To verify if Apgar score and umbilical cord pH are adequate criteria to predict which infants will develop multiorgan system dysfunction. Methods: This study included all term infants with Apgar scores below 7 at 1 and 5 minutes and umbilical cord blood pH below 7.20, born in Hospital de Clínicas de Porto Alegre from March 1995 to March 1998. Venous umbilical cord blood was collected for blood gas analysis. The infants were divided in two groups: Group A with pH < 7.0, and Group B with pH > 7.0 and < 7.20. Patients were evaluated for the presence of pulmonary hypertension, renal failure, inappropriate secretion of antidiuretic hormone, ischemic cardiopathy, early seizures, and neurologic injury at hospital discharge or at death. Results: Twenty-five infants were included in the study. Group A had 12 infants, and Group B, 13. There were no differences between the groups in respect to mode of delivery, sex, race, and birth weight. Group B had a lower gestational age than Group A. There were significant differences between both groups in mean cord blood pH, pCO2 and BE (P<0.05). There was a positive association between umbilical cord blood pH and Apgar score. Higher occurrence of neurologic injury at hospital discharge in Group A was the only statistically significant clinical manifestation (P<0.05). Conclusion: Apgar score and umbilical cord pH are not adequate criteria to predict multiorgan system dysfunction.
MethodsThis study included all term infants with Apgar scores below 7 at 1 and 5 minutes and umbilical cord blood pH below 7.20, born in Hospital de Clínicas de Porto Alegre from March 1995 to March 1998. Venous umbilical cord blood was collected for blood gas analysis. The infants were divided in two groups: Group A with pH < 7.0, and Group B with pH > 7.0 and < 7.20. Patients were evaluated for the presence of pulmonary hypertension, renal failure, inappropriate secretion of antidiuretic hormone, ischemic cardiopathy, early seizures, and neurologic injury at hospital discharge or at death. Results: Twenty-five infants were included in the study. Group A had 12 infants, and Group B, 13. There were no differences between the groups in respect to mode of delivery, sex, race, and birth weight. Group B had a lower gestational age than Group A. There were significant differences between both groups in mean cord blood pH, pCO2 and BE (P<0.05). There was a positive association between umbilical cord blood pH and Apgar score. Higher occurrence of neurologic injury at hospital discharge in Group A was the only statistically significant clinical manifestation (P<0.05). Conclusion: Apgar score and umbilical cord pH are not adequate criteria to predict multiorgan system dysfunction.
ResultsTwenty-five infants were included in the study. Group A had 12 infants, and Group B, 13. There were no differences between the groups in respect to mode of delivery, sex, race, and birth weight. Group B had a lower gestational age than Group A. There were significant differences between both groups in mean cord blood pH, pCO2 and BE (P<0.05). There was a positive association between umbilical cord blood pH and Apgar score. Higher occurrence of neurologic injury at hospital discharge in Group A was the only statistically significant clinical manifestation (P<0.05). Conclusion: Apgar score and umbilical cord pH are not adequate criteria to predict multiorgan system dysfunction.
ConclusionApgar score and umbilical cord pH are not adequate criteria to predict multiorgan system dysfunction.
Verificar se o escore de Apgar aliado ao pH do sangue de cordão umbilical é suficiente para indicar qual o recém-nascido que desenvolverá comprometimento sistêmico.
MétodosFoi realizado um estudo envolvendo todos os recém-nascidos a termo, com escore de Apgar no 1º e 5º minutos <7 e pH no sangue de cordão umbilical <7,20, nascidos no Hospital de Clínicas de Porto Alegre, no período de março de 1995 a março de 1998. Foram coletadas amostras do sangue de cordão, para realização de gasometria venosa de todos os pacientes. Os recém-nascidos foram separados em dois grupos : Grupo A com pH < 7,0; Grupo B com pH > 7,0 e < 7,20. Foram avaliados quanto à presença de hipertensão pulmonar, insuficiência renal, síndrome da secreção inapropriada de hormônio antidiurético, cardiopatia isquêmica, convulsões precoces, seqüelas neurológicas no momento da alta e óbito.
ResultadosDos 25 recém-nascidos, 12 formaram o Grupo A e 13, o Grupo B. Não houve diferença significativa entre os grupos quanto ao tipo de parto, sexo, cor, e peso de nascimento. A idade gestacional foi menor no grupo B. Houve diferença significativa entre as médias do pH, pCO2 e EB do sangue de cordão dos dois grupos (p<0,05). Houve uma associação positiva entre o pH do sangue cordão umbilical e o escore de Apgar. A única manifestação clínica que apresentou diferença estatisticamente significativa foi a presença maior de seqüelas neurológicas no momento da alta no grupo A (p<0,05).
ConclusãoO escore de Apgar, mesmo aliado ao pH do sangue do cordão, não é adequado para indicar qual o recém-nascido com risco de comprometimento sistêmico.
