The role of cord blood gases in birth injury and medical malpractice casesAbnormal acidotic cord blood gases can be a sign of hypoxic-ischemic encephalopathy (HIE)
Both in legal and medical settings, where there’s a reason to investigate potential causes of labor and delivery or birth injuries, several factors or sources of evidence are considered. In addition to findings from electronic fetal monitoring, some assessments after delivery are often helpful. These include cord blood gas analysis and Apgar scores.
What is cord blood gas?
The umbilical cord is basically the anatomical connection between the mom and the baby she’s carrying. The umbilical cord has three blood vessels.
• One umbilical vein carries oxygen-rich blood from the mother to the baby.
• Two smaller umbilical arteries carry oxygen-free blood and waste from the baby to the mom.
Cord blood gas refers to a laboratory analysis of a blood sample from the umbilical cord. Typically, a needle is used to collect a cord blood sample from the umbilical vein and another needle is used to obtain a sample from an umbilical artery.
The laboratory will perform an arterial cord blood analysis and venous cord blood analysis, including pH, pO2, pCO2, bicarbonate, and base deficit. The lab’s report will provide normal reference ranges, but it’s up to the physician to interpret the significance of the data.
Generally speaking, cord blood gas analysis is considered an objective measure of the baby’s metabolic condition at the time of delivery.
Both the American College of Obstetricians and Gynecologists and American Academy of Pediatrics recommended cord blood gas analysis orders for all high-risk deliveries where reason to suspect any fetal metabolic abnormality. At some hospitals, it’s standard practice to perform this lab work on all deliveries.
When there are cord blood gas abnormalities reflecting acidosis, physicians often consider this a sign of fetal distress and low oxygen levels (hypoxia) at or shortly before the time of birth.
Cord blood gas results must be correlated to the whole clinical picture, though. One study reported that acidotic cord blood gas results are consistent with fetal distress from hypoxia. However, the study also noted, that as an isolated finding, it’s a poor predictor of the dreaded brain injury called hypoxic-ischemic encephalopathy (HIE).
To determine the cause of HIE, physicians and experts must consider cord blood gases, Apgar scores after birth, and the electronic fetal heart tracing pattern.
As you can tell, figuring out the cause of a birth injury requires experience and careful analysis of many different sources of information. One of those sources is cord blood gas lab work.
If you suspect a labor and delivery or birth-related injury, including HIE, occurred in a Texas hospital, contact a top-rated Texas medical malpractice attorney who is experienced in birth injuries for a free strategy session about your potential case.
Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.
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