Fetal acidosis from obstetric interventions during the first vaginal delivery.
OBJECTIVE
The aim of this study was to analyze the blood gas values of umbilical cord blood in newborns of first vaginal deliveries with or without obstetric interventions.


METHODS
In a prospective descriptive study conducted during the 6-month period from August 2003 through February 2004 at a university hospital, we analyzed the umbilical cord blood gas results of 80 term newborns delivered vaginally from healthy nulliparous women. Multivariate logistic analysis was used to evaluate the associations between fetal acidosis (pH<7.20) and any obstetric interventions.


RESULTS
The mean of umbilical cord blood arterial pH was 7.26 (standard deviation, 0.072). After controlling for the confounding factors with multivariate logistic regression, fetal acidosis (pH<7.20) was found to be significantly associated with oxytocin augmentation (odds ratio [OR], 16.48; 95% confidence interval [CI], 1.21-226.1) and vacuum extraction (OR, 10.76; 95% CI, 1.025-112.9). In contrast, there was no significant relationship between fetal acidosis with episiotomy (OR, 1.096; 95% CI, 0.07-16.6) or epidural anesthesia (OR, 0.074; 95% CI, 0.003-2.09).


CONCLUSIONS
Oxytocin augmentation and vacuum extraction were significantly related to low cord arterial pH values (pH<7.20), but there were no adverse effects to the newborns of first vaginal deliveries.
Su
Chi-Feng
CF
Department of Obstetrics and Gynecology, Kuang Tien General Hospital, and Department of Obstetrics and Gynecology, and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Tsai
Horng-Jyh
HJ
Huang
Che-Cheng
CC
Luo
Kan-Hung
KH
Lin
Long-Yau
LY
D000138:Acidosis / Q000097:blood* / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D016015:Logistic Models; D015999:Multivariate Analysis; D010121:Oxytocin / Q000009:adverse effects; D010298:Parity; D011247:Pregnancy; D014469:Umbilical Arteries; D014471:Umbilical Veins; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects
D010121:Oxytocin