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Transcript 
Providence Nursing Institute
Clinical Academy
1
PERINATAL CURRICULUM
LAST REVIEWED: JUNE 13, 2016
Providence Clinical Academy
2016.06
Intro to Acid-Base Status
2
INTERPRETING FHR AND CORD GASES
“WHAT DOES IT MEAN?”
Providence Clinical Academy
2016.06
Reduced gas
exchange
occurs at
approximately
20 mmHg
Providence Clinical Academy
3
2016.06
If you can
palpate the
contraction,
then it is
having some
effect on blood
flow and gas
exchange
Providence Clinical Academy
Minimum
palpable
strength
4
2016.06
Study from Bakker
et al. demonstrates
that increased
uterine activity
(especially
decreased
relaxation time) is
significantly
associate with a
higher incidence of
an umbilical artery
pH of ≤ 7.11
Bakker, Kurver, Kuik, & Van
Geijn (2007)
Providence Clinical Academy
5
2016.06
6
 Primary mode of energy production in a wellFetal Metabolism
oxygenated fetus
Aerobic
L. Miller, Advanced Fetal Monitoring Course (2015)
Providence Clinical Academy
2016.06
7
 Happens when oxygen is not available
Fetal Metabolism
Anaerobic
 Produces much less energy compared to
aerobic metabolism
 Uses glucose and glycogen stores
 Produces lactic acid

Needs a buffer – HCO3 (bicarb)
L. Miller, Advanced Fetal Monitoring Course (2015)
Providence Clinical Academy
2016.06
Fetal Acidemia
8
Respiratory
Metabolic
 Problem: Too much CO2 – can’t
 Problem: Not enough
clear it
 First breath at birth can correct
this issue
O2
 Leads to lactic acid
production
 Potential for injury
 Base deficit (or base
excess) reflects the
severity
Providence Clinical Academy
2016.06
Cord Gas Interpretation
9
Read cord gas results in this order
#1
Providence Clinical Academy
pH
#2
Base
Deficit
#3
pCO2
2016.06
Providence Clinical Academy
10
L. Miller, Advanced Fetal Monitoring Course (2015)
2016.06
11
 pH
Cord Gas
Interpretation
Practice #1
 pO2
 pCO2
 HCO3
 BD
7.01
9
78
12
17
Respiratory
Metabolic
Mixed
Providence Clinical Academy
2016.06
12
 pH
Cord Gas
Interpretation
Practice #2
 pO2
 pCO2
 HCO3
 BD
7.10
20
62
21
7
Respiratory
Metabolic
Mixed
Providence Clinical Academy
2016.06
13
 pH
Cord Gas
Interpretation
Practice #3
 pO2
 pCO2
 HCO3
 BD
6.96
12
58
21
17
Respiratory
Metabolic
Mixed
Providence Clinical Academy
2016.06
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