Mode of Delivery and Cord Blood Hematocrit


Abstract:Background: The hematocrit (Hct) is one of the important tests of cord blood indices, it is an indicator of both the mean corpuscular volume and red blood cell count and it is influenced by many fetal, placental, maternal and environmental factors. Objective: To find out the effect of mode of delivery on cord blood hematocrit.Subjects & Methods: The study was done on 246 live born neonates; all were delivered at term, their birth weight ranging between 2.5-4.6Kg. We excluded infants of smoking mothers, infants with meconium-stained amniotic fluid, dysmorphic, infants of diabetic mothers and infants with intrauterine growth retardation or multiple gestation pregnancy outcomes. All mothers were healthy, non-anemic, and all pregnancies were uncomplicated. Only infants with APGAR scores above 7 at 1 and 5 minutes were included in the study. Case group was divided into; Group one included vaginal delivered(VD) infants, group two included elective cesarean section(CS) delivered infants, while group three included infants delivered by cesarean section because of arrest of descent. Blood was collected from the umbilical vein and tested for hematocrit and hemoglobin.The study was carried out in three maternity hospitals (Ibn Al-Baladi hospital, St. Raphael hospital and Al-Hayat maternity hospital in Baghdad) over a Four months period (1st of Februaryـ-30th of May 2005). Results: Mean birth weight of the study group was 3.349 Kg (+/-0.479). The males: females were 130:116.Repeated CS was the commonest indication of elective CS deliveries.The mean birth weight and median APGAR scoring at one and five minutes did not differ significantly in the three groups, there was a significant difference in gestational age in-between elective CS group and the two other groups(P value <0.001) by approximately one week. Mean cord hematocrit was not significantly different in two CS groups, but was significantly lower than VD group (P value <0.001). While sex, birth weight, gestational age or APGAR scoring had no significant influence on cord Hct.Conclusion: Differences in blood volume and plasma volume in infants of cesarean section deliveries and those delivered by normal vaginal delivery would make the mode of delivery an important predictor of venous cord blood hematocrit. Key words: Hematocrit, Cord blood hematocrit, Mode of delivery.