Umbilical cord blood gas analysis at the time of delivery

Abstract

Aims: it is now recommended that cord blood acid-base measurement is performed routinely at time of delivery in the UK as a measure of fetal response to labour. However, there remains some uncertainty about the value of this procedure. In this paper our experience of cord blood analysis is described and the literature is reviewed to: (1) provide an overview of the physiological basis of cord blood acid-base assessment; (2) describe the appropriate methodology and identify issues which have contributed to confusion and undermined the value of cord blood sampling; and (3) address the practical issues of cord blood sampling.

Conclusions: cord blood acid-base measurement has a sound physiological basis. It provides objective information which is a useful adjunct to subjective methods of newborn assessment, enables babies at risk of neonatal morbidity to be identified, can be helpful in litigation cases and is a prerequisite for clinical audit. However, to be of benefit the information must be correct and correctly interpreted.