[Discrepancy between Apgar score and umbilical artery pH value in the newborn infant. (Correlation to mode of delivery and fetal outcome?)].
In a retrospective study data from more than 9000 live births were analyzed. Our aim was to compare the significance of Apgar-Score and umbilical artery pH in predicting the condition and development of the newborn. We were particularly interested in three groups of patients: "Group A" included patients with a 5 minute Apgar-Score < or = 7 and a normal pH > 7,2. In "Group P" the pH was < 7,10 combined with a normal Apgar-Score (8 to 10). Both groups were compared with a "normal group" (pH > 7,20 and Apgar-Score between 8 and 10). There was a higher percentage of operative deliveries in group A (38%) and group P (20%) compared to the normal group (15%). The only predictor of a low Apgar-Score was meconium stained amniotic fluid (Group A 16%). A poor condition of the newborn correlated much better with a low Apgar-Score than with a low umbilical artery pH. In group A the rate of newborns transferred to the neonatology unit was 43% and the perinatal mortality rate was 50%. The poor correlation of a low umbilical artery pH and the fetal outcome is partly explainable by the standard cut off level of 7,20 for acidosis, which seems to be too high.
Obwegeser
R
R
II. Univ. Frauenklinik Wien.
Böhm
R
R
Gruber
W
W
D000136:Acid-Base Equilibrium / Q000502:physiology*; D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000175:diagnosis / Q000503:physiopathology; D002585:Cesarean Section; D005113:Extraction, Obstetrical; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis* / Q000503:physiopathology; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D009460:Neurologic Examination; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012016:Reference Values
Diskrepanz zwischen Apgar Score und Nabelarterien pH-Wert beim Neugeborenen. (Korrelation zu Geburtsmodus und Fetal Outcome?).