Relationship between immediate postpartum umbilical cord blood pH and fetal distress

Abstract

Background: Umbilical cord pH is best indicator of fetal hypoxemia. Objectives: To establish relation between cord blood pH and fetal distress, diagnose true fetal distress retrospectively, reduce caesarean section rates. Methods: Prospective study of 30 term women reporting to labour room of department of Obstetrics Gynecology of a rural tertiary care centre of Central India with complaints of labour pains and during labour who developed fetal distress was conducted between April - May 2015. Immediately after delivery, umbilical cord arterial blood sample was collected. Maternal demographic profile, neonatal outcomes in terms of APGAR score, cord pH, immediate ventilation, NICU admissions were recorded. The correlation between non-reassuring fetal hearts, meconium stained liquor and neonatal outcome was analyzed using SPSS version 20. Results: Of 30 cases, 2 (6.67%) women had fetal bradycardia, 13 (43.34%) abnormal non-stress test, 5 (16.67%) meconium stained liquor and 10 (33.34%) fetal bradycardia/tachycardia with meconium stained liquor. Of all delivered babies, 10 (33.34%) had acidosis, with one having severe hypoxemia and acidosis (pH 6.85). Of these, 7 (70%) required NICU admission, one intubated for severe birth asphyxia. Rest 23 (76.67%) were born healthy, cared by mother. Of 13 women having abnormal NST, 10 (76.92%) underwent emergency cesarean section, 3 (23.07%) delivered vaginally. Of these, only 3 (23.07%) babies had acidosis and required NICU admission. All mothers were discharged with their babies healthy. Conclusions: Neither Non-reassuring fetal heart rate, nor thin meconium stained liquor correlate with adverse neonatal outcome. Furthermore NST resulted in unnecessary increased cesarean sections.