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Arterio-venous blood gas Δvalues for validation of umbilical cord blood samples at birth are biased not only by sample mix ups but also affected by clinical factors.

08:00 EDT 26th September 2018 | BioPortfolio

Summary of "Arterio-venous blood gas Δvalues for validation of umbilical cord blood samples at birth are biased not only by sample mix ups but also affected by clinical factors."

Traditional validation of umbilical cord blood samples with positive veno-arterial (V-A) ΔpH and A-V ΔpCO values confirms the source of samples, where negative Δvalues represent mix-up of samples. To investigate whether this is true, the distributions of V-A ΔpO and A-V Δlactate were also explored and related to clinical characteristics. In addition, different cord blood sampling techniques were evaluated MATERIAL AND
METHODS:
Register study with cord blood acid-base and clinical data from 27 233 newborns. Clinical characteristics were related to positive, zero and negative Δvalues. Blood samplings from unclamped and double-clamped cords were compared. A two-sided p<0.05 was considered significant
RESULTS:
ΔpH and ΔpCO values distributed into positive, around zero, and negative sub-populations, with significant differences in pH and clinical characteristics between sub-populations. No such sub-populations were distinguished for ΔpO and Δlactate. 2.5 and 5 ΔpH percentiles were 0.013 and 0.022 respectively, and for ΔpCO 0.30 and 0.53 kPa. Applying 5 percentile criteria resulted in 3.5% of "approved" cases showing a ΔpO ≤0. Puncture and sampling of the unclamped cord resulted in significantly better sample quality
CONCLUSIONS:
Unphysiological negative ΔpO values occurred despite correct validation with traditional criteria. Δlactate cannot be used for validation because both positive and negative values are physiological. Positive/around zero/negative ΔpH and ΔpCO sub-populations were associated with significant differences in pH and clinical characteristics, indicating that defective sampling and sample handling are not the sole explanations for negative Δvalues. Prompt puncture and sampling of the unclamped cord resulted in best sample quality. This article is protected by copyright. All rights reserved.

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This article was published in the following journal.

Name: Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
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Medical and Biotech [MESH] Definitions

Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery.

Venous vessels in the umbilical cord. They carry oxygenated, nutrient-rich blood from the mother to the FETUS via the PLACENTA. In humans, there is normally one umbilical vein.

Specialized arterial vessels in the umbilical cord. They carry waste and deoxygenated blood from the FETUS to the mother via the PLACENTA. In humans, there are usually two umbilical arteries but sometimes one.

Transplantation of STEM CELLS collected from the fetal blood remaining in the UMBILICAL CORD and the PLACENTA after delivery. Included are the HEMATOPOIETIC STEM CELLS.

Endothelial cells that line venous vessels of the UMBILICAL CORD.

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