Blood gas analysis of umbilical cord blood and Apgar scale in prognosis of newborns fetal distress

Objective: To evaluate the clinical significance of blood gas analysis of umbilical cord blood,Apgar scale in the diagnosis of fetal distress.Methods: A retrospective study of 220 pregnant women who suffered from fetal distress in the process of delivery in our hospital between October,2009 and January,2011 was performed.Blood gas analysis of umbilical cord blood was carried out immediately after delivery and the outcome of neonates were followed up.Meanwhile,umbilical arterial blood from normal births during the same period were taken and analyzed to make a contrast.Results: The PH value of umbilical cord blood from 76 cases was less than 7.2 in the fetal distress group,which accounted for 34.5%.Of them,23.6% had pure abnormal monitoring fetal heart,43.2% had pure amniotic fluid pollution,and 32.9% had both abnormalities.Analysis showed that the PH value of eight cases was less than 7.2,which accounted for 8%.The difference was statistical significance(P0.05).Cases with pH of umbilical arterial blood less than 7.2 and with higher Apgar score than 7 accounted for 23.6%,while cases with pH lower than 7.2 and Apgar score lower than 7 accounted for 86.8%.There was a significant difference(P0.05) between the two groups.To predict the neonatal morbidity in perinatal period,the positive predictive value of Apgar score was 42.1%,while gas analysis was 26.3%,The positive predictive value of combined indicators was 51.5%.Conclusions: Excessive diagnosis phenomenon with normal blood gas analysis and Apgar score may exist in the clinical diagnosis of fetal distress in the process of delivery.Blood gas analysis of umbilical cord blood and Apgar scale should be combined to evaluate neonatal outcomes,so that the neonatal morbidity rates in the perinatal period can be reduced.