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Cord blood sampling

A method for determining birth asphyxia at the moment of delivery

The pH, pCO2 and base excess from the cord arteries provide valuable objective evidence of the metabolic condition of neonates at the moment of delivery, which makes the use of blood gas analysis relevant for the Neonatal Intensive Care Units.

According to the World Health organization there has been a substantial decline, none the less it is estimated that most neonatal death (75%) occur during the first week of life, and in 2019 about 1 million newborns died within the first 24 hours.

Preterm birth, childbirth-related complications (birth asphyxia or lack of breathing at birth), infections and birth defects cuased most neonatel deaths in 2019.

Cord blood analysis is an objective measure of the fetal metabolic condition at the time of delivery. By determining fetal acid-base status, it helps identify infants at risk for neonatal encephalopathy.

What is the clinical relevance of the determination of the acid-base values of the cord blood of the newborn, and what are acceptable values?
How and when should the sample be collected?
Why should you collect a blood sample from both a cord artery and the cord vein?
Which parameters are important to measure: pH, pCO₂, base excess, lactate...?
Should cord blood gas analysis be reserved for selected neonates or should it be applied for all neonates?
What is the value of cord blood gas on record for all neonates in case of litigation?
What do your national guidelines indicate and how do they compare to guidelines around the world?

Get the answers in Chris Higgins’ article ‘Umbilical-cord blood gas analysis’ published on acutecaretesting.org.

Supporting neonatal care

Immediately after birth, cord blood gas testing is performed to determine the acid-base status of the neonate at the moment of delivery in order to detect birth asphyxia. The cord blood gas result can also be used to document quality of care [1] and can prove to be important documentation in case of litigation [2].

Radiometer’s ABL90 FLEX PLUS blood gas analyzer and safePICO arterial blood gas syringes, provides fast and accurate results on critical parameters for the assessment of the neonate.

Proven measuring performance means reliable results

Accurate test results on cord blood samples are critical for making well-informed medical assessments of the neonate’s wellbeing.

The integrated sample mixer on the ABL90 FLEX PLUS analyzer enables fast and standardized mixing of safePICO arterial blood gas syringes. That helps obtain a homogeneous sample and reduce the risk for clots.

Nurse performing a blood gas analysis on the ABL90 FLEX plus from Radiometer

References

1.Perinatal Safety Programme – a quality project in all maternity wards in Denmark] Sikre fødsler – et kvalitetsprojekt på alle fødeafdelinger I Danmark. http://www.regioner.dk/sundhed/kvalitet/patientsikkerhed/sikre+fødsler. Accessed 2014-10-10
2.Boog, G. [Cerebral palsy and perinatal asphyxia (II--Medicolegal implications and prevention)] Asphyxie périnatale et infirmité motrice d'origine cérébrale (II - Implications médico-légales et prévention). Gynecol Obstet Fertil 2011; 39(3): 146-73.

MAPSSS-000423 R2

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