Abstract
Objectives
The aim of this pilot study was to establish reference values for strong ion difference
(SID) in umbilical cord blood and investigate the feasibility of evaluating fetal
metabolism according to the comprehensive approach to acid–base abnormalities, based
on Stewart's physiochemical theory.
Study design
A prospective observational study. Women who underwent an elective cesarean section
at term (n = 40) were compared to women who completed a normal spontaneous delivery at term (n = 40). The primary outcome was the establishment of normal values for SID in the umbilical
cord vein. We also compared acid–base variables in the umbilical vein between the
groups.
Results
The apparent SID in the umbilical vein was 34.61 ± 3.92 mequiv./L after normal delivery and 35.98 ± 2.56 mequiv./L after elective cesarean section (the effective SID is 37.43 ± 1.93 and 38.29 ± 2.38 mequiv./L, respectively). The pH values were similar in both groups, but the pCO2 was significantly higher and the plasma principal weak acids (albumin and phosphate)
were significantly lower after cesarean sections.
Conclusions
SID enables a comprehensive approach to acid–base abnormalities in the neonate, making
it a potential additional tool for evaluating fetal acid–base status.
Keywords
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Article info
Publication history
Published online: May 08, 2009
Accepted:
April 20,
2009
Received in revised form:
March 27,
2009
Received:
December 20,
2008
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
