[CG] Umbilical Cord Sampling for pH at Delivery
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At delivery cord samples should be obtained from:
- All babies with a suspicious or pathological CTG in labour
- All babies who had FBS in labour (regardless of the result)
- All babies with significant meconium in labour
- All babies born with Apgar <5 at 1 minute and/or <7 at 5 minutes
- All vaginal breech deliveries
- All cases of shoulder dystocia
- All cases with intrapartum fever >38°C
- All babies with a birth weight < 10th centile
- All preterm babies (24 – 36+6 weeks)
|When taking a cord sample:|
- Double clamp a section of the cord.
- Two heparinised syringes should be used to take the sample.
- Sample the umbilical vein and artery and identify each.
Importance of paired samples
- Arterial blood better represents the condition of the fetus
- A venous sample is less representative of the fetus
- Single result gives no means of checking whether your sample was arterial or venous
- A venous result may give additional information
- A normal venous result does not rule out acidaemia
- Normally expect a difference of at least 0.03 units between arterial and Venous pH readings
- Sampling should be completed as soon as possible after delivery but always within 30 minutes. If a delay is suspected store the clamped cord in the fridge.
- Should the analyser on labour ward be unavailable, there is another analyser available in the Neonatal Unit.
- Document as to whether there was delayed cord clamping and its duration.
- The result should be inserted onto Badger in the appropriate section (the Postnatal tab).
- The responsibility for obtaining the sample and documenting the result lies with the person delivering the woman.