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Umbilical cord blood sampling--a tool for delivery quality control?
N Bulkmans1, S Lyrenäs, G Hallberg
1Department of Obstetrics and Gynecology, Uppsala University, Sweden.
Acta Obstetricia Et Gynecologica Scandinavica
|May 1, 1997
Summary
Routine umbilical cord blood analysis offers accurate auditing of intrapartum care, especially in high-risk deliveries. Establishing consistent sampling protocols is crucial for effective quality control and newborn assessment.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Clinical Pathology
Background:
- Umbilical cord blood analysis is a key method for auditing intrapartum care quality.
- Acid-base data from umbilical artery samples are vital for assessing newborns at risk of asphyxia.
- This study explored routine cord blood analysis in all deliveries.
Purpose of the Study:
- To investigate the feasibility and utility of routine postpartum umbilical cord blood analysis.
- To evaluate cord blood acid-base status and lactate concentration for quality control in intrapartum care.
Main Methods:
- Collected paired umbilical artery and vein blood samples from all deliveries (vaginal and cesarean) over two months.
- Analyzed samples for complete acid-base status and lactate concentration.
- Focused on samples obtained between 8 am and 4 pm.
Main Results:
- Achieved true paired artery-venous samples in 48% of cases.
- Sampling proved most challenging after emergency cesarean sections and vaginal twin deliveries.
- Lactate concentration provided information comparable to base excess in extracellular fluid (BEecf) regarding neonatal metabolic state.
Conclusions:
- Cord blood acid-base data enhance retrospective analysis of cardiotocography (CTG) tracings and partographs for intrapartum care quality control.
- Well-established sampling routines in delivery rooms and operating theaters are essential for obtaining critical umbilical artery samples.
- A new graph simplifies postpartum documentation and interpretation of acid-base data.