TY - JOUR
T1 - Reference values for strong ion difference-A novel tool for fetal metabolic assessment
AU - Cohen, Yoni
AU - Nimord, Adi
AU - Ascher-Landsberg, Jessica
AU - Kupferminc, Michael J.
AU - Lessing, Joseph B.
AU - Many, Ariel
PY - 2009/8
Y1 - 2009/8
N2 - Objectives: The aim of this pilot study was to establish reference values for strong ion difference (SID) in umbilical cord blood and investigate the feasibility of evaluating fetal metabolism according to the comprehensive approach to acid-base abnormalities, based on Stewart's physiochemical theory. Study design: A prospective observational study. Women who underwent an elective cesarean section at term (n = 40) were compared to women who completed a normal spontaneous delivery at term (n = 40). The primary outcome was the establishment of normal values for SID in the umbilical cord vein. We also compared acid-base variables in the umbilical vein between the groups. Results: The apparent SID in the umbilical vein was 34.61 ± 3.92 mequiv./L after normal delivery and 35.98 ± 2.56 mequiv./L after elective cesarean section (the effective SID is 37.43 ± 1.93 and 38.29 ± 2.38 mequiv./L, respectively). The pH values were similar in both groups, but the pCO 2 was significantly higher and the plasma principal weak acids (albumin and phosphate) were significantly lower after cesarean sections. Conclusions: SID enables a comprehensive approach to acid-base abnormalities in the neonate, making it a potential additional tool for evaluating fetal acid-base status.
AB - Objectives: The aim of this pilot study was to establish reference values for strong ion difference (SID) in umbilical cord blood and investigate the feasibility of evaluating fetal metabolism according to the comprehensive approach to acid-base abnormalities, based on Stewart's physiochemical theory. Study design: A prospective observational study. Women who underwent an elective cesarean section at term (n = 40) were compared to women who completed a normal spontaneous delivery at term (n = 40). The primary outcome was the establishment of normal values for SID in the umbilical cord vein. We also compared acid-base variables in the umbilical vein between the groups. Results: The apparent SID in the umbilical vein was 34.61 ± 3.92 mequiv./L after normal delivery and 35.98 ± 2.56 mequiv./L after elective cesarean section (the effective SID is 37.43 ± 1.93 and 38.29 ± 2.38 mequiv./L, respectively). The pH values were similar in both groups, but the pCO 2 was significantly higher and the plasma principal weak acids (albumin and phosphate) were significantly lower after cesarean sections. Conclusions: SID enables a comprehensive approach to acid-base abnormalities in the neonate, making it a potential additional tool for evaluating fetal acid-base status.
KW - Acidosis
KW - Blood gas
KW - Fetal metabolism
KW - Strong ion difference
KW - Umbilical cord
UR - http://www.scopus.com/inward/record.url?scp=67650087523&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2009.04.021
DO - 10.1016/j.ejogrb.2009.04.021
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AN - SCOPUS:67650087523
SN - 0301-2115
VL - 145
SP - 145
EP - 148
JO - European Journal of Obstetrics and Gynecology and Reproductive Biology
JF - European Journal of Obstetrics and Gynecology and Reproductive Biology
IS - 2
ER -