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Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations

Wiberg, Nana LU ; Källén, Karin LU and Olofsson, Per LU (2008) In BJOG: An International Journal of Obstetrics & Gynaecology 115(6). p.697-703
Abstract
BJECTIVE: To estimate the influence of delayed umbilical cord clamping at birth on arterial and venous umbilical cord blood gases, bicarbonate (HCO3-), base excess (BE) and lactate in vigorous newborns. SETTING: University hospital. DESIGN: Prospective observational. SAMPLE: Vaginally delivered term newborns. MATERIAL AND METHODS: Umbilical cord arterial and venous blood was sampled repeatedly every 45 seconds (T(0)= time zero; T(45)= 45 seconds, T(90)= 90 seconds) until the cord pulsations spontaneously ceased in 66 vigorous singletons with cephalic vaginal delivery at 36-42 weeks. Longitudinal comparisons were performed with the Wilcoxon signed-ranks matched pairs test. Mixed effect models were used to describe the shape of the... (More)
BJECTIVE: To estimate the influence of delayed umbilical cord clamping at birth on arterial and venous umbilical cord blood gases, bicarbonate (HCO3-), base excess (BE) and lactate in vigorous newborns. SETTING: University hospital. DESIGN: Prospective observational. SAMPLE: Vaginally delivered term newborns. MATERIAL AND METHODS: Umbilical cord arterial and venous blood was sampled repeatedly every 45 seconds (T(0)= time zero; T(45)= 45 seconds, T(90)= 90 seconds) until the cord pulsations spontaneously ceased in 66 vigorous singletons with cephalic vaginal delivery at 36-42 weeks. Longitudinal comparisons were performed with the Wilcoxon signed-ranks matched pairs test. Mixed effect models were used to describe the shape of the regression curves. MAIN OUTCOME MEASURES: Longitudinal changes of umbilical cord blood gases and lactate. RESULTS: In arterial cord blood, there were significant decreases of pH (7.24-7.21), HCO3- (18.9-18.1 mmol/l) and BE (-4.85 to -6.14 mmol/l), and significant increases of PaCO(2) (7.64-8.07 kPa), PO(2) (2.30-2.74 kPa) and lactate (5.3-5.9 mmol/l) from T(0) to T(90), with the most pronounced changes at T(0)-T(45). Similar changes occurred in venous blood pH (7.32-7.31), HCO3- (19.54-19.33 mmol/l), BE (-4.93 to -5.19 mmol/l), PaCO(2) (5.69-5.81 kPa) and lactate (5.0-5.3 mmol/l), although the changes were smaller and most pronounced at T(45)-T(90). No significant changes were observed in venous PO(2). CONCLUSION: Persistent cord pulsations and delayed cord clamping at birth result in significantly different measured values of cord blood acid-base parameters. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BJOG: An International Journal of Obstetrics & Gynaecology
volume
115
issue
6
pages
697 - 703
publisher
Wiley-Blackwell
external identifiers
  • wos:000254856300004
  • scopus:41949131040
ISSN
1471-0528
DOI
10.1111/j.1471-0528.2008.01708.x
language
English
LU publication?
yes
id
77fc728c-8358-488a-8470-d7ea8b3ef9e1 (old id 1146873)
date added to LUP
2008-08-27 14:06:58
date last changed
2017-10-22 04:26:24
@article{77fc728c-8358-488a-8470-d7ea8b3ef9e1,
  abstract     = {BJECTIVE: To estimate the influence of delayed umbilical cord clamping at birth on arterial and venous umbilical cord blood gases, bicarbonate (HCO3-), base excess (BE) and lactate in vigorous newborns. SETTING: University hospital. DESIGN: Prospective observational. SAMPLE: Vaginally delivered term newborns. MATERIAL AND METHODS: Umbilical cord arterial and venous blood was sampled repeatedly every 45 seconds (T(0)= time zero; T(45)= 45 seconds, T(90)= 90 seconds) until the cord pulsations spontaneously ceased in 66 vigorous singletons with cephalic vaginal delivery at 36-42 weeks. Longitudinal comparisons were performed with the Wilcoxon signed-ranks matched pairs test. Mixed effect models were used to describe the shape of the regression curves. MAIN OUTCOME MEASURES: Longitudinal changes of umbilical cord blood gases and lactate. RESULTS: In arterial cord blood, there were significant decreases of pH (7.24-7.21), HCO3- (18.9-18.1 mmol/l) and BE (-4.85 to -6.14 mmol/l), and significant increases of PaCO(2) (7.64-8.07 kPa), PO(2) (2.30-2.74 kPa) and lactate (5.3-5.9 mmol/l) from T(0) to T(90), with the most pronounced changes at T(0)-T(45). Similar changes occurred in venous blood pH (7.32-7.31), HCO3- (19.54-19.33 mmol/l), BE (-4.93 to -5.19 mmol/l), PaCO(2) (5.69-5.81 kPa) and lactate (5.0-5.3 mmol/l), although the changes were smaller and most pronounced at T(45)-T(90). No significant changes were observed in venous PO(2). CONCLUSION: Persistent cord pulsations and delayed cord clamping at birth result in significantly different measured values of cord blood acid-base parameters.},
  author       = {Wiberg, Nana and Källén, Karin and Olofsson, Per},
  issn         = {1471-0528},
  language     = {eng},
  number       = {6},
  pages        = {697--703},
  publisher    = {Wiley-Blackwell},
  series       = {BJOG: An International Journal of Obstetrics & Gynaecology},
  title        = {Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations},
  url          = {http://dx.doi.org/10.1111/j.1471-0528.2008.01708.x},
  volume       = {115},
  year         = {2008},
}