|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: cord pH and "birth asphyxia"From: Danny Tucker (danny.tucker@dial.pipex.com)Wed Aug 28 11:07:05 1996
In article <199608280147.VAA07051@itchy.mindspring.com>, robert Modugno <robgyn@mindspring.com> writes
>Do any of you out there in cyberspace have any thoughts regarding the Was there anything else to suggest that the damage was antecedent to labour, eg prematurity, IUGR, decreased variability on the admission CTG or reduced amniotic fluid volume with thick meconium? A 10-minute Apgar of 3 is obviously worrying. Nelson [1] looked at the association of Apgars & long term neurological outcome. 18% of babies (>2500g) with this died within 1 year, and 4.7% of survivors had cerebral palsy. Apgars alone are obviously a poor predictor of outcome and the presence of Sarnat Grade 2/3 HIE is more indicative of a perinatal insult, though this of course doesn't mean that it was preventable, especially if faced with a terminal bradycardia. There is evidence that babies with low Apgar scores and severe acidaemia have a better outcome than those with low scores and no acidaemia, suggesting that the origin of the damage was antenatal and the fetus was unable to mount an appropriate response to hypoxic insult [2,3,4]. Also take a look at the report of Menticoglou et al [5], who presents a couple of cases not dissimilar to yours. The presence of the normal cord pH should reassure you, I think. The reason I have these ref's to hand is that only last week I delivered a baby in the 2nd stage following a prolonged bradycardia with pH 6.80. The mother was a long-term abuser of amphetamines, opiates, cannabis & alcohol. This babe was depressed at birth also, but has not developed signs of HIE. I feel sure that in my case the antenatal insults rendered this baby, maybe not neurologically damaged prior to labour but certainly short on metabolic reserve. Regards, Danny ---------------------------------------------- Dr Danny Tucker ---------------------------------------------- Senior SHO -- ---------------------------------------------- Obstetrics & Gynaecology Derby City General Hospital, UK danny.tucker@dial.pipex.com ----------------------------------------------
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 05:17:05 2009 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.