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Umbilical Cord Blood Gases Level and Birth Injury

One of the ways that any lawyer can screen a potential birth injury case prior to referring it to a birth injury specialist, is to evaluate the lab report for the baby's cord blood gases.

The term “Cord Blood Gases" refers to the analysis of the oxygen and carbon dioxide in the blood from the baby’s umbilical cord. This gives a snapshot of the oxygenation status of the baby in the moments before birth. It can tell you whether the baby was being asphyxiated at that time and gives clues as to how long that condition existed.

The umbilical cord has venous blood as well as arterial blood. The report should have values for both. If not, one cannot assure that the arterial blood is represented in the report. Blood gases should be obtained whenever there is anything non-reassuring about the fetal status. For example, when there is an Apgar score less than 7 or when any of the delivery room personnel think it is indicated. The cord gases provide data for a better resuscitation effort of infant, especially if the cause of the infant’s depression is compression of the umbilical cord during labor. The blood should be drawn for this as soon as possible, and the blood samples should be immersed in ice water pending analysis.

Here are the basic Rules of Relationship between Umbilical vein and arterial blood gases:

  • Blood from the umbilical vein always has a higher pH than blood from the artery, and will have a lower PCO2 and higher PO2. The base excess and bicarbonate values are usually the same. If one is worse, it must be the arterial blood. When the differences in pH are < .04 – then look at the pCO2. If they are similar, then the samples came from the same vessel. If you contaminate the sample, it makes the pO2 unreliable.
  • A pH of less than 7 suggests fetal asphyxia. But, pH values between 7.0 and 7.2 have also been implicated in fetal asphyxia cases.

If the baby has suffered a fetal asphyxia situation, then consultation with an experienced birth injury lawyer is strongly advised.

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