dc.contributor.author | Wasunna, Anthony O | |
dc.date.accessioned | 2013-05-23T13:34:20Z | |
dc.date.available | 2013-05-23T13:34:20Z | |
dc.date.issued | 2009 | |
dc.identifier.citation | Master of medicine in obstetrics and gynaecology | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24960 | |
dc.description.abstract | Background: The most objective measure (qualitative)of a neonate's acid-base status at birth
is the analysis of its (easily attainable) umbilical cord blood. As a practice this is gaining worldwide
recommendation by various respectable health bodies and institutions. It is useful in
identifying acid-base derangement in neonates who by other measures of weII-being e.g. Apgar
scoring (quantitative) would be labeIIed healthy because in certain circumstances, there is no
correlation between the two. This derangement could also be found foIIowing elective
caesarean delivery.
Objective: The main objective was to determine the prevalence of acidosis at birth among
neonates delivered by elective caesarean section.
Subjects: Low risk Kenyatta National Hospital antenatal clinic attendees at term, eligible for
an elective caesarean section
Method: A cross-sectional study was carried out at the Kenyatta National Referral Hospital's
Maternity Theatre. A total of 113 paired arterio-venous umbilical-cord-blood samples were
analysed. On delivery, cord artery and vein samples were obtained and dispatched for acid-base
analysis by a blood gas analyser, and any acidosis reported to the paediatric team. The
methodology was entirely non-invasive. FinaIIy, indication for the caesarean section, mode of
anaesthesia and presence or absence of the standard 15-degree left lateral tilt operating position
were documented for each case, as these have been shown by previous studies to influence
acid-base values.
Results: The overaII prevalence of acidosis among neonates delivered by elective caesarean
section was 18.6%, more than double that found in comparable Western studies. Acidosis in the
presence of good Apgars accounted for 17.7%, while Acidosis with poor Apgars contributed
only 0.9%. No significant associations were found between mode of anaesthesia and acidosis,
presence/absence of the standard 15degree left-lateral tilt operating position and acidosis. The
vast majority of elective operations were due to previous caesarean sections | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | The value of umbilical-cord-blood acid-base analysis in neonates delivered by elective caesarean section | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Dept of Obstetrics and Gynaecology | en |