Acidosis at birth in term infants and early neurophysiological and cardiovascular changes

Abstract

This thesis was mounted to evaluate and quantify the role of umbilical cord pH measurements in relation to the baby’s clinical condition, electroencephalographic pattern, heart rate variability and analysis of sucking activity as measured by manometry. The first limb of my research related to the application of 30 lead digital EEG recordings of term newborn infants with cord pH values≤7.25. In the early (48 hours) post-natal period EEG changes were identified during quiet sleep (QS). The nature of these changes was in relation to the maximum amplitude, frequency, number of sharp waves and length of the interburst interval (IBI). These were all increased in the more severely acidotic babies (cord pH ≤7.0), regardless of their clinical status. Using digital EEG technology I was able to identify the emergence of a spectrum between sub-clinical and clinical encephalopathy. My results also offer reassurance in the frequently encountered clinical scenario of a clinically well infant who is mildly to moderately acidotic (i.e. pH 7.01-7.25) as all these infants had normal EEG recordings.