In cord compression, PO2 will typically be low, and if the compression persists, there will be a progression to metabolic acidosis with an accumulation of lactic acid. High PCO2 is most commonly seen in umbilical cord compression, which hinders or prevents the movement of blood to and from the baby. In other words, CO2 is not readily diffusing from the umbilical artery and capillaries into the maternal placenta and maternal circulation. If pH is low, the baby’s blood is acidic, which means that at birth, the baby had an elevated PCO2 and/or an increased number of acidic by-products (mainly lactic acid) caused by anaerobic metabolism. In general, an elevated PCO2 means that the fetus is producing more CO2 than can be eliminated through circulation. A pH below 7.18 for a term infant is considered abnormally low, but research shows a strong association between a pH of less than 7.0 – 7.24 and adverse outcomes (such as HIE, intraventricular hemorrhage, PVL, and cerebral palsy) in the baby. If pH is low, the medical team should be alert to the fact that the baby may have HIE or other forms of brain damage. pHĪ low arterial cord pH is probably the single most important value used to determine if hypoxia near the time of delivery was severe enough to cause hypoxic-ischemic encephalopathy (HIE). Of course, oxygen deprivation may still have taken place, even if these values are normal. Terms associated with oxygen deprivation are asphyxia, hypoxia (decreased oxygen at the tissue level) and ischemia (restricted or reduced blood flow).Ī pH below 7.18 and a base excess more negative than -8 are indications that the newborn suffered oxygen deprivation. The other values impact pH and BE, but pH and BE are the main numbers examined to determine if the baby suffered from a lack of oxygen to the brain either shortly before or during delivery. The key point for parents to know is that pH and BE/BD are the main values examined by the medical team. We have written extensively about umbilical cord blood gas interpretation. Interpreting Arterial Cord Blood Gas Values Normal arterial cord values in a preterm newborn: Base excess (BE): -8 – 0 (mmol/L) (Base deficit (BD): 0 – 8).Normal arterial cord blood gases for a term newborn: Note: The “P” in PCO2 and PO2 stands for “partial pressure,” which is how these gases are measured. Normal umbilical cord blood gas values are listed below. Oxygen deprivation ( birth asphyxia) can cause brain damage, hypoxic-ischemic encephalopathy (HIE), periventricular leukomalacia (PVL – usually seen in premature babies), intraventricular hemorrhages (brain bleeds) and lifelong conditions such as cerebral palsy (CP), seizure disorders, intellectual disabilities, and developmental delays. This blood is analyzed to determine if there was a complication shortly before or during delivery that deprived the baby of oxygen. FLOC & NSDA 2022 Legal Oratory ScholarshipĪs soon as a baby is born, the medical team usually draws blood from the baby’s umbilical cord artery.
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