Fetal umbilical cord blood erythropoietin, interleukin-6, pH, pO(2), pCO(2), and base excess levels in histologic and/or clinical chorioamnionitis: is the response only inflammatory?

OBJECTIVE: To determine the correlation of histological chorioamnionitis (CA) with and without clinical CA with umbilical cord blood gases, erythropoietin (EPO), and interleukin-6 (IL-6) levels. METHODS: Umbilical artery blood gas analysis (pH, pO(2), pCO(2), BE) and umbilical vein EPO and IL-6 levels were measured in 202 infants from normal, histological, and no clinical CA and histological plus clinical CA pregnancies. RESULTS: Umbilical artery blood gas analyses were not different between normal controls and histological and clinical CA groups. Blanc Stage 1 histological CA had no abnormal EPO or IL-6 umbilical blood results. EPO in umbilical venous blood was elevated only in those infants with both histological and clinical CA. Umbilical vein IL-6 levels were elevated in all advanced microscopic and clinical CA. High and low EPO groups also have corresponding high and low IL-6 levels suggesting a common stimulus for these substances. CONCLUSIONS: Blanc stage I histological CA is probably clinically insignificant. CA is infrequently associated with abnormal umbilical artery blood gas levels. Advanced histological and clinical CA can elevate both EPO and IL-6 in umbilical blood and these may be key elements of mechanisms that effect fetal brain function.

Are placental chorionic capillary nucleated red blood cell counts useful compared to umbilical cord blood tests?

OBJECTIVE: To compare measurement of fetal nucleated red blood cell (NRBC) counts in paired histologic samples of the placenta and umbilical cord bloods. METHOD: Forty-five randomly selected pregnancies had two determinations of the NRBC count. A sample of umbilical venous blood had a NRBC count measured and sections of the placenta were examined for their villous capillary NRBC counts. RESULTS: Umbilical venous blood had NRBC/100 white blood cell counts ranging from 0 to 67. Paired evaluation of placental tissue had NRBC counts of 0-5 with 60% being zero compared to 8% zero counts in cord blood. There was no correlation between the paired counts (R(2) = 0.04). CONCLUSION: Umbilical cord blood provides different information on fetal NRBC count than does histologic study of the placenta.

Prediction of ABOG written examination performance from the third-year CREOG in-training examination results.

OBJECTIVE: To study the ability of the Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training examination score to predict American Board of Obstetrics and Gynecology (ABOG) written examination performance. STUDY DESIGN: Twenty-six physicians took the CREOG examination during the third year of their residency and the ABOG written examination during their fourth year. These 2 test scores were compared. RESULTS: There was a statistically significant correlation between the 2 examination scores (r = 0.69, p < 0.001). CONCLUSION: The CREOG in-training examination at the third year of the residency correlates well with the ABOG written examination score and can be used to identify residents who need remedial study before finishing the program.

The correlation between automated hematology and manually read smears for the determination of nucleated red blood cells in umbilical cord blood.

OBJECTIVE: To determine the correlation between automated hematology nucleated red blood cell counts and manual counts in umbilical cord blood. METHODS: Umbilical cord venous blood was obtained after cord clamping at the time of delivery. The number of nucleated red blood cells per one hundred white blood cells was measured using an automated hematology analyzer and compared with direct microscopic visualization of prepared slides by experienced hematology technicians. RESULTS: The umbilical cord blood from 128 women was studied. The mean, median and standard deviations of nucleated red blood cell counts were not significantly different between the automated reading and the manual reading (mean 9.3+/-11.2 versus 9.1+/-13.1, respectively, P=0.76; median 5.9 versus 5.0, P=0.95; range 0-77, 0-105). Automated derived nucleated red blood cell counts and manual numbers were highly correlated with a correlation coefficient of 0.794. CONCLUSION: The automated hematology analyzer readings of nucleated red blood cell counts correlate well with readings by laboratory hematologists.