Ulloa-Ricárdez A, Meneses-Roldán E, Del Castillo-Medina A

Language: Spanish
References: 38
Page: 75-79
PDF size: 165.59 Kb.

ABSTRACT

Introduction. The perinatal asphyxia is a syndrome with a disturbance in gas exchange with increasing hypoxemia and hypercapnea, in addition to metabolic changes and acidemia. The causes can be maternal or fetal and can be present in the most of cases during the labor. Different methods have been useful to defined, mainly Apgar score at five minutes, encephalopaties features and low pH in umbilical arterial blood; however, there has been little correlation between perinatal asphyxia and pH at birth, and recently lactate in cordon blood has been reported with better relation. Objective. The aim of the present study was to evaluate the relationship between umbilical cord arterial blood lactate and pH and clinical manifestations in perinatal asphyxia. Material and methods. We retrospectively reviewed the records of all inborn full-term and preterm neonates suspected of having suffered from a significant degree of intrapartum asphyxia from a period of January 2008 to December 2009, samples were taken from cord artery blood for pH and lactate analysis. Records were analyzed with clinical manifestations. Results. 63 newborn were diagnosed with perinatal asphyxia, 57.1 % were male , gestational age were 31.3-42.4 weeks. Level of lactate we found were between 2.00 and 17.00 mmol/L and pH between 6.75 and 7.37, with a correlation between pH and lactate of r = 0.56. The cases of perinatal asphyxia mild and moderate were 52, lactate averaging 5.94 mmol/L and 7.15 of pH, perinatal asphyxia were 11 with lactate averaging 12.29 and 7.01 pH (p ‹ 0.05). Conclusion. pH and lactate have a correlation of 0.56 in newborn with perinatal asphyxia. Patients with lactate levels › 10 and pH ‹ 7.0 had higher frequency of clinical features like encephalopathy, distress respiratory and kidney damage.

REFERENCES

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14. Nordstrom L, Arulkumaran S. Intrapartum fetal hypoxia and biochemical markers: a review. Obstet Gynecol Survey 1998; 53: 645-57.

15. Bretscher J, Saling E. pH values in the human fetus during labor. Am J Obstet Gynecol 1967; 97: 906-11.

16. Westgren M, Kuger K, Ek S, Grunevald C, Kublickas M, Naka K, et al. Lactate compared with pH analysis at fetal scalp blood sampling : a prospective randomised study. Br J Obstet Gynaecol 1998; 105: 29-33.

17. Nordstrom L, Wiberg-Itzel E, Lipponer C, Norman M, Herbst A, Prebensen D, et al. Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomized controlled multicentre trial. BMJ 2008; 336 (7656): 1284-7.

18. Chanrachakul B, Chua S, Nordstrom L, et al. Umbilical artery blood gas and lactate in healthy newborns. J Med Assoc Thai 1999; 82: 388-93.

19. East CE, Leader LR, Sheehan P, Henshall NE, Colditz PB. Cochrane Database Syst Rev 2010; (3): CD006174.

20. González de Dios J. Definición de asfixia perinatal en la bibliografía médica: necesidad de un consenso. Rev Neurol 2002; 35(7): 628-34.

21. Nordstrom L, Arulkumaran S. Intrapartum fetal hypoxia and biochemical markers: a review. Obstet Gynecol Suvery 1998; 53(10): 645-57.

22. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Arch Neurol 1976; 33: 696-705.

23. Murguía-de Sierra M, Lozano R, Santos J. Mortalidad perinatal por asfixia en México: problema prioritario de salud pública por resolver. Bol Med Hosp Infant Mex 2005; 62(5): 375-83.

24. Romero Esquiliano G, Méndez Ramírez I, Tello Valdés A, Torner Aguilar CA. Daño neurológico secundario a hipoxia isquemia perinatal. Arch Neurocien 2004; 9(3): 143-50.

25. Federación Nacional de Neonatólogos de México. PAC Neonatología-1. México: Intersistemas; 2004.

26. American Academy of Pediatrics and American College of Obstetricians and Gynecologists. Care of the neonate. Guidelines for perinatal care. Gilstrap LC, Oh W (Eds.). Elk Grove Village (IL): American Academy of Pediatrics; 2002: 196-7.

27. Lennart Nordstrom. Fetal scalp and cord blood lactate. Best Practice & Research Clinical Obstetrics and Gynaecology 2004; 18(3): 467-76.

28. Andres RL, Saade G, Gilstrap LC, Wilkins I, et al. Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal academia. Am J Obstet Gynecol 1999; 181: 867-71.

29. Goldaber KG, Glistrap LC, Leveno KJ, et al. Pathologic fetal acidemia. Am J Obstet Gynecol 1991; 78: 1103-7.

30. Borruto F, Comparetto C, Treisser A. Prevention of cerebral palsy during labour: role of foetal lactate. Arch Gynecol Obstet 2008; 278: 17-22.

31. Da Silva S, Hennebert N, Denis R, Wayenberg JL. Clinical value of a single postnatal lactate measurement after intrapartum asphyxia. Acta Paediatr 2000; 89(3): 320-3.

32. Borruto F, Comparetto C, Treisser A. Prevention of cerebral palsy durin labour: role of fetal lactate. Arch Gynecol Obstet 2008; 278: 17-22.

33. Nordstrom L, Arulkumaran S. Intrapartum fetal hypoxia and biochemical markers: a review. Obstet Gynecol Survey 1998; 53: 645-57.

34. Bretscher J, Saling E. pH values in the human fetus during labor. Am J Obstet Gynecol 1967; 97: 906-11.

35. Westgren M, Kuger K, Ek S, Grunevald C, Kublickas M, Naka K, et al. Lactate compared with pH analysis at fetal scalp blood sampling : a prospective randomised study. Br J Obstet Gynaecol 1998; 105: 29-33.

36. Nordstrom L, Wiberg-Itzel E, Lipponer C, Norman M, Herbst A, Prebensen D, et al. Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomized controlled multicentre trial. BMJ 2008; 336 (7656): 1284-7.

37. Chanrachakul B, Chua S, Nordstrom L, et al. Umbilical artery blood gas and lactate in healthy newborns. J Med Assoc Thai 1999; 82: 388-93.

38. East CE, Leader LR, Sheehan P, Henshall NE, Colditz PB. Cochrane Database Syst Rev 2010; (3): CD006174.