The case for routine umbilical blood acid-base studies at delivery

Article Abstract:

Fetal asphyxia occurs when the oxygen supply to the fetus is compromised. The Apgar score, an index of fetal well-being performed at one and five minutes after birth, is a quick way to detect fetal depression. An abnormal fetal heart rate and the presence of meconium (first fetal stool) in the amniotic fluid are signs of fetal asphyxia. However, a low score, meconium staining and abnormal fetal heart tracings may occur in the absence of fetal asphyxia. Since treatment is dependent on the cause of the abnormal results, a correct diagnosis is essential. A sample of the fetus's blood obtained from the umbilical cord at birth is the only accurate method for detecting fetal asphyxia. An inadequate oxygen supply upsets the acid-base (pH) balance of the blood. The degree of acidity in the blood accurately reflects the status of fetal tissue and determines fetal asphyxia. It is argued that umbilical cord sampling is easily obtained in the delivery room, with results available within 20 minutes. Obtaining these results may be useful in some malpractice cases. Although the cost-effectiveness of routine acid-base determinants has yet to be determined, it is an effective diagnostic tool that can aide therapeutic decisions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Testing, Complications and side effects, Physiological aspects, Infants (Newborn), Newborn infants, Fetal blood, Acidosis, Asphyxia, Acid-base imbalances, Acid-base imbalance, Labor, Complicated, Labor complications

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Pregnancy outcome for women with very low levels of maternal serum unconjugated estriol on second-trimester screening

Article Abstract:

Pregnant women who experience a low blood level of unconjugated estriol in the second trimester may be at risk for the death of fetuses before birth and for placental sulfatase deficiency. Unconjugated estriol levels are tested, along with the levels of two other substances, in the blood of pregnant women to detect fetuses with birth defects. Researchers found that 62 women out of 44,146 women tested had very low unconjugated estriol levels. Fetal death occurred in 23 (37.1%) of the patients, including six deaths that followed normal prenatal visits. Of 18 women with very low unconjugated estriol levels for which there was no explanation, 16 gave birth to boys. Male infants are predisposed to X chromosome-linked abnormalities.

Measurement, Estrogen, Estrogens, Urine, Urinalysis

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The millennial mark

Article Abstract:

The president of the South Atlantic Association of Obstetricians and Gynecologists examines the health of Americans since 1900. Topics include maternal and infant mortality, teenage pregnancy, assisted reproductive technology, infectious diseases such as HIV infection and AIDS, and breast cancer.

United States, Public health, 20th century AD

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