• N Wiberg, K Källén, and P Olofsson.
• Department of Obstetrics and Gynecology, Malmö University Hospital, University of Lund, Malmö, Sweden. nana.wiberg@med.lu.se
• BJOG. 2008 May 1;115(6):697-703.

ObjectiveTo estimate the influence of delayed umbilical cord clamping at birth on arterial and venous umbilical cord blood gases, bicarbonate (HCO3-), base excess (BE) and lactate in vigorous newborns.SettingUniversity hospital.DesignProspective observational.SampleVaginally delivered term newborns.Material And MethodsUmbilical cord arterial and venous blood was sampled repeatedly every 45 seconds (T(0)= time zero; T(45)= 45 seconds, T(90)= 90 seconds) until the cord pulsations spontaneously ceased in 66 vigorous singletons with cephalic vaginal delivery at 36-42 weeks. Longitudinal comparisons were performed with the Wilcoxon signed-ranks matched pairs test. Mixed effect models were used to describe the shape of the regression curves.Main Outcome MeasuresLongitudinal changes of umbilical cord blood gases and lactate.ResultsIn arterial cord blood, there were significant decreases of pH (7.24-7.21), HCO3- (18.9-18.1 mmol/l) and BE (-4.85 to -6.14 mmol/l), and significant increases of PaCO(2) (7.64-8.07 kPa), PO(2) (2.30-2.74 kPa) and lactate (5.3-5.9 mmol/l) from T(0) to T(90), with the most pronounced changes at T(0)-T(45). Similar changes occurred in venous blood pH (7.32-7.31), HCO3- (19.54-19.33 mmol/l), BE (-4.93 to -5.19 mmol/l), PaCO(2) (5.69-5.81 kPa) and lactate (5.0-5.3 mmol/l), although the changes were smaller and most pronounced at T(45)-T(90). No significant changes were observed in venous PO(2).ConclusionPersistent cord pulsations and delayed cord clamping at birth result in significantly different measured values of cord blood acid-base parameters.

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