Analysis of umbilical cord blood gas in term and near term asphyxiated newborn babies

Abstract

Introductions: This study aims to determine the incidence of perinatal asphyxia in neonates with low Apgar and Hypoxic Ischemic Encephalopathy (HIE) in asphyxiated babies.

Methods: This was a cross sectional study from November 1, 2010 to July 30, 2011. Babies with Apgar score of less than seven at five minute were enrolled in the study. Blood was drawn from umbilical cord artery for blood gas analysis. Neonates were followed up in every six hours for at least 48 hours. Staging of HIE according to Sarnat staging was done in babies with Apgar score of <7 at five minutes within 24 hours of birth. 

Results: Total of 2,425 live births, 56 (2.30%) were born with an Apgar of < 7 at five minute, six were excluded (due to set exclusion criteria) and remaining 50 were analysed. Thirty-four (68% of 50) of babies with low Apgar score had maternal risk factors – meconium stained liquor being the commonest risk factor. Majority (46%) had cord blood pH of >7.2, 40% had between 7.1 to 7.2, 12% between 7 to 7.1 and remaining 2% had pH < 7. HIE developed in 22% (11/50) of the asphyxiated babies.

Conclusions: More than 1/3rd (46%) of babies with low Apgar had low cord blood pH, 1/4th (26%) had base excess, and 22% developed features of HIE. Cord blood pH were better predictors than Apgar in asphyxiated babies.

Keywords: Apgar score, cord blood, hypoxic ischemic encephalopathy (HIE)