Quantification of Posterior Risk Related to Intrapartum FIGO 2015 Criteria for Cardiotocography in the Second Stage of Labor
| Autor: | Paolo Cavoretto, Anna Seidenari, Anna Nunzia Della Gatta, Antonio Farina, Massimo Candiani, Yasmin Sara Ismail, Silvia Amodeo, Roberta Nale |
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| Přispěvatelé: | Paolo Ivo Cavoretto, Anna Seidenari, Silvia Amodeo, Anna Nunzia Della Gatta, Roberta Nale, Yasmin Sara Ismail, Massimo Candiani, Antonio Farina |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Bradycardia
Embryology medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities Cardiotocography Population Logistic regression 03 medical and health sciences 0302 clinical medicine Intrapartum fetal monitoring Labor Stage Second Pregnancy medicine.artery medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine education Retrospective Studies Asphyxia Fetus education.field_of_study 030219 obstetrics & reproductive medicine medicine.diagnostic_test Obstetrics business.industry International Federation of Gynecology and Obstetrics 2015 cardiotocography classification Birth asphyxia Parturition Obstetrics and Gynecology Gestational age Umbilical artery General Medicine Risk estimation cardiotocography Heart Rate Fetal Feto-neonatal pH Fetal surveillance Childbirth Case-Control Studies Pediatrics Perinatology and Child Health Female medicine.symptom business Intrapartum Cardiotocography |
| Popis: | Introduction: Intrapartum cardiotocography (CTG) was used for several decades to detect a stressed fetus so that delivery can be expedited to prevent birth asphyxia. The main aim of the study was to calculate the risk of neonatal acidemia (pH ≤ 7.10) according to duration of the 2nd stage of labor and occurrence of the International Federation of Gynecology and Obstetrics (FIGO) 2015 CTG classification parameters. Materials and Methods: This was a retrospective case-control study on 552 pregnancies receiving continuous CTG monitoring in labor and immediate hemogasanalysis at birth. Cases with umbilical artery (UA) pH ≤ 7.10 and controls with UA pH ≥ 7.10 were matched for parity and gestational age at delivery, with ratio 1:5. Logistic regression analysis, adjusted for the expected risk in the general population, was used to calculate the baseline risk of UA pH ≤ 7.10 in the absence of any CTG pathological feature and those associated with pathological CTG patterns occurring in the 2nd stage according to FIGO 2015. Results: Seventy-three cases and 387 controls reached 2nd stage and were included in the analysis. For those reaching 2nd stage, the mean adjusted risk of acidemia associated with nonpathological CTG was 1.6%. Stratification of risk according to duration of the 2nd stage yielded risks of neonatal acidemia of 1.23, 2.08, 5.81, and 15.22% at 30, 60, 120, and 180 min, respectively. Bradycardia >10 min was associated with risk of neonatal acidemia of 9.9 and 15.8% for 2nd-stage durations of 30 and 60 min, respectively. Risks associated with 1 prolonged deceleration >5 min were 6.80, 11.08, 27.0, and 51.0% at 30, 60, 120, and 180 min, respectively. Repetitive late or prolonged decelerations >30 min were associated with risk of neonatal acidemia of 2.43, 4.14, 11.17, and 26.45% at 30, 60, 120, and 180 min, respectively. Conclusion: The risk of neonatal acidemia is directly proportional to duration of the 2nd stage, irrespective of the presence of CTG abnormalities, increasing 12-fold (1.2–15.3%) from 30 to 180 min. Occurrence of FIGO 2015 pathological CTG patterns showed a decreasing impact from bradycardia >10 min to decelerations >5 min, recurrent later or prolonged decelerations >30 min, and nonpathological CTG. |
| Databáze: | OpenAIRE |
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