title: [Systematic umbilical cord blood analysis at birth: feasibility and reliability in a French labour ward].
abstract: OBJECTIVE
  At birth, evaluation of neonatal well-being is crucial. It is though important to perform umbilical cord blood gas analysis, and then to analyze the samples. We wanted to establish the feasibility and reliability of systematic umbilical cord blood sampling in a French labour ward.
  
  
  METHODS
  Study of systematic umbilical cord blood gas analysis was realized retrospectively from 1000 consecutive deliveries. We first established the feasibility of the samples. Feasibility was defined by the ratio of complete cord acid-base data on the number of deliveries from alive newborns. Afterwards, we established the reliability on the remaining cord samples. Reliability was the ratio of samples that fulfilled quality criteria defined by Westgate et al. and revised by Kro et al., on the number of complete samples from alive newborns. At last, we looked for factors that would influence these results.
  
  
  RESULTS
  The systematic umbilical cord blood sample feasibility reached 91.6%, and the reliability reached 80.7%. About the delivery mode, 38.6% of emergency caesarians (IC 95% [30.8-46.3]; P<0.0001) led to non-valid samples, when only 11.3% of programmed caesarians (IC 95% [4.3-18.2]; P<0.0001) led to non-valid samples. Umbilical cord blood analysis were significantly less validated during emergency caesarians.
  
  
  CONCLUSIONS
  Realization of systematic cord blood gas analysis was followed by 8.4% of incomplete samples, and by 19.3% that were uninterpretable. Training sessions should be organized to improve the feasibility and reliability, especially during emergency caesarians.
authors.affiliation: Service de gynécologie-obstétrique, centre hospitalo-universitaire de Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France. deborahernst@hotmail.com
authors.forename: D
authors.initials: D
authors.lastname: Ernst
authors.forename: J
authors.initials: J
authors.lastname: Clerc
authors.forename: E
authors.initials: E
authors.lastname: Decullier
authors.forename: G
authors.initials: G
authors.lastname: Gavanier
authors.forename: O
authors.initials: O
authors.lastname: Dupuis
mesh_terms: D000136:Acid-Base Equilibrium; D001784:Blood Gas Analysis; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005602:France; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007743:Labor, Obstetric; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies