000			03543nam a22005657a 4500
008			191010s20192019 xxu||||| |||| 00| 0 eng d
022			_a0172-0643
024			_a10.1007/s00246-019-02189-x [doi]
024			_a10.1007/s00246-019-02189-x [pii]
040			_aOvid MEDLINE(R)
099			_a31471626
245			_aUmbilical Cord Blood Gas in Newborns with Prenatal Diagnosis of Congenital Heart Disease: Insight into In-Utero and Delivery Hemodynamics.
251			_aPediatric Cardiology. 40(8):1575-1583, 2019 Dec.
252			_aPediatr Cardiol. 40(8):1575-1583, 2019 Dec.
252			_zPediatr Cardiol. 2019 Aug 30
253			_aPediatric cardiology
260			_c2019
260			_fFY2020
265			_saheadofprint
265			_sppublish
266			_d2019-10-10
268			_aPediatric Cardiology. 2019 Aug 30
501			_aAvailable online from MWHC library: 1997 - present
520			_aThe primary objective was to determine if newborns with congenital heart disease (CHD) are at a higher risk for acidosis at delivery as determined by cord blood gas analysis. The secondary objective was to determine whether specific fetal cardiac diagnosis, delivery method, or duration of labor is associated with an increased risk for acidosis. This was a retrospective study of newborns with CHD diagnosed prenatally and comparable patients without a CHD diagnosis. Study participants included 134 CHD-affected newborns and 134 controls. Median UA pH in CHD newborns was 7.22 (CI 7.2-7.4) and in controls it was 7.22 (CI 7.21-7.24), p = 0.91. There was no difference in median UA pH comparing newborns with single-ventricle CHD and two-ventricle CHD [7.23 (CI 7.2-7.26) vs. 7.22 (CI 7.22-7.24), p = 0.77], or newborns with CHD with aortic obstruction and those without aortic obstruction [7.23 (CI 7.21-7.26) vs. 7.22 (CI 7.2-7.24), p = 0.29]. After controlling for delivery method and duration of labor, CHD patients who underwent a spontaneous vaginal delivery were found to have a declining median UA pH as labor progressed. Our results show that newborns with CHD have a normal UA pH at delivery suggesting a compensated circulation in utero. Spontaneous vaginal delivery with a progressively longer duration of labor in CHD newborns was associated with lower UA pH. This suggests that fetuses with CHD may be at risk for hemodynamic instability at birth with a longer duration of labor as a potentially modifiable factor to improve outcome.
546			_aEnglish
650			_a*Delivery, Obstetric/sn [Statistics & Numerical Data]
650			_a*Fetal Blood/ch [Chemistry]
650			_a*Obstetric Labor Complications/ep [Epidemiology]
650			_aAdult
650			_aBlood Gas Analysis
650			_aCase-Control Studies
650			_aDelivery, Obstetric/ae [Adverse Effects]
650			_aFemale
650			_aHeart Defects, Congenital/di [Diagnosis]
650			_aHumans
650			_aInfant, Newborn
650			_aMale
650			_aPregnancy
650			_aPrenatal Diagnosis
650			_aRetrospective Studies
650			_aUmbilical Cord
651			_aMedStar Washington Hospital Center
656			_aObstetrics and Gynecology/Maternal-Fetal Medicine
657			_aJournal Article
700			_aAdams, April D
700			_aIqbal, Sara N
790			_aAdams AD, Aggarwal N, Donofrio MT, Iqbal SN, McCarter R, Skurow-Todd K, Tague L
856			_uhttps://dx.doi.org/10.1007/s00246-019-02189-x _zhttps://dx.doi.org/10.1007/s00246-019-02189-x
942			_cART _dArticle
999			_c4603 _d4603