Pathologic fetal acidemia

K. G. Goldaber, L. C. Gilstrap, K. J. Leveno, J. S. Dax, D. D. McIntire

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Abstract

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 < .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.

Original languageEnglish (US)
Pages (from-to)1103-1107
Number of pages5
JournalObstetrics and Gynecology
Volume78
Issue number6
StatePublished - 1991

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Umbilical Arteries
Seizures
Apgar Score
Morbidity
Mortality

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Goldaber, K. G., Gilstrap, L. C., Leveno, K. J., Dax, J. S., & McIntire, D. D. (1991). Pathologic fetal acidemia. Obstetrics and Gynecology, 78(6), 1103-1107.

Pathologic fetal acidemia. / Goldaber, K. G.; Gilstrap, L. C.; Leveno, K. J.; Dax, J. S.; McIntire, D. D.

In: Obstetrics and Gynecology, Vol. 78, No. 6, 1991, p. 1103-1107.

Research output: Contribution to journalArticle

Goldaber, KG, Gilstrap, LC, Leveno, KJ, Dax, JS & McIntire, DD 1991, 'Pathologic fetal acidemia', Obstetrics and Gynecology, vol. 78, no. 6, pp. 1103-1107.
Goldaber KG, Gilstrap LC, Leveno KJ, Dax JS, McIntire DD. Pathologic fetal acidemia. Obstetrics and Gynecology. 1991;78(6):1103-1107.
Goldaber, K. G. ; Gilstrap, L. C. ; Leveno, K. J. ; Dax, J. S. ; McIntire, D. D. / Pathologic fetal acidemia. In: Obstetrics and Gynecology. 1991 ; Vol. 78, No. 6. pp. 1103-1107.
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