Relationships between umbilical cord arterial blood pH levels at delivery and Bayley Psychomotor Development Index scores in early childhood

2008 ◽  
Vol 36 (4) ◽  
Author(s):  
Robert Mittendorf ◽  
Sung Yun Won ◽  
John G. Gianopoulos ◽  
Peter G. Pryde ◽  
Nancy Roizen
Keyword(s):  
Early Childhood ◽  
Umbilical Cord ◽  
Psychomotor Development ◽  
Development Index ◽  
Psychomotor Development Index ◽  
Arterial Blood ◽  
Blood Ph

Correlation between Intrapartum Cardiotocogram findings and cord blood pH in term and preterm labors

2021 ◽  
Vol 17 ◽  
Author(s):  
Shubha Rao ◽  
Himanshi Jain ◽  
Anjali Suneel ◽  
Roopa Padavagodu Shivananda ◽  
Akhila Vasudeva
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Preterm Labor ◽  
Fetal Monitoring ◽  
Cord Blood Sample ◽  
Arterial Blood ◽  
Blood Ph ◽  
Preterm Group ◽  
Fetal Acidosis

Background: The purpose of intrapartum fetal monitoring by cardiotocograph (CTG) is to identify early signs of developing hypoxia so that appropriate action can be taken to improve the perinatal outcome. Although CTG findings are well known to monitor the progress of the labor due to the paucity of recommendations, there has always been a clinical dilemma as the term fetuses respond differently than a preterm fetus. However, umbilical cord blood pH can distinguish the infant at high risk for asphyxia and related sequel. Therefore, because of differences in fetal physiology in term and preterm fetuses, CTG findings vary, and hence the validity of CTG to determine fetal acidosis should be different. Aims and Objectives: This study aimed to correlate abnormal intrapartum CTG findings with umbilical cord blood pH in term and preterm labor and thus evaluate the success of CTG in predicting fetal acidosis during labor. Methods: The present study included 210 women in labor (70 preterm and 140 term) with abnormal intrapartum CTG that was classified as per 2015 revised International Federation of Gynecologists and Obstetrician (FIGO) guidelines. Immediately after delivery 2 ml Umbilical artery cord blood sample was taken in a pre-heparinized syringe for analysis, pH <=7.2 was taken as acidosis and pH >7.2 was taken as normal. The measured data were maternal general characteristics which included gravida status, associated comorbidities, method of induction and character of liquor, the intrapartum CTG tracings recorded the cord arterial blood pH and the neonatal characteristics such as APGAR score and neonatal outcome. Results: Data from 70 preterm labor was compared with 140 term labor. In this study, 20.9 % of the babies had acidosis. Suspicious CTG due to decreased variability were more common in the preterm group than in the term group (21.4% vs. 8.6% p<0.05). Positive predictive value (PPV) of abnormal CTG for fetal acidosis in the preterm group was found to be higher than that in term group, PPV of pathological CTG being even higher than suspicious CTG. Women with suspicious CTG had 82 % less risk of fetal acidosis as compared to pathological CTG. Women with Bradycardia had 5.9 times the risk of fetal acidosis as compared with normal and tachycardia. Conclusion: Abnormal CTG should be managed appropriately without any delay to prevent acidosis and cord blood pH should be done in all labors with abnormal CTG. However, our findings of a higher incidence of lower cord blood pH and suspicious CTG due to decreased variability alone, highlight the limitation of criteria currently used for interpretation of CTG in preterm labors.

scholarly journals Study of intrapartum fetal distress with the help of cardiotocography and its correlation with umbilical cord blood sampling

2020 ◽  
Vol 9 (4) ◽  
pp. 1580
Author(s):  
S. Neeraja ◽  
Sugathi Parimala ◽  
Naima Fathima
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Risk Groups ◽  
Normal Vaginal Delivery ◽  
Arterial Blood ◽  
Blood Ph ◽  
Fetal Acidosis

Background: Even in low risk mothers, fetal acidosis occurs as in high risk groups. Aim of fetal monitoring is to detect early response to intrauterine hypoxia and prevent irreversible neurological damage and death. Objective of this study was to correlate the intrapartum fetal distress with the help of cardiotocography CTG with umbilical cord blood sampling.Methods: A total 100 consecutive patients attending the labor ward were studied. Immediately at birth, before the baby’s first breath and before delivery of the placenta, the umbilical cord blood was collected as per the standard guidelines laid down in the standard textbooks. Fetal acidosis was assessed by umbilical cord arterial blood pH. Fetal acidosis was considered when umbilical artery pH <7.2. Cardiotocography features were used to clinically diagnose fetal distress.Results: Most of the mothers were multigravida. They belonged to the age group of 20-25 years. Only 18% had abnormal CTG. Out of 50 mothers with normal vaginal delivery, all had normal CTG. Out of 43 mothers who were delivered by LSCS, no one had normal CTG, 25 had indeterminate CTG and 18 had abnormal CTG. As CTG became abnormal, proportion of mothers with the thick meconium increased. NICU admission proportion increased as CTG changed from normal to the abnormal. There was a significant association between the abnormal CTG and the umbilical cord blood pH being acidic.Conclusions: CTG is a simple test, easy to perform and can alert obstetrician for necessary interventions in case of an abnormal CTG. It can detect fetal distress in labor thus helping to reduce neonatal morbidity by early intervention in cases of abnormal tracing.

scholarly journals A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome

2020 ◽  
Vol 8 (2) ◽  
pp. 30-35
Author(s):  
Nutan Singh ◽  
Asheesh Kumar Gupta ◽  
Ajay Kumar Arya
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Outcome ◽  
Outcome Measurement ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Arterial Blood ◽  
Blood Ph

Background: Perinatal asphyxia is one of the major causes of neonatal morbidity & mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia & early neonatal outcome. Subjects and Methods: A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST & there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed & encephalopathy (sarnat & sarnat stage). Results: In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH <7.1 (ROC=0.998) is very significant in predicting the adverse outcome. Conclusion: Cord blood pH is very sensitive and specific & has good correlation in predicting the birth asphyxia & adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.

scholarly journals The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants

2019 ◽  
Vol 57 (1) ◽  
pp. 63-71
Author(s):  
Andrew B Goldstone ◽  
Michael Baiocchi ◽  
David Wypij ◽  
Christian Stopp ◽  
Dean B Andropoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mental Development ◽  
Psychomotor Development ◽  
Absolute Difference ◽  
Systematic Bias ◽  
Development Index ◽  
Mental Development Index ◽  
Neurodevelopmental Disability ◽  
Psychomotor Development Index ◽  
Bayley Scales

Abstract OBJECTIVES Neurodevelopmental disability is the most common complication among congenital heart surgery survivors. The Bayley scales are standardized instruments to assess neurodevelopment. The most recent edition (Bayley Scales of Infant and Toddler Development 3rd Edition, Bayley-III) yields better-than-expected scores in typically developing and high-risk infants than the second edition (Bayley Scales of Infant Development 2nd Edition, BSID-II). We compared BSID-II and Bayley-III scores in infants undergoing cardiac surgery. METHODS We evaluated 2198 infants who underwent operations with cardiopulmonary bypass between 1996 and 2009 at 26 institutions. We used propensity score matching to limit confounding by indication in a subset of patients (n = 705). RESULTS Overall, unadjusted Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores (90.7 ± 17.2 vs 77.6 ± 18.8, P &lt; 0.001), and unadjusted Bayley-III composite cognitive and language scores were higher than BSID-II Mental Development Index scores (92.0 ± 15.4 vs 88.2 ± 16.7, P &lt; 0.001). In the propensity-matched analysis, Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores [absolute difference 14.1, 95% confidence interval (CI) 11.7–17.6; P &lt; 0.001] and the Bayley-III classified fewer children as having severe [odds ratio (OR) 0.24; 95% CI 0.14–0.42] or mild-to-moderate impairment (OR 0.21; 95% CI 0.14–0.32). The composite of Bayley-III cognitive and language scores was higher than BSID-II Mental Development Index scores (absolute difference 4.0, 95% CI 1.4–6.7; P = 0.003), but there was no difference between Bayley editions in the proportion of children classified as having severe cognitive and language impairment. CONCLUSIONS The Bayley-III yielded higher scores than the BSID-II and classified fewer children as severely impaired. The systematic bias towards higher scores with the Bayley-III precludes valid comparisons between early and contemporary cardiac surgery cohorts.

Prolonged Mechanical Ventilation and Intracranial Hemorrhage: Impact on Developmental Progress Through 18 Months in Infants Weighing 1,200 Grams or Less at Birth

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 670-676 ◽  
Author(s):  
Mary Ellen A. Bozynski ◽  
Michael N. Nelson ◽  
Terence A. S. Matalon ◽  
Karen J. O'Donnell ◽  
Patricia M. Naughton ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intracranial Hemorrhage ◽  
Prolonged Mechanical Ventilation ◽  
Psychomotor Development ◽  
Prospective Longitudinal Study ◽  
Development Index ◽  
Psychomotor Development Index ◽  
Developmental Progress ◽  
Main Effect ◽  
Prospective Longitudinal

In this prospective, longitudinal study, the relative impact of intracranial hemorrhage and prolonged mechanical ventilation on developmental progress during the first 18 months of life of infants weighing 1,200 g or less at birth was examined. A total of 159 surviving infants were divided into two groups: infants with and those without intracranial hemorrhage. These groups were then subdivided into groups of infants receiving prolonged mechanical ventilation (&gt; 21 days) and those mechanically ventilated for 21 days or less, thus creating four subgroups. Group 1 (intracranial hemorrhage and prolonged mechanical ventilation) and group 3 (intracranial hemorrhage and no prolonged mechanical ventilation) showed no statistically significant differences for severity of intracranial hemorrhage, persistence of yentriculomegaly, or presence of periventricular leukomalacia. A repeated-measures analysis of variance demonstrated a main effect for prolonged mechanical ventilation on outcome as measured by the Bayley Mental Development Index and Bayley Psychomotor Development Index at 4, 8, 12, and 18 months of age (corrected for prematurity). Forward stepwise regression revealed prolonged mechanical ventilation to be the best predictor of Bayley indexes at all ages except 4 months of age, for which the Psychomotor Development Index was best predicted by length of hospitalization. No main effect for intracranial hemorrhage was demonstrated, but the motor performance of infants with intracranial hemorrhage declined significantly with age. By contrast prolonged mechanical ventilation was associated with uniformly poor performance at every age and serves as a powerful marker for poor developmental progress during the first 18 months of life in infants weighing 1,200 g or less at birth.

The Kent Infant Development Scale: Concurrent and Predictive Validity of a Modified Administration

1987 ◽  
Vol 60 (3) ◽  
pp. 887-894 ◽  
Author(s):  
Mary Morrow-Tlucak ◽  
Claire B. Ernhart ◽  
Cherie L. Liddle
Keyword(s):  
Predictive Validity ◽  
Infant Development ◽  
Predictive Ability ◽  
Psychomotor Development ◽  
Intelligence Scale ◽  
Development Index ◽  
Mental Development Index ◽  
Psychomotor Development Index ◽  
A Prospective Study ◽  
Bayley Scales

A modified administration of the Kent Infant Development Scale for infants 6 to 8 mo. old was used in a prospective study of risk factors in infant development. The Mental Development Index and Psychomotor Development Index of the Bayley Scales of Infant Development were also administered at 6 mo., the Mental Index only at 1 and 2 yr. and the Stanford-Binet Intelligence Scale at age 3. The modified administration is described. Concurrent validity with the 6-mo. Bayley scales was substantial. Adequate predictive validity for 1- and 2-yr. Bayley scores and 3-yr. Stanford-Binet IQ was achieved with the Kent as compared to the predictive ability of the 6-mo. Bayley index.

scholarly journals Bronchopulmonary dysplasia as a predictor factor for motor alteration at 6 months corrected age in premature infants

2010 ◽  
Vol 68 (5) ◽  
pp. 749-754 ◽  
Author(s):  
Priscila Silveira Martins ◽  
Rosane Reis de Mello ◽  
Kátia Silveira da Silva
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Neurological Examination ◽  
Infant Development ◽  
Very Low Birth Weight ◽  
Psychomotor Development ◽  
Predisposing Factor ◽  
Development Index ◽  
Psychomotor Development Index ◽  
Confounding Variables

OBJECTIVE: The study aimed to assess bronchopulmonary dysplasia (BPD) as a predisposing factor for alteration in the psychomotor development index (PDI) in premature infants and verify the incidence of neuromotor alterations at 6 months corrected age. METHOD: This was a prospective cohort study that followed the neuromotor development of 152 very low birth weight premature infants, with psychomotor development index as the outcome. The study used the Bayley Scale of Infant Development at 6 months corrected age, and neurological examination. RESULTS: Incidence of BPD was 13.2% (n=20). Logistic regression analysis showed an association between BPD and altered psychomotor development index (OR 3.98; 95%CI: 1.04-15.1) after adjusting for confounding variables. Neurological examination was altered in 67.1% of the 152 infants. CONCLUSION: Bronchopulmonary dysplasia acted as an independent predisposing factor for alteration in the psychomotor development index in premature infants at 6 months corrected age.

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