Role of umbilical cord arterial pH and lactate in newborn assessment of term antenatal women with hypertensive disorders of pregnancy

Problem To know role of cord arterial blood pH and lactate dehydrogenase levels in neonatal outcome assessment. Methods Present observational study was conducted in Obstetrics and Gynecology department of a rural tertiary center of Northern India over 6 months (July–January 2019) on 155 term (≥37-≤42 weeks) antenatal women with hypertensive disorders of pregnancy fulfilling inclusion criteria. Immediately after delivery, arterial blood sample was drawn from doubly clamped 10–12 cm long umbilical cord in pre-heparinized insulin syringe, which was sent for pH estimation and 0.5 ml in lithium heparin tube for lactate dehydrogenase levels. One- and 5-min neonatal Apgar score was noted by pediatrician. Cord blood pH and lactate levels were then compared with overall neonatal outcome. Statistical analysis was done using SPSS-22 version. Results Mean values of umbilical cord arterial pH and LDH was 7.2 ± 0.1 and 449.5 ± 562.9 U/L respectively. Significantly low mean cord blood pH (7.03 ± 0.12) and high LDH levels (939.74 ± 781.75 U/L) were observed in neonates of eclamptic mothers (p = 0.00). Mode of delivery had significant effects on cord blood parameters with significantly low pH and elevated LDH levels seen in neonates delivered by emergency LSCS for fetal distress (p < 0.05). Cord blood LDH levels were more significantly associated with NICU admission, neonatal morbidity and mortality. Cord blood LDH was a better predictor of neonatal outcome with 100% sensitivity and 79.73% specificity. Conclusion Cord arterial blood lactate dehydrogenase levels were better predictor of overall neonatal outcome.