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Umbilical Cord Blood Gases

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https://www.readbyqxmd.com/read/30452689/rapid-communication-maternal-melatonin-implants-improve-fetal-oxygen-supply-and-body-weight-at-term-in-sheep-pregnancies
#1
F Sales, O A Peralta, E Narbona, S McCoard, A González-Bulnes, V H Parraguez
Fetal hypoxia, resulting in oxidative stress in pregnancies contributes to reduced fetal growth. Melatonin, a potent antioxidant has been associated with improved oxidative status. Maternal oral melatonin supplementation in sheep from day 50 of gestation ameliorates the consequences of fetal growth restriction in sheep. In rats, melatonin supplementation increases fetal weight via improved placental efficiency and reduction of oxidative stress. The objective of this study was to evaluate whether melatonin supplementation of single (S)- or twin-bearing (T) ewes using either 0 (0MEL), 1 (18 mg MEL) or 2 (36 mg MEL) slow release 18-mg melatonin implants (Regulin®) from 100 to 140 days of pregnancy (n=8 per group) influenced fetal oxygen supply and fetal weight...
November 19, 2018: Journal of Animal Science
https://www.readbyqxmd.com/read/30339043/are-short-umbilical-cords-seen-in-pathology-really-short
#2
Adanna Ukazu, Sitara Ravikumar, Natalie Roche, Debra S Heller
PURPOSE: Short umbilical cords are associated with adverse perinatal outcomes. Clinicians may rely on measurements made by pathologists, which do not include portions of the cord remaining n the child or sent for blood gasses. METHODS: This was a retrospective chart review of term placentas. Sequential cases from January through August 2017 were reviewed from the Pathology archive. RESULTS: 198 placentas were recorded as either third trimester of mature, of which 146 were 37 or greater weeks of gestation...
October 19, 2018: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/30037602/clinical-features-of-a-fatal-shoulder-dystocia-the-hypovolemic-shock-hypothesis
#3
E Cesari, S Ghirardello, G Brembilla, A Svelato, A Ragusa
Shoulder dystocia is a rare but severe obstetric complication associated with an increased risk of brachial plexus palsies, fractures of the clavicle and humerus, hypoxic-ischemic encephalopathy and, rarely, neonatal death. Here we describe a fatal case of shoulder dystocia in a term newborn, although labor was uneventful, fetal heart rate tracing was normal until the delivery of the head and the head-to-body delivery interval (HBDI) occurred within 5 min. Full resuscitation was performed for 35 min without success...
September 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/30036590/baby-directed-umbilical-cord-clamping-a-feasibility-study
#4
Douglas A Blank, Shiraz Badurdeen, C Omar F Kamlin, Susan E Jacobs, Marta Thio, Jennifer A Dawson, Stefan C Kane, Alicia T Dennis, Graeme R Polglase, Stuart B Hooper, Peter G Davis
INTRODUCTION: Over five percent of infants born worldwide will need help breathing after birth. Delayed cord clamping (DCC) has become the standard of care for vigorous infants. DCC in non-vigorous infants is uncommon because of logistical difficulties in providing effective resuscitation during DCC. In Baby-Directed Umbilical Cord Clamping (Baby-DUCC), the umbilical cord remains patent until the infant's lungs are exchanging gases. We conducted a feasibility study of the Baby-DUCC technique...
October 2018: Resuscitation
https://www.readbyqxmd.com/read/29843068/when-should-foetal-ph-measurements-be-performed-after-a-prolonged-deceleration-an-experimental-study-in-a-fetal-sheep-model
#5
H Dupuis, L Ghesquière, Julien De Jonckheere, E Aubry, D Sharma, P Deruelle, L Storme, V Houfflin-Debarge, C Garabedian
OBJECTIVE: The aim of fetal heart rate monitoring during labour is to identify and prevent foetal distress, but its evaluation is not perfect. Fetal scalp blood sampling for pH measurement is one of the second-line methods of monitoring when fetal heart rate is classified as suspicious. This study aims to determine when pH testing should be performed after a prolonged deceleration. STUDY DESIGN: This was an experimental study in a fetal sheep model. A partial umbilical cord occlusion was performed for seven minutes followed by a recuperation period of 30 min...
July 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29742984/maternal-serum-endocan-concentration-in-pregnancies-complicated-by-intrauterine-growth-restriction
#6
Agata Szpera-Gozdziewicz, Katarzyna Kosicka, Tomasz Gozdziewicz, Mariola Krzyscin, Przemyslaw Wirstlein, Anna Siemiatkowska, Franciszek Glowka, Ewa Wender-Ozegowska, Grzegorz H Breborowicz
OBJECTIVES: Endocan plays a role in the development of vascular tissue in health and disease and is an indicator of endothelial cells activation and angiogenesis. Therefore, this study aimed to investigate the relationship between maternal endocan serum level and intrauterine growth restriction (IUGR) as well as ultrasound Doppler flow measurements indicating placental insufficiency. METHODS: This study included a group of women with IUGR (n = 37) and a group of healthy pregnant women (controls, n = 37)...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29680084/no-197b-fetal-health-surveillance-intrapartum-consensus-guideline
#7
Robert Liston, Diane Sawchuck, David Young
OBJECTIVE: This guideline provides new recommendations pertaining to the application and documentation of fetal surveillance in the intrapartum period that will decrease the incidence of birth asphyxia while maintaining the lowest possible rate of obstetrical intervention. Pregnancies with and without risk factors for adverse perinatal outcomes are considered. This guideline presents an alternative classification system for antenatal fetal non-stress testing and intrapartum electronic fetal surveillance to what has been used previously...
April 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29643616/labor-analgesia-in-parturients-of-fetal-growth-restriction-having-raised-umbilical-doppler-vascular-indices
#8
Sukhen Samanta, Kajal Jain, Neerja Bhardwaj, Vanita Jain, Preet Mohinder Singh, Sujay Samanta, Veenu Singla, Rini Saha
Background and Aims: Fetuses with abnormal umbilical blood flow are at a higher risk of adverse perinatal outcome than those with normal flow. Epidural analgesia (EA) has shown to decrease villous vascular resistance in preeclamptic women during labor. The present study evaluates the effects of epidural ropivacaine and intramuscular (IM) tramadol on Doppler blood flow in parturients with fetal growth restriction and raised umbilical artery (UmA) blood flow. Material and Methods: In this prospective nonrandomized comparative study, 36 term parturients with sonographic evidence of UmA systolic-diastolic (S-D) ratio ≥3 were enrolled...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29581058/nuchal-cord-at-delivery-and-perinatal-outcomes-single-center-retrospective-study-with-emphasis-on-fetal-acid-base-balance
#9
REVIEW
Rohitkumar Vasa, Roger Dimitrov, Shivani Patel
AIM: Our study objectives were to evaluate umbilical cord blood acid-base balance in presence of nuchal cord at delivery, effects of nuchal cord at delivery on perinatal outcomes and incidence of nuchal cord in a racially diverse population. METHODS: Perinatal records of 2530 women (predominantly African American and Hispanic) who delivered in 2012 were examined. Perinatal outcomes of women who delivered a baby with nuchal cord were compared with those without nuchal cord...
March 5, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29065736/investigation-of-possible-maternal-and-fetal-factors-which-affect-umbilical-coiling-index
#10
Muberra Namli Kalem, Ziya Kalem, Nilufer Akgun, Ebru Yuce, Hatice Aktas
AIM: The aim of this study was to investigate the possible maternal and fetal factors, which affect the Umbilical Coiling Index (UCI). METHODS: This prospective, observational, analytic study was conducted using the data of 380 women with term pregnancy and newborns who presented at a University Hospital. Hemoglobin (Hb), ferritin, iron, and the total iron binding capacity (TIBC) of the maternal blood were measured, and transferrin saturation was estimated based on the ratio between serum iron and TIBC...
November 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28838010/supplemental-oxygen-study-a-randomized-controlled-study-on-the-effect-of-maternal-oxygen-supplementation-during-planned-cesarean-delivery-on-umbilical-cord-gases
#11
Valeria B Simon, Alex Fong, Michael P Nageotte
OBJECTIVE:  The aim was to determine the fetal umbilical blood gas effects of supplemental maternal oxygenation compared with room air (RA) during term planned cesarean delivery. METHODS:  This is a prospective randomized controlled study of singleton planned cesarean deliveries randomized to receive supplemental oxygen (O2 ) at 10 L per minute (L/min) via facemask or RA. Umbilical cord gases were collected. The primary outcome was umbilical arterial pH level...
January 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/28682955/ringer-s-lactate-versus-normal-saline-in-urgent-cesarean-delivery-in-a-resource-limited-setting-a-pragmatic-clinical-trial
#12
Emmanuel Timarwa Ayebale, Arthur Kwizera, Cephas Mijumbi, Samuel Kizito, Anthony Michael Roche
BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer's lactate (RL) versus 0.9% normal saline (NS) on maternal and neonatal blood pH and 24-hour postoperative morbidity in urgent cesarean delivery in a low-resource setting. Our hypothesis was that RL would result in 30% less acidosis than NS. METHODS: This was a pragmatic prospective double-blind randomized controlled trial in the Mulago National Referral Hospital Labor Ward Theater from September 2011 to May 2012...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28606652/rocuronium-versus-suxamethonium-for-rapid-sequence-induction-of-general-anaesthesia-for-caesarean-section-influence-on-neonatal-outcomes
#13
RANDOMIZED CONTROLLED TRIAL
M Kosinova, P Stourac, M Adamus, D Seidlova, T Pavlik, P Janku, I Krikava, Z Mrozek, M Prochazka, J Klucka, R Stoudek, I Bartikova, H Harazim, H Robotkova, K Hejduk, Z Hodicka, M Kirchnerova, J Francakova, L Obare Pyszkova, J Hlozkova, P Sevcik
BACKGROUND: In a previous study we compared rocuronium and suxamethonium for rapid-sequence induction of general anaesthesia for caesarean section and found no difference in maternal outcome. There was however, a significant difference in Apgar scores. As this was a secondary outcome, we extended the study to explore this finding on a larger sample. METHODS: We included 488 parturients of whom 240 were women from the original study. Women were randomly assigned to receive either rocuronium 1mg/kg (ROC n=245) or suxamethonium 1mg/kg (SUX n=243) after propofol 2mg/kg...
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28441439/hemodynamics-and-gas-exchange-during-chest-compressions-in-neonatal-resuscitation
#14
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Myra Wyckoff, Satyan Lakshminrusimha
PURPOSE: Current knowledge about pulmonary/systemic hemodynamics and gas exchange during neonatal resuscitation in a model of transitioning fetal circulation with fetal shunts and fluid-filled alveoli is limited. Using a fetal lamb asphyxia model, we sought to determine whether hemodynamic or gas-exchange parameters predicted successful return of spontaneous circulation (ROSC). METHODS: The umbilical cord was occluded in 22 lambs to induce asphyxial cardiac arrest...
2017: PloS One
https://www.readbyqxmd.com/read/28277364/intrauterine-hyperoxemia-and-risk-of-neonatal-morbidity
#15
Nandini Raghuraman, Lorene A Temming, Molly J Stout, George A Macones, Alison G Cahill, Methodius G Tuuli
OBJECTIVE: To test the hypothesis that intrauterine hyperoxemia is associated with an increased risk of neonatal morbidity. METHODS: This was a secondary analysis of a prospective study of singleton, nonanomalous deliveries at or beyond 37 weeks of gestation at an institution with a universal umbilical cord gas policy from 2010 to 2014. The primary outcome was a composite of neonatal morbidity including neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermic therapy...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28235526/cardiac-output-changes-with-phenylephrine-and-ephedrine-infusions-during-spinal-anesthesia-for-cesarean-section-a-randomized-double-blind-trial
#16
COMPARATIVE STUDY
W Mon, A Stewart, R Fernando, K Ashpole, N El-Wahab, S MacDonald, P Tamilselvan, M Columb, Y M Liu
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#17
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigsknecht, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2 ) or saturations (SpO2 ) to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n = 21)...
June 2017: Pediatric Research
https://www.readbyqxmd.com/read/27687377/a-randomized-trial-comparing-prophylactic-phenylephrine-and-ephedrine-infusion-during-spinal-anesthesia-for-emergency-cesarean-delivery-in-cases-of-acute-fetal-compromise
#18
RANDOMIZED CONTROLLED TRIAL
Kajal Jain, Jeetinder Kaur Makkar, Siva Subramani Vp, Shalini Gander, Praveen Kumar
BACKGROUND: Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. METHODS: Ninety parturients showing acute fetal compromise during intrapartum period and taken up for CD (category II) under spinal anesthesia were randomized to receive prophylactic infusion of ephedrine 2...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27501619/reference-values-for-umbilical-cord-blood-gases-of-newborns-delivered-by-elective-cesarean-section
#19
Kattiya Manomayangkul, Arunotai Siriussawakul, Akarin Nimmannit, Thassayu Yuyen, Sopapan Ngerncham, Kanit Reesukumal
BACKGROUND: Umbilical cord blood gas values are better indicators of perinatal asphyxia than Apgar scores. Many studies have reported normal ranges of umbilical cord blood gases, which vary greatly due to many factors. This study aimed to establish the reference values of umbilical cord blood gases of normal cesarean newborns in a university hospital setting. MATERIAL AND METHOD: Blood samples from the umbilical artery and vein were collected from 160 newborns delivered by elective cesarean section...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27427266/obstetrical-correlates-and-perinatal-consequences-of-neonatal-hypoglycemia-in-term-infants
#20
D Ogunyemi, P Friedman, K Betcher, A Whitten, N Sugiyama, L Qu, Amitai Kohn, Holtrop Paul
OBJECTIVE: To determine independent perinatal and intrapartum factors associated with neonatal hypoglycemia. METHOD: Of singleton pregnancies delivered at term in 2013; 318 (3.8%) neonates diagnosed with hypoglycemia were compared to 7955 (96.2%) neonate controls with regression analysis. RESULTS: Regression analysis showed that independent prenatal factors were multiparity (odds-ratio [OR] = 1.61), gestational age (OR = 0.68), gestational diabetes (OR = 0...
June 2017: Journal of Maternal-fetal & Neonatal Medicine
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