Document Detail

Pathologic fetal acidemia.
MedLine Citation:
PMID:  1945216     Owner:  NLM     Status:  MEDLINE    
There is no clearly established umbilical artery pH cutoff to be used for defining pathologic fetal acidemia (ie, the threshold associated with major neonatal morbidity or mortality). Classically, a pH cutoff of less than 7.20 has been used. Our goal was to define this pH cutoff more precisely. There were 3506 term newborns (2500 g or greater) with an umbilical artery pH of less than 7.20; these newborns were divided into five pH groups. Eighty-seven (2.5%) had a pH of less than 7.00, 95 (2.7%) a pH of 7.00-7.04, 290 (8.3%) 7.05-7.09, 798 (22.8%) 7.10-7.14, and 2236 (63.8%) 7.15-7.19. Two-thirds (66.7%) of the newborns with an umbilical artery pH less than 7.00 had a metabolic component in their acidemia, compared with 13.7% or less in all other pH groups. Significantly more (P less than .05) newborns in the less-than-7.00 pH group had low (less than 3) 1- and 5-minute Apgar scores compared with the other four pH groups. In addition, neonatal death was significantly more common (P = .03) in newborns with a pH less than 7.00, and seven (50%) of the 14 deaths occurred in this group. The statistically significant pH cutoff for all seizures was less than 7.05 (P = .004), and for unexplained seizures was less than 7.00 (P = .01). Eight (67%) of the 12 unexplained seizures occurred in this latter pH group. Thus, a more realistic pH cutoff for defining pathologic fetal acidemia would appear to be less than 7.00.
K G Goldaber; L C Gilstrap; K J Leveno; J S Dax; D D McIntire
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  78     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1991-12-18     Completed Date:  1991-12-18     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1103-7     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas.
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MeSH Terms
Acidosis / blood*,  mortality
Apgar Score
Fetal Diseases / blood*
Hydrogen-Ion Concentration
Infant, Newborn
Obstetric Labor Complications / etiology
Seizures / etiology

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