What is fetal metabolic acidemia?
As mentioned earlier, fetal metabolic acidosis most frequently occurs when abnormal uteroplacental function or blood flow results in fetal hypoxemia. Fetal hypoxemia then causes a shift to anaerobic metabolism and large quantities of lactic acid accumulate.
What causes fetal acidemia?
Maternal causes of chronic fetal acidosis include reduced oxygenation of maternal blood, such as in severe respiratory or cardiac disease, or reduced blood flow to the placenta as in connective tissue diseases—for example, systemic lupus erythematosus—and pre-eclampsia.
What do cord gases mean?
Cord blood gas analysis is an objective measure of the fetal metabolic condition at the time of delivery. By determining fetal acid-base status, it helps identify infants at risk for neonatal encephalopathy. Pathological acidosis reflects significant fetal distress due to hypoxic stress.
What does low cord pH mean?
pH. A low arterial cord pH is probably the single most important value used to determine if hypoxia near the time of delivery was severe enough to cause hypoxic-ischemic encephalopathy (HIE). If pH is low, the medical team should be alert to the fact that the baby may have HIE or other forms of brain damage.
What is metabolic acidemia newborn?
Introduction. Neonatal metabolic acidosis (NMA) is the accumulation of non-carbonic acid equivalents, which arises from excessive production or inadequate excretion of hydrogen ions or from an increased loss of bicarbonate (1).
What is late metabolic acidosis of newborn?
The term “late metabolic acidosis” is generally used to define a population of apparently health LBW infants who fail to grow and have a base deficit in excess of 5 mEq/l (CO2TOT<21 mM). A relationship between hypobasemia and the lack of appropriate growth was postulated.
What pH is fetal acidosis?
A capillary-blood pH value below 7.20 indicates a pathological fetal acidosis, and the fetus should be delivered immediately.
What is a normal cord gas?
Normal arterial blood cord gases values in a full-term newborn: Mean pH: 7.28 ± 0.07. Mean PCO2 (carbon dioxide): 49.9 ± 14.2 (mmHg) Mean PO2 (oxygen): 23.7 ± 10.0 (mmol/L) Mean base deficit: -3.6 ± 2.8 (mmol/L)
What is a normal cord pH?
The reference range for arterial cord blood pH is 7.12-7.35, and for arterial cord BD it is +9.3 to –1.5 mmol/L. In obstetrics, significant metabolic acidosis is often defined as cord arterial blood pH <7.0 and BD >12.0 mmol/L. Some institutions have adopted a higher pH threshold of <7.1.
How is metabolic acidosis treated in children?
Tromethamine (also called THAM or tris [hydroxymethyl]-aminomethane) is a buffer that can be used to treat acidosis when concerns exist regarding carbon dioxide accumulation from the metabolism of administered sodium bicarbonate. THAM increases serum bicarbonate predictably: THAM + H2 CO3 → THAM-H + HCO.
Which conditions can cause metabolic acidosis?
It can be caused by:
- Cancer.
- Carbon monoxide poisoning.
- Drinking too much alcohol.
- Exercising vigorously for a very long time.
- Liver failure.
- Low blood sugar (hypoglycemia)
- Medicines, such as salicylates, metformin, anti-retrovirals.
- MELAS (a very rare genetic mitochondrial disorder that affects energy production)