiration syndrome
The authors recommend universal umbilical cord blood gas testing.
