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Relation between um...
Relation between umbilical cord blood pH, base deficit, lactate, 5-minute Apgar score and development of hypoxic ischemic encephalopathy.
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- Wiberg, Nana (författare)
- Lund University,Lunds universitet,Urogynekologi och reproduktionsfarmakologi,Forskargrupper vid Lunds universitet,Urogynaecology and Reproductive Pharmacology,Lund University Research Groups
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- Källén, Karin (författare)
- Lund University,Lunds universitet,Tornbladinstitutet,Forskargrupper vid Lunds universitet,Tornblad Institute,Lund University Research Groups
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- Herbst, Andreas (författare)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Olofsson, Per (författare)
- Lund University,Lunds universitet,Urogynekologi och reproduktionsfarmakologi,Forskargrupper vid Lunds universitet,Urogynaecology and Reproductive Pharmacology,Lund University Research Groups
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(creator_code:org_t)
- Wiley, 2010
- 2010
- Engelska.
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 89:10, s. 1263-1269
- Relaterad länk:
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http://www.ncbi.nlm....
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.3...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: Umbilical cord acid-base analysis is fundamental for assessing intrapartum hypoxia. The accuracy of arterial umbilical cord blood lactate, pH and base deficit to reflect a low 5-minute Apgar score and hypoxic ischemic encephalopathy (HIE) stage 2-3 was assessed, and new gestational age-adjusted reference standards were compared with traditional stationary reference values. DESIGN AND SAMPLE: A total of 13,735 pH-validated routine cord acid-base values from singleton deliveries were tested with stationary and gestational age-adjusted reference values using receiver operating characteristic curves and calculation of area under curve. SETTING: University hospital. MAIN OUTCOME MEASURES: Accuracy of low pH, high base deficit and high lactate, alone or in combination, to imply 5-minute Apgar score < 7 or < 4 or HIE. RESULTS: Gestational age-adjusted values were for all parameters significantly better than crude values to indicate Apgar score < 7. For Apgar score < 4, the differences were not significant. The frequency of HIE was 0.046%, making statistical analyses pointless. Gestational age-adjusted lactate had the overall best accuracy and among combinations; a low age-adjusted pH plus high age-adjusted lactate was slightly better than a low age-adjusted pH plus high age-adjusted base deficit. The sensitivity and positive predictive value were low for all parameters. CONCLUSIONS: Lactate in cord arterial blood at birth is at least as good as base deficit to reflect an impaired condition at birth, and best when gestational age-adjusted values are used. Due to methodological confounding involved in calculation of base deficit, lactate may replace base deficit as an acid-base outcome parameter at birth.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Hypoxia-Ischemia
- Brain: blood
- Carbon Dioxide: blood
- Fetal Blood: chemistry
- Brain: etiology
- Brain: physiopathology
- Lactic Acid: blood
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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