Severe acidosis and subsequent neurologic status

Article Abstract:

A compromised oxygen supply to the fetus, fetal asphyxia, can cause brain damage and future neurological disabilities. The Apgar score, which measures fetal well-being at one and five minutes after birth, can predict long-term neurological damage when the scores are particularly low, but it is inadequate in diagnosing mild neurological damage caused by fetal asphyxia. When the oxygen supply to the fetus is compromised, the acid-base equilibrium of the blood becomes disturbed. This results in acidosis, indicated by a pH of less than 7, which is too much acid in the blood. A sample obtained by umbilical cord sampling during pregnancy can reveal the acidity of the fetal blood. To determine the relationship between the umbilical cord blood gases and actual fetal outcome, the charts of 15,528 fetuses were reviewed. A pH of less than 7.05 was found in 142 newborns (0.91 percent). There were 110 full-term infants and 32 premature infants with acidosis. Of the infants who had neurological assessments performed in the hospital, neurological deficits were present in 9 out of the 110 term infants and 14 out of 32 premature infants. Follow-up information was available for 7 out of 9 term infants and 8 out of 15 premature infants. Five term infants and six premature infants exhibited either a mild developmental delays or mild abnormalities in muscle tone during the first year of life. Therefore, the evaluation of umbilical cord blood gases was not useful in predicting future neurological deficits. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Complications and side effects, Asphyxia, Acid-base imbalances, Acid-base imbalance, Neurologic examination

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Is intrauterine transfusion associated with diminished fetal growth?

Article Abstract:

Nonanemic growth-retarded fetuses have high blood levels of lactic acid and an altered acid-base balance. This type of growth retardation has been thought to be caused by poor placental circulation, which would cause decreased delivery of nutrients such as glucose. However, poor delivery of oxygen might also cause this condition. Poor oxygen delivery can also result from fetal anemia or replacement of fetal blood with adult blood, which does not carry oxygen as well. In fact, an altered acid-base balance is found in severely anemic fetuses and in transfused infants with moderate anemia, suggesting a similarity to growth-retarded non-anemic fetuses. To elucidate the relationship between oxygen deprivation and fetal growth, the growth rates in 17 fetuses who required complete transfusions of adult blood were evaluated. Head and abdominal circumference and birth weight of transfused fetuses were not significantly different from normal fetuses, nor did the rates of growth of any of these parameters change after transfusion. Final head circumferences of transfused fetuses were significantly more likely to fall in the upper range than were those of the general fetal population. In spite of similarities among fetuses with poor oxygen delivery and poor growth, the study suggests that diminished fetal oxygenation does not lead to poor fetal growth. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fetus, Fetal growth retardation, Blood transfusion, Intrauterine, Intrauterine blood transfusion

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Hypoxia, the subsequent systemic metabolic acidosis, and their relationship with cerebral metabolite concentrations: an in vivo study in fetal lambs with proton magnetic resonance spectroscopy

Article Abstract:

Low oxygen levels may not immediately damage the fetal brain if the blood pH is greater than 7.28 or the base excess is greater than -8 mmol per liter. It is important to know exactly when brain damage occurs so preventive measures can be taken.

Risk factors

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