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Evaluation of selection criteria for validating paired umbilical cord blood gas samples: an observational study.
MedLine Citation:
PMID:  22530937     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Please cite this paper as: White C, Doherty D, Kohan R, Newnham J, Pennell C. Evaluation of selection criteria for validating paired umbilical cord blood gas samples: an observational study. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03308.x. Objective  To compare six validation criteria for umbilical cord blood gas (UCBG) values in vigorous and nonvigorous neonates. Design  Retrospective cohort study. Setting  Single tertiary obstetric centre, King Edward Memorial Hospital (KEMH), Perth, Western Australia. Sample  A total of 37 763 consecutive deliveries at >23 weeks of gestation. Methods  Six validation criteria were compared to evaluate the proportion of deliveries with 'valid' UCBG data; and the proportion of vigorous and nonvigorous neonates with metabolic acidaemia. Main outcomes  Proportion of deliveries with 'valid' UCBG values; proportions of vigorous and nonvigorous neonates with normal, borderline and abnormal UCBG values. Results  The criteria based on KEMH 5th centile arteriovenous pH and Pco(2) differences resulted in a higher proportion of neonates with 'valid' UCBG values than the previously described Westgate and Kro criteria. The increase in 'valid' UCBG values occurred across the entire study population including vigorous and nonvigorous neonates. Among neonates with short-term neonatal complications there was an increase in nonvigorous neonates with umbilical artery metabolic acidaemia. There was no corresponding increase in vigorous neonates diagnosed with abnormal UCBG values. Conclusions  Use of the KEMH criteria results in an increase in the proportion of nonvigorous term neonates with UCBG data considered 'valid' to aid clinicians in the management of the neonate shortly after delivery. This change occurs without increasing the rate of false-positive diagnoses of acidaemia in vigorous neonates. The KEMH 'validation' criteria were developed from an entire presenting population and provide a simple algorithm that can be universally applied to identify neonates with nonphysiological UCBG values.
Authors:
Crh White; DA Doherty; R Kohan; Jp Newnham; Ce Pennell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-24
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  -     ISSN:  1471-0528     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
Affiliation:
School of Women's and Infants' Health, The University of Western Australia, Perth, WA, Australia Women and Infants Research Foundation, Perth, WA, Australia Department of Neonatal Paediatrics, King Edward Memorial Hospital, Perth, WA, Australia.
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