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PubMed1989

Correlation of Apgar scores and umbilical artery acid-base status to mortality and morbidity in the low birth weight neonate.

Neonatal mortality, idiopathic respiratory distress syndrome, and early periventricular/intraventricular hemorrhage in the neonate weighing 2000 g or less were correlated with umbilical artery acid-base status. Neonatal mortality and, to a lesser extent, idiopathic respiratory distress syndrome correlated with umbilical artery acidosis. Early periventricular/intraventricular hemorrhage was associated with low Apgar scores, but showed no correlation with umbilical artery acid-base status.

Acidosis↗
PubMed2006

The Apgar score.

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Apgar Score↗
PubMed1990

Apgar score.

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Apgar Score↗
PubMed1981

[Apgar score].

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Apgar Score↗
PubMed2006

Sequential neurological examinations in infants with neonatal encephalopathy and low apgar scores: relationship with brain MRI.

OBJECTIVE: The aims of this study were to (a) describe the evolution of neurological signs after the neonatal period in infants with neonatal encephalopathy and abnormal outcome and (b) to establish the relationship between the evolution of neurological signs and patterns of lesions on brain MRI. PATIENTS: Fifteen children with low Apgar scores, abnormal neurological signs at the end of the neonatal period, and abnormal outcome were examined at 1 - 2 weeks, 5 - 7 weeks, and 6 months. All the infants had at least one MRI scan performed in the neonatal period. RESULTS: All infants had persistent abnormalities on all examinations performed but the severity of neurological impairment was variable and was related to the pattern of brain lesions. Infants with severe basal ganglia and white matter lesions showed abnormal axial and limb tone, movements, and visual function on all the examinations and none achieved independent sitting. In infants with moderate basal ganglia lesions and/or severe white matter changes, visual function and feeding improved by 5 - 7 weeks and were still normal at 6 months while limb tone, which was reduced in the first weeks, appeared to be normal at 5 - 6 weeks but was found to be increased at 6 months; all were able to sit unsupported at 2 years and most of them achieved the ability to walk with support. CONCLUSIONS: Our results suggest that the evolution of the neurological patterns after the neonatal period in infants with persisting neonatal abnormalities depends on their pattern of brain lesions.

Apgar Score↗
PubMed1987

Acid-base evaluation of umbilical cord blood: relation to delivery mode and Apgar scores.

Acid-base status of umbilical artery and vein blood was measured immediately after delivery in 300 cases. A slight acidosis of mixed respiratory/metabolic type was found in newborns delivered following a second stage of 10-30 min duration. After a second stage of more than 30 min the metabolic contribution to the acidosis was predominating. With Apgar scores lower than 10 the pH was found to decrease and carbon dioxide tension to increase. Induction or augmentation of labor by oxytocin did not influence the acid-base status of umbilical cord blood. Delivery by vacuum extraction or low forceps resulted in lower pH and higher carbon dioxide tension in umbilical cord blood, but the changes were associated with the indication for instrumental delivery and not with mode of delivery. A large arterio-venous difference between the acid-base parameters was usually connected to vigorous newborns and a small difference to depressed infants. The carbon dioxide tension was usually increased in newborns with decreased pH, and a close correlation between these parameter was found. No case of acidosis (pH below 7.15) was found in this population at carbon dioxide tensions below 7.2 kPa; at higher Pco2 values only 25% of the newborns were acidotic. A Pco2 level of 7.7 kPa might be used at transcutaneous carbon dioxide monitoring during labor, although the sensitivity and specificity of this parameter will have to be decided in a prospective study.

Acid-Base Equilibrium↗
PubMed1987

Lack of correlation between umbilical artery pH, retinal hemorrhages and Apgar score in the newborn.

Measurement of pH was carried out in blood from the umbilical artery in 100 uncomplicated deliveries immediately after birth. The data were correlated with the results of fundoscopic examination carried out on the same infants within the subsequent 24 h. No relationship could be demonstrated between the grade of retinal hemorrhages and the cord blood pH measurements. Similarly, none of the neonatal birth parameters, including Apgar scores, could be related to individual differences in umbilical blood pH or the incidence or grade of retinal bleedings. The duration of bearing down was significantly and positively correlated (p less than 0.001) to the degree of acidosis in the umbilical blood. It is concluded that the presence of retinal hemorrhages provides little or no information about neonatal wellbeing or the impact of spontaneous birth on the fetus.

Acidosis↗
PubMed1976

Respiratory distress syndrome with mature lecithin/sphingomyelin ratios: diabetes mellitus and low Apgar scores.

A detailed study was made of 150 women delivered of their infants within 72 hours of an amniocentesis where the lecithin/sphingomyelin (L/S) ratio was 2.0 or greater. There were nine neonates with respiratory distress (6.0 per cent). There were two neonatal deaths, both due to severe congenital heart disease. A mature amniotic fluid L/S ratio predicts a newborn infant who will not have respiratory distress syndrome (RDS) in most pregnancies. There is a significantly increased risk of RDS in neonates with a mature L/S ratio if the mother has insulin-dependent diabetes or if there is a resulting low Apgar score. The method of delivery (cesarean section or vaginal) does not affect the frequency of RDS where the L/S ratio is 2.0 or more.

Amniotic Fluid↗