UMBILICAL CORD ARTERIAL LACTATE LEVELS IN NEWBORNS WITH AND WITHOUT ACIDOSIS
- Authors: PRIKHOD'KO A.M.1, ROMANOV A.Y.1, BAEV O.R.1,2
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Affiliations:
- V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia
- I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)
- Issue: No 5 (2020)
- Pages: 85-89
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248873
- DOI: https://doi.org/10.18565/aig.2020.5.85-89
- ID: 248873
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Abstract
Aim. To investigate the role of measuring umbilical cord arterial lactate level in the diagnosis of hypoxia and prediction of neonatal complications. Materials and methods. A prospective study comprised 250 newborns, who were tested at birth for the acid-base balance (ABB) of arterial blood obtained from the umbilical cord. Of them, 202 (80.8%) had normal ABB and formed group 1; 48 (19.2%) patients with metabolic acidosis were enrolled in group 2. Results. Umbilical cord arterial lactate levels were 5.4 (3.9 - 7.3) and 11.5 (8.5 - 14.0) mmol/L in groups 1 and 2, respectively, p=0.0001. At lactate levels above 8.5 mmol/L, the OR for metabolic acidosis was 34.6 (95% CI=13.6-87.8). Thirty-four (16.8%) newborns without metabolic acidosis had lactate levels above 8.5 mmol/ L. Of them, 24 (70.9%) experienced morbidities in the early neonatal period (low Apgar score, encephalopathy, infections, meconium aspiration, and DIC). Conclusion. An increased concentration of lactate in arterial umbilical cord blood in newborns with low pH values, combined with a severe base deficit, an increase in pCO2, and a decrease in pO2 reflects the presence of metabolic acidosis. At the same time, an increased umbilical cord arterial lactate level in newborns without other signs of metabolic acidosis is suggestive of increased risk of complications in the early neonatal period.
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About the authors
Andrey M. PRIKHOD'KO
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia
Email: a_prikhodko@oparina4.ru
Ph.D., Physician at the 1st Maternity Department, Teaching Assistant at the Department of Obstetrics and Gynecology, Researcher at the Department of Innovative Technologies, Institute of Obstetrics Moscow, Russia
Andrey Yu. ROMANOV
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia
Email: romanov1553@yandex.ru
Ph.D. Student, Specialist at the R&D Department Moscow, Russia
Oleg R. BAEV
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Minzdrav of Russia; I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)
Email: o_baev@oparina4.ru
Dr.Med.Sci., Professor, Head of the 1st Maternity Department, V.I. Kulakov NMRC for OG&P of Minzdrav of Russia, Professor at the Department of Obstetrics, Gynecology, Perinatology and Reproductology, I.M. Sechenov First MSMU of Minzdrav of Russia (Sechenov University) Moscow, Russia
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