RESUMEN
Thirty newborn babies delivered by elective caesarean section were studied. They were randomly placed in two groups. The first group consisted of newborns who scored 3 or less on the Apgar scale at one minute and 8 or more after five minutes. The other group included newborns which scored 8 or higher at one minute and 9 at five minutes. Blood samples were obtained from the umbilical cord which allowed for the measuring of the infants' pH, serum gases and pyruvic lactic acid levels. An increased level lactate was found in asphyctic infants. Five cases presented lactic acidosis which continued to be persistent in four of them an hour after they were born. Although increased levels of lactate were found also in the control group, they never presented lactic acidosis. No correlation was found between the pH and lactate levels nor between lactate and bicarbonate. A clear correlation between lactic acidosis and fetal distress was documented. It was concluded that lactate quantification is a useful indicator of neonatal asphyxia. Lactic acidosis; Apgar scores; asphyxia.
Asunto(s)
Acidosis Láctica/etiología , Asfixia Neonatal/complicaciones , Acidosis Láctica/sangre , Puntaje de Apgar , Asfixia Neonatal/sangre , Asfixia Neonatal/terapia , Sangre Fetal/análisis , Humanos , Recién NacidoRESUMEN
Thirty cesarean section-delivered newborn were studied. Fifteen of them scored from 0 to 3 and, 8 and greater on the Apgar scale when measured at one and five minutes, respectively. The other 15 scored 8 or more at one minute and 9 at five minutes. Arterial electrolyte and blood gases were measured in samples obtained from the umbilical cord. The anion gap formula was then applied. The average weight of the depressed newborns was found to be less than for those of the control group. The mean gestational age for both groups was 39 weeks. The average values for electrolyte, bicarbonate and the anion gap were found to be practically the same in both groups. No correlation was found between the pH and the gap nor for the gap and the hydrogen ion concentration [H+]. The correlation between the gap and the bicarbonate was 0.78. No differences were seen between anion gap values for the newborn with lactic acidosis or hyperlactemia when compared to those of the control group. It is therefore concluded that the anion gap is not useful for the detection of newborns suffering from metabolic acidosis. Anion gap; bicarbonate; Apgar score; depressed neonates; metabolic acidosis.