Cord blood gas analysis provides the only practical objective measure of the infant's condition at birth, as opposed to the Apgar score which is subjective, usually assigned retrospectively and is influenced by many factors other than hypoxia during labour.

The presence of an arterial metabolic acidosis will identify those infants who have experienced significant oxygen deficit prior to delivery, and who therefore may be at risk of neonatal problems.

Conversely, normal blood gas results can refute any subsequent claim of hypoxic related birth. It is essential in defending litigation.

It encourages a physiologically-based approach to infant assessment - i.e. causes people to THINK about the physiology of what's going on during birth and helps them to retrospectively review the fetal heart rate trace during labour.

It is useful information to have when counselling parents of babies who encounter problems in the neonatal period. It provides an objective tool for the audit of care during birth - i.e. the number of babies born with a metabolic acidosis can be used as a quality standard of care.

An outcome measure is needed that can reliably reflect the condition of the infant at birth and provide an indication of the level of oxygen deprivation actually sustained during labour. This information is essential to audit care from the infant's viewpoint.

To be of any value, one must obtain a blood sample from both the cord artery and vein. However, the artery can be quite difficult to sample. If there is no mechanism to check the results at the time of sampling then often two vein samples are obtained instead of an artery and a vein pair. A single sample has little clinical value and absolutely no value in a court of law.

When we reviewed data from a multicentre trial in the UK and Europe where DataCare had not been used, it was found that only 40% of cases had both successful artery and vein samples. With a success rate this low it is hardly worth bothering to do cord blood gas analysis.

Expert DataCare ensures Quality Data
In units where Expert DataCare is used, the success rate in obtaining true paired results can be greater than 90%.

Recognition of sampling errors
Expert DataCare has in built expert knowledge to enable it to recognise when an erroneous sample has been obtained. Sample errors are flagged up at the time of sampling to enable an opportunity to obtain a better quality sample.

Physiological errors cannot be detected by the blood gas analyser - they can only be detected by Expert DataCare.

Physiological error ranges have been identified based on our experience of using cord blood gases in many thousands of cases.

Expert interpretation of results
Acid-base balance is a difficult area and this is particularly so for umbilical cord acid-base measurements. The system uses the experience and knowledge of physiologists, obstetricians and paediatricians to interpret the results and identify infants who may experience problems in the neonatal period.

The validated results are interpreted using a database of rules and classified into one of 36 groups ranging from all results normal to severe arterial and venous metabolic acidosis. A full and summarised explanation of the results is given.

Expert DataCare interfaces to all popular cord blood gas analysers.
This includes Bayer (formally Chiron and Ciba Corning), Radiometer, Instrumentation Laboratory and AVL.

Training
We will provide all units with 1 day's training on the software and on the operational aspects of adopting routine cord blood gas analysis into your unit.

Software updates
All software updates and updates to the expert system knowledge will be provided free as part of the maintenance contract. We anticipate this to be at least once per annum.

Customer Support
We have midwives working with K2 Medical Systems to provide you with quality customer support. They have in-depth product knowledge of Expert DataCare and much practical experience of cord blood sampling.

Clinical Audit
K2MS will provide a confidential annual report of your units' cord blood gas data.

Every 6 months we will provide you with a clinical audit report that can be used to track changes in clinical performance. You can compare your unit's performance with the previous year and we will also provide you with data from a comparable unit (anonymous)