Arteriovenous Cord Blood pH Discordancy in a High-Risk Population and Its Clinical Significance

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Abstract
Five hundred and twenty patients with gestational ages between 24 and 42 weeks who had both umbilical cord venous (V) and arterial (A) gases recorded were studied retrospectively to 1) establish the normal range of pH difference between V and A umbilical cord blood (DLpH) throughout gestation, and 2) investigate the clinical significance of discordancy in pH. The mean V pH was 7.33 and the mean A pH was 7.28. The mean DLpH was 0.06 (90th percentile 0.12) and it was not gestational age dependent. Fifty-three neonates were pH discordant (DLpH > 0.12). Analysis of the remaining V and A gases suggested a placental compensatory mechanism which allows more efficient gas exchange in cases of pH discordancy. Vaginal delivery in the presence of normal placental reserve is the most likely cause of DLpH discordancy.

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