Clinical Application Of Neonatal Umbilical Cord Blood Gas Analysis In The Prognosis Of Fetal Distress

Objective:To explore the diagnostic specificity of neonatal umbilical cord blood gas analysis in fetal distress,and to provide theoretical basis for neonatal rescue,so as to reduce neonatal mortality and the incidence of cerebral palsy.Methods:A retrospective analysis of large samples was carried out.Among 5862pregnant women who delivered in the obstetric department of Affiliated Hospital of Hubei University for Nationalities from May 2012 to December 2018,100 prenatal patients diagnosed as acute fetal distress were randomly selected as observation group1,100 prenatal patients diagnosed as chronic fetal distress were randomly selected as observation group 2,and 100 single and non-fetal distress cases were randomly selected as observation group 2.The pregnant women were divided into the control group,and there was no significant difference in the age of the pregnant women,the number of pregnancies and births,the gestational weeks at delivery and the sex of the fetus among the three groups.The umbilical artery blood samples were taken before the establishment of spontaneous breathing in all three groups,and the Apgar scores of 1 minute,5 minute and 10 minute after birth were measured.The umbilical artery blood gas analysis values and Apgar scores of the three groups were recorded and analyzed statistically.Results:1.The proportion of neonatal distress in control group and fetal distress group was 2.00%and 20.50%respectively.Logistic regression analysis showed that fetal distress was a risk factor for neonatal asphyxia?OR=12.29,P=0.001?,and the difference between the control group and the fetal distress group was statistically significant?P<0.05?.2.The normal range of pH value of neonatal umbilical artery blood gas analysis in Enshi Tujia and Miao Autonomous Prefecture fluctuates from 7.16 to 7.39,the normal range of BE fluctuates from 8.25 to 1.67 mmol/L,and the normal range of HCO ₃^-fluctuates from 15.60 to 30.70 mEq/L.3.The specificity and sensitivity of umbilical artery blood gas analysis for neonatal asphyxia were 251/257*100%=97.7%and 35/43*100%=81.40%.The specificity and sensitivity of Apgar score for neonatal asphyxia were 250/257*100%=97.3%and 30/43*100%=69.77%.4.The rates of neonatal asphyxia in chronic fetal distress group and acute fetal distress group were 28.00%and 13.00%.The difference between the two groups was p=0.009,with statistical significance?P<0.05?.5.There were 10 cases of neonatal mild asphyxia in chronic fetal distress group,18 cases of neonatal severe asphyxia,11 cases of neonatal mild asphyxia in acute fetal distress group,2 cases of neonatal severe asphyxia,?² value was 8.497,P=0.004.There was statistical significance between observation group 1 and observation group2 in the degree of asphyxia?P<0.05?.6.Comparing the neonatal blood gas analysis indexes of observation group 1,observation group 2 and control group,it was found that there was a statistical difference in the pH value level among the three groups?P=0.0005?;comparing the two groups,it was found that the pH value level of the chronic fetal distress group?P<0.0001?was lower than that of the control group,while there was no significant difference between the other two groups.There was significant difference in BE value level among the three groups?P<0.0001?;the comparison between the two groups showed that BE value level in chronic fetal distress group?P=0.002?was lower than that in control group and acute fetal distress group?P<0.0001?,but there was no significant difference in BE value level between control group and acute fetal distress group?P=1.000?.In addition,there was no significant difference in PCO₂ and PO₂among the three groups?all P>0.05?.Conclusion:1.Fetal distress is a high risk factor for neonatal asphyxia.The risk of neonatal asphyxia in the fetal distress group is 12.29 times higher than that in the control group.2.Normal umbilical artery blood gas analysis indicators of neonates in Enshi Tujia and Miao Autonomous Prefecture are consistent with those reported in domestic guidelines,so there is no regional difference in umbilical cord blood gas analysis indicators of neonates among ethnic minorities.3.Compared with Apgar score alone,umbilical artery blood gas analysis has higher sensitivity and specificity in the diagnosis of neonatal asphyxia.Therefore,umbilical artery blood gas analysis is recommended for routine diagnosis of neonatal asphyxia.4.The proportion of neonatal asphyxia in the chronic fetal distress group was higher than that in the acute fetal distress group.It is suggested that the clinical treatment of chronic fetal distress should be better prepared for neonatal treatment.5.The proportion of severe neonatal asphyxia caused by chronic fetal distress is significantly higher than that of acute fetal distress group,which has a greater impact on the prognosis.Therefore,we must pay attention to cord blood gas index for newborns with a history of chronic fetal distress,and observe it in neonatal department when necessary.6.The levels of pH value and BE value in the chronic fetal distress group were lower than those in the control group,but there was no significant difference between the acute fetal distress group and the control group in terms of pH value and BE value.It suggested that acidosis was more likely in the chronic fetal distress group,but there was no significant difference in the prognosis between the acute fetal distress group and the normal non-fetal distress group if the etiology was corrected as soon as possible and the pregnancy terminated as possible.There was no significant difference in PCO₂ and PO₂ among the three groups.