Document Detail

Head-to-body delivery interval and risk of fetal acidosis and hypoxic ischaemic encephalopathy in shoulder dystocia: a retrospective review.
MedLine Citation:
PMID:  21199293     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the association between head-to-body delivery interval (HBDI) and cord arterial pH and base excess (BE), and the risk of development of hypoxic ischaemic encephalopathy (HIE).
DESIGN: Retrospective review.
SETTING: A university hospital.
POPULATION: Pregnancies complicated with shoulder dystocia during the period 1995-2009.
METHODS: Cases were identified from a search of the hospital electronic delivery records. Cord arterial pH and BE, and the incidence of HIE and perinatal death, were retrieved from medical records and correlated with HBDI, birth weight, mode of delivery and presence of nonreassuring fetal heart rate pattern and maternal diabetes using univariate analysis, followed by multivariate analysis.
MAIN OUTCOME MEASURES: Any association between cord pH and HBDI.
RESULTS: Of the 200 cases identified, the mean (standard deviation) HBDI was 2.5 minutes (1.5 minutes). Both HBDI and the presence of nonreassuring fetal heart rate pattern were independent factors for pH, and HBDI was the only significant factor for BE. Arterial pH dropped at a rate of 0.011 per minute [95% confidence interval (95% CI), 0.017-0.004; P = 0.002] with HBDI. The mode of delivery, birth weight and maternal diabetes did not affect blood gas levels. The respective risks of severe acidosis (pH < 7) and HIE with HBDI of <5 minutes were 0.5% and 0.5% versus 5.9% and 23.5% with HBDI ≥ 5 minutes.
CONCLUSIONS: Cord arterial pH drops with HBDI during shoulder dystocia, but the risk of acidosis or HIE is very low with HBDI < 5 minutes.
T Y Leung; O Stuart; D S Sahota; S S H Suen; T K Lau; T T Lao
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Publication Detail:
Type:  Journal Article     Date:  2010-12-24
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  118     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-10     Completed Date:  2011-03-28     Revised Date:  2011-09-23    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  474-9     Citation Subset:  AIM; IM    
Copyright Information:
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, China.
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MeSH Terms
Acidosis / etiology*
Delivery, Obstetric / methods*
Fetal Blood / chemistry
Fetal Diseases / etiology*
Hydrogen-Ion Concentration
Hypoxia-Ischemia, Brain / etiology*
Infant, Newborn
Retrospective Studies
Risk Factors
Comment In:
BJOG. 2011 Sep;118(10):1273-4; author reply 1274   [PMID:  21834885 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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