Clinical and laboratory alterations in newborns with a cord arterial PH less or equal to 7.18 Hospital de San José december 2009 to march 2012 Alteraciones clínicas y paraclínicas en recién nacidos con PH arterial de cordón umbilical menor o igual a 7,18 Hospital de San José diciembre 2009 a marzo 2012

Abstract

Modera te neonatal respiratory depression and perinatal asphyxia are uncommon in our setting (2 % at the neonatal unit). Arterial cord pH <7.00 infers a higher risk of multisystem complications, although prognosis is still not clear for pH values between 7.00 and 7.18. Objective: to describe clinical and laboratory alterations in neonates with a score <6 on the one-minute Apgar assessment and cord arterial pH <7.18, between December 2009 and March 2012, at Hospital San José de Bogotá DC. Methodology: a descriptive prospective study on the frequency of multisystem involvement in neonates who met the inclusion criteria. Deaths were also recorded. Results: 52 patients were included, 45 had a pH between 7.11 and 7.18. Liver disorders and elevated lactate dehydrogenase (100%), when measured, were the most common manifestations. Two cases developed encephalopathy (pH 6.96 and 7.13), two presented renal failure (oliguria). Necrotizing enterocolitis was not evidenced. Five babies with a cord pH< 7.00 died during the trial. Conclusions: although a cord pH < 7.00 is considered the best evidence of perinatal asphyxia and constitutes a morbidity and mortality predictor, patients with a pH value between 7.00 and 7.18 require evaluation and monitoring, for they present with multisystem involvement of varied severity including death.