Intrapartum fetal heart rate monitoring: evaluation of a standardized system of interpretation for prediction of metabolic acidosis at delivery and neonatal neurological morbidity

Soncini, E; Paganelli, Simone; Vezzani, Cristina; Gargano, Giancarlo; Sala, Giovanni Battista La

doi:10.3109/14767058.2013.858690

Cited by 16 publications

(3 citation statements)

References 13 publications

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“…According to the current literature, neonatal acidemia was reported between 12-30% in patients with non-reassuring intrapartum fetal heart rate tracings. [20,21] In our study, the PPV of intrapartum FHR monitoring for fetal acidosis was lower than the values reported in the literature (11% for pH <7.1). This was interpreted as "obstetricians in Türkiye are not guaranteed by the laws, and there may be increased malpractice concerns, so they may act hastily in the cesarean section decision.…”

Section: Discussioncontrasting

confidence: 75%

Non-reassuring fetal heart rate patterns in association with umbilical artery acidosis

Eyisoy

2024

Zeynep Kamil Med J

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Objective:The main purpose of the study was to evaluate the clinical outcomes of fetuses who had intrapartum non-reassuring fetal heart rate tracings.Material and Methods: Patients who underwent cesarean section as an emergency operation due to non-reassuring fetal heart rate patterns were included in the study. All FHR paper traces were reevaluated by an expert obstetrician, blinded to the neonatal outcomes, based on the guidelines of the NICHD workshop. Patients were placed into five groups considering the variability and accompanying deceleration type. Clinical outcomes, Apgar scores, and umbilical artery blood parameters were evaluated. Results:The study consisted of 84 patients; Group 1, normal variability with late decelerations (n=32); Group 2, normal variability with variable decelerations (n=16); Group 3, decreased variability (n=10); Group 4, decreased variability with late decelerations (n=14); Group 5, decreased variability with variable decelerations (n=12). Groups with decreased variability and decelerations (groups 4 and 5) had higher rates of NICU admission than the groups with normal variability with decelerations (groups 1 and 2) (p<0.05). In the decreased variability with late decelerations group (Group 4), umbilical artery blood pH and ABE were significantly lower while lactate levels were higher than in groups 1, 2, and 3 (p<0.001). Among all patients, inverse correlations were shown between umbilical artery blood lactate and pH (r=-0.734, p<0.001), and also between lactate and ABE (r=-0.581, p<0.001). For the prediction of umbilical artery blood pH<7.1 and/or ABE<-12, the optimal umbilical artery blood lactate cut-off level is 7 mmol/L with a sensitivity of 88.9% and specificity of 89.3%. Conclusion:Decreased variability in non-reassuring intrapartum fetal heart rate patterns should be considered as important as decelerations. In the evaluation of intrapartum fetal asphyxia, lactate appears to be as good a marker as pH and ABE.

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Section: Discussioncontrasting

confidence: 75%

Non-reassuring fetal heart rate patterns in association with umbilical artery acidosis

Eyisoy

2024

Zeynep Kamil Med J

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“…Haemorrhage occurred more often in patients who received mifepristone and misoprostol (51.44 %) than in those who received mifepristone alone (22.41 %) [41] . As shown by the results of a randomised controlled trial, there were no differences in the adverse side effects between the mifepristone plus misoprostol and placebo plus misoprostol groups for the management of missed miscarriage [42] . Therefore, it can be assumed that the adverse side effects were mainly associated with the use of misoprostol rather than mifepristone.…”

Section: Discussionmentioning

confidence: 94%

Comparison of outpatient with inpatient mifepristone usage for cervical ripening: A randomised controlled trial

Baev

Карапетян

Babich

et al. 2023

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Outro aspecto que coloca a ME intraparto sob julgamento é o fato deste método ser utilizado há mais de meio século, com a premissa de identificar casos de acidemia fetal, sem repercutir em redução das taxas de EHI de causa obstétrica (Soncini et al, 2014;Brocklehurst et al, 2017) (Yeh et al, 2012;Morgan et al, 2015;Parer & Ugwumadu, 2016;Clark et al, 2017).…”

Section: Resultsunclassified

A associação da cardiotocografia intraparto com a Dopplervelocimetria fetal aumenta a capacidade preditiva de resultados adversos perinatais?

Assis¹

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exemplo de profissional e de ser humano, agradeço a oportunidade de ter sido sua aluna, residente e mestranda. Certamente levo seu entusiasmo com a Obstetrícia e sua constante busca para uma melhor assistência às pacientes como ensinamentos. Não teria conseguido sem seu apoio e dedicação constantes. À Suelen Soares Bezerra, responsável pela secretaria da pós-graduação em Ginecologia e Obstetrícia da FMRP-USP, pela paciência, disponibilidade e orientação. Aos docentes, médicos assistentes, residentes e funcionários do Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto -USP, pelo comprometimento em manter o prestígio da instituição e a qualidade na assistência à população. Aos funcionários do Serviço de Arquivos Médicos (SAME) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto -USP, pela organização e ajuda quando precisei.À minha Família Patrizzi, sempre participativa em minhas conquistas, desde a época do vestibular para o curso de Medicina. Obrigada por ser minha base. À Família Assis, que me acolheu e me incentiva a ser melhor sempre.Ao meu núcleo familiar, Rangel e Giulia, pela compreensão e apoio. Vocês são minha vida.Às pacientes e seus filhos que permitiram a utilização de um pedaço tão nobre de suas vidas para estudo, possibilitando melhorias na assistência obstétrica O presente trabalho foi realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior -Brasil (CAPES) por meio do Programa de Excelência Acadêmica (PROEX). RESUMO Assis LPB.A associação da cardiotocografia intraparto com a Dopplervelocimetria fetal aumenta a capacidade preditiva de resultados adversos perinatais? [dissertação].

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Intrapartum fetal heart rate monitoring: evaluation of a standardized system of interpretation for prediction of metabolic acidosis at delivery and neonatal neurological morbidity

Abstract: Our study demonstrates that the interpretation of fetal heart rate tracings based on a strictly standardized system is closely associated with umbilical artery acid-base status at delivery.

Cited by 16 publications

References 13 publications

Non-reassuring fetal heart rate patterns in association with umbilical artery acidosis

Non-reassuring fetal heart rate patterns in association with umbilical artery acidosis

Comparison of outpatient with inpatient mifepristone usage for cervical ripening: A randomised controlled trial

A associação da cardiotocografia intraparto com a Dopplervelocimetria fetal aumenta a capacidade preditiva de resultados adversos perinatais?

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