Implementing umbilical cord blood gas analysis

Umbilical cord acid-base analysis is the most objective assessment of the acid-base status at birth. Metabolic acidosis in the umbilical cord artery has been accepted as an essential criterion defining intrapartum hypoxia. We designed a protocol for implementation of umbilical cord acid-base analysis at the delivery room and established a training period lasting 21 days. The blood samples were obtained after immediate double clamping by the professional responsible for delivery. There were 125 births during the considered period and 80 pairs of samples were collected (64%). We had 53.75% of valid samples according to the criteria established initially in our protocol and 67.5% after revision of validation criteria according to Kro G group. Most reported problems were arterial blood sampling and sample identification. Our result was far from the objective (75%) and we promote a new period of training.