The combined detection of umbilical cord nucleated red blood cells and lactate: early prediction of neonatal hypoxic ischemic encephalopathy
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Zhang Haiju
Abstract
Objective: To establish a simple and quick method that could be used to predict the occurrence of hypoxic ischemic encephalopathy (HIE) as early as possible by investigating the variations of nucleated red blood cells per 100 white blood cell (NRBC/100 WBC) counts and lactate levels in cord blood.
Methods: In 46 cases of acute fetal distress (AFD) and 54 cases of chronic fetal distress (CFD) neonates we measured the percentage (NRBCs/100 WBC) and lactate in the umbilical blood.
Results: Both lactate levels and NRBC/100WBC counts were higher in CFD and AFD groups than in controls (both P<0.01). The numbers of NRBC/100 WBC and the values of lactate in moderate-severe HIE group were higher than in mild-HIE group (P=0.002 and P=0.042, respectively). The combined sensitivity and specificity was 94% and 96% at 15NRBC/100WBC and 4.25 mmol/L level by combined detecting NRBC and lactate to predict HIE. Three infants (including 1 death and 2 survivors) had the highest levels of NRBC/100WBC and lactate in cord blood, and the 2 survivors had the lowest mental development index (MDI) and psychomotor development index (PDI).
Conclusions: Combined detection with NRBC/100WBC and lactate allows early prediction of development and severity of HIE. The levels of these parameters are related to the neurodevelopment outcome of HIE infants.
©2008 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Recommendations and guidelines for perinatal practice
- Guideline for the use of antenatal corticosteroids for fetal maturation
- Original articles – Obstetrics
- The quality of intrapartum uterine activity monitoring
- Negative fetal fibronectin: Who is still treating for threatened preterm labor and does it help?
- Seroprevalence and risk factors associated with herpes simplex virus infection among pregnant women
- P-selectin in placenta and gestational myometrium: its measurements and hypothetical role in hemostasis of placental bed after labor
- Exodus-1 (CCL20): evidence for the participation of this chemokine in spontaneous labor at term, preterm labor, and intrauterine infection
- Original article – Fetus
- Increasing rates of sex-discordant twins no longer correspond to decreasing perinatal mortality rates
- Original articles – Newborn
- Disinfection of Burkholderia cepacia complex from non-touch taps in a neonatal nursery
- The combined detection of umbilical cord nucleated red blood cells and lactate: early prediction of neonatal hypoxic ischemic encephalopathy
- Hematological profile of Korean very low birth weight infants
- Integrated backscatter of the brain of preterm infants
- Opinion paper
- Pregnancy among young adolescents: trends, risk factors and maternal-perinatal outcome
- Short communication
- Omniview-SisPorto® 3.5 – a central fetal monitoring station with online alerts based on computerized cardiotocogram+ST event analysis
- Letters to the editor
- Prenatal supply of docosahexaenoic acid (DHA): should we be worried?
- Prenatal docosahexaenoic acid (DHA) and arachidonic acid (AA) supplementation better for neurodevelopment than supplementation with DHA only?
- Three episodes of acquired pure red cell aplasia restricted to pregnancy
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