title: Umbilical Cord Blood pH in Intrapartum Hypoxia.
abstract: OBJECTIVE
  To determine the association of cord arterial blood pH with neonatal outcome in cases of intrapartum fetal hypoxia.
  
  
  METHODS
  Descriptive analytical study.
  
  
  METHODS
  Gynaecology Unit-II, Civil Hospital, Karachi, from September 2011 to November 2012.
  
  
  METHODS
  All singleton cephalic fetuses at term gestation were included in the study. Those with any anomaly, malpresentation, medical disorders, maternal age < 18 years, multiple gestation and ruptured membranes were excluded. Patients with abnormal cardiotocography and/or meconium stained liquor were enrolled as index case and immediate next delivery with no such signs as a control. Demographic characteristics, pH level < or > 7.25, neonatal outcome measures (healthy, NICU admission or neonatal death), color of liquor and mode of delivery recorded on predesigned proforma. Statistical analysis performed by SPSS 16 by using independent-t test or chi-square test and ANOVA test as needed.
  
  
  RESULTS
  A total of 204 newborns were evaluated. The mean pH level was found to be significantly different (p=0.007) in two groups. The pH value 7.25 had significant association (p < 0.001) with the neonatal outcome. However, the association of neonatal outcome with severity of acidemia was not found to be significant. Grading of Meconium Stained Liquor (MSL) also did not relate positively with pH levels as 85.7% of grade I, 68.9% of grade II and 59.4% of grade III MSLhad pH > 7.25. Majority (63.6%) cases needed caesarean section as compared to 31.4% controls.
  
  
  CONCLUSIONS
  There is a significant association of cord arterial blood pH at birth with neonatal outcome at pH < or > 7.25; but below the level of pH 7.25 it is still inconclusive.
authors.affiliation: Department of Obstetrics and Gynaecology, DIMC and DUHS, Civil Hospital, Karachi.
authors.forename: Fouzia
authors.initials: F
authors.lastname: Perveen
authors.affiliation: Department of Obstetrics and Gynaecology, DIMC and DUHS, Civil Hospital, Karachi.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Khan
authors.affiliation: Department of Obstetrics and Gynaecology, DIMC and DUHS, Civil Hospital, Karachi.
authors.forename: Tahmina
authors.initials: T
authors.lastname: Ali
authors.affiliation: Department of Obstetrics and Gynaecology, DIMC and DUHS, Civil Hospital, Karachi.
authors.forename: Syeda
authors.initials: S
authors.lastname: Rabia
mesh_terms: D000137:Acid-Base Imbalance / Q000175:diagnosis*; D001034:Apgar Score; D015148:Cardiotocography; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005311:Fetal Hypoxia / Q000175:diagnosis*; D005333:Fetus / Q000502:physiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008297:Male; D008470:Meconium / Q000502:physiology; D008471:Meconium Aspiration Syndrome / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies