title: [The practice of neonatal umbilical blood gas analysis in the "Alsace" regional French perinatal network].
abstract: OBJECTIVE
  The assessment of neonatal well-being is paramount in delivery rooms. For that purpose, it is recommended in France to carry out a systematic neonatal umbilical cord blood gas analysis. The aim of this study is to evaluate how umbilical cord blood gas sampling is realised, analysed and interpreted by midwives in a French regional perinatal network.
  
  
  METHODS
  We conducted a survey focused on randomly selected midwives partitioning in different maternities that constitute the "Alsace" regional perinatal network. A questionnaire concerning the modalities of umbilical cord blood sampling, its analysis and the interpretation of results was used during interviews with included midwives.
  
  
  RESULTS
  Fifty-one midwives were included in the study (15.8% of whom were working in delivery rooms). Only 13% of maternities constituting the perinatal network did not realise systematic neonatal umbilical cord blood analysis. Among interviewed midwives, 78.4% reported umbilical cord clamping after the first breath of the child. Among the midwives included, 86.3% of them realise sampling from the umbilical artery and 29.4% from both umbilical artery and vein. For 86.3% of interviewed midwives, the leitmotif of realising umbilical blood sampling was medico-legal. More than two third of included midwives interpret blood gas taking into account two parameters (either pH and base excess, or lactate). They settled at 7.0-7.2, the limit below which a newborn might present sequelae.
  
  
  CONCLUSIONS
  This study shows that the neonatal umbilical cord blood gas analysis at birth is almost systematic in this regional French perinatal network. It is realised primarily for medico-legal purpose. However, there are significant variations in sampling procedures and interpretation. This should lead to the establishment within each maternity of a neonatal umbilical cord blood gas sampling protocol along with a midwifery training program.
authors.affiliation: Département de gynécologie-obstétrique, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Kellenberger
authors.affiliation: Département de gynécologie-obstétrique, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg, France.
authors.forename: C Y
authors.initials: CY
authors.lastname: Akladios
authors.affiliation: Département de gynécologie-obstétrique, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg, France.
authors.forename: N
authors.initials: N
authors.lastname: Sananes
authors.affiliation: Département de gynécologie-obstétrique, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Gaudineau
authors.affiliation: Département de gynécologie-obstétrique, hôpital de Hautepierre, avenue Molière, 67098 Strasbourg, France. Electronic address: Bruno.Langer@chru-strasbourg.fr.
authors.forename: B
authors.initials: B
authors.lastname: Langer
mesh_terms: D000138:Acidosis / Q000097:blood*; D000328:Adult; D001238:Asphyxia Neonatorum / Q000097:blood; D001784:Blood Gas Analysis / Q000379:methods / Q000592:standards*; D005312:Fetal Blood / Q000737:chemistry*; D005602:France; D006771:Hospitals, Maternity / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood*; D008880:Midwifery / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data
keywords: Acidose; Acidosis; Asphyxia; Asphyxie; Cord pH; Sang cordon ombilical; Umbilical cord blood; pH au cordon