Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption

Takano, Y; Furukawa, Shoei; Ohashi, Masanao; Michikata, Kaori; Sameshima, Hiroshi; Ikenoue, Tsuyomu

doi:10.1111/j.1447-0756.2012.01945.x

Cited by 16 publications

(7 citation statements)

References 23 publications

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“…Sentinel events are frequently reported in cases of cerebral palsy (19).Placental abruption has also been associated with adverse neonatal outcomes, especially when accompanied by severe FHR abnormalities (20). We also found comparable associations in our population of neonates with HIE.…”

Section: Discussionsupporting

confidence: 80%

Factors associated with neonatal hypoxic ischemic encephalopathy in infants with an umbilical artery pH less than 7.00

Barrois

Patkaï

Delorme

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Discussionsupporting

confidence: 80%

Factors associated with neonatal hypoxic ischemic encephalopathy in infants with an umbilical artery pH less than 7.00

Barrois

Patkaï

Delorme

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Decelerations exceeding 5 minutes, with FHR maintained at less than 80 bpm and reduced variability within the deceleration (Fig. 9), are frequently associated with acute fetal hypoxia/acidosis [22,[28][29][30] and require emergent intervention.…”

Section: Decelerationsmentioning

confidence: 99%

FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography

Ayres-de-Campos¹,

Spong²,

Chandraharan³

2015

Intl J Gynecology & Obste

655

549

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“…This finding is supported by a retrospective study of 83 placental abruptions: 10 of these involved bradycardia <80 bpm and an average umbilical artery pH of 6.85 ± 0.24, and four cases resulted in poor outcomes (three cases of cerebral palsy and one neonatal death). 9 In addition, a database of 591 infants resuscitated at birth has shown that infant heart rate <60 bpm during the first minutes of life may be a predictor of early neonatal mortality and brain injury in survivors. In that study, fetal bradycardia was reported in 222 cases, but no information about the cause of the bradycardia was available.…”

Section: Discussionmentioning

confidence: 99%

Fetal heart rate nadir during bradycardia and umbilical artery acidemia at birth

Lepercq

Nghiem

Goffinet

2021

Acta Obstet Gynecol Scand

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Introduction Fetal bradycardia due to sentinel events such as placental abruption, cord prolapse or uterine rupture is associated with an increased risk of acidemia at birth. In the absence of a sentinel event, data regarding neonatal prognosis are scarce, and it seems plausible that the depth of bradycardia might be associated with an increased risk of acidosis at birth. The objective was to determine whether the depth of bradycardia is associated with a higher risk of umbilical artery acidemia at birth in term singleton pregnancies requiring cesarean delivery during labor. Material and methods A retrospective comparative study of all cesarean deliveries for bradycardia in an academic tertiary center in the 6‐year period of 2013‐2018, among term singleton pregnancies. Bradycardia associated with a sentinel event such as placental abruption, cord prolapse or uterine rupture, were excluded. The nadir of the bradycardia was defined as the lowest fetal heart rate baseline lasting at least 3 minutes during bradycardia. Women who delivered an infant with an umbilical pH at birth <7.00 (acidosis group) were compared with women who delivered an infant with an umbilical pH at birth ≥7.00 (non‐acidosis group). Results Among 111 eligible cases, 32 women in the acidosis group were compared with 79 in the non‐acidosis group. The median nadir of the bradycardia was lower in the acidosis than in the non‐acidosis group (60 bpm, interquartile range [56‐65] vs 70 [60‐76], P < .01). A bradycardia nadir <60 bpm emerged as the optimal threshold for predicting acidemia and was more frequently observed in the acidosis than in the non‐acidosis group (10 [31%] vs 10 [13%], P = .02). In the multivariable analysis, a nadir <60 bpm was independently associated with an umbilical artery pH <7.00 (adjusted OR 3.16, 95% CI 1.10‐9.04). Conclusions A bradycardia nadir <60 bpm was associated with a tripled risk of umbilical artery acidemia at birth.

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Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption

Abstract: Poor neonatal outcome of placental abruption is closely related to NRFHR, especially the degree of bradycardia. In the rLD and sVD/PD groups, risk factors, such as prematurity and fetal inflammation, co-existed.

Cited by 16 publications

References 23 publications

Factors associated with neonatal hypoxic ischemic encephalopathy in infants with an umbilical artery pH less than 7.00

Factors associated with neonatal hypoxic ischemic encephalopathy in infants with an umbilical artery pH less than 7.00

FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography

Fetal heart rate nadir during bradycardia and umbilical artery acidemia at birth

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