Predictive value of fetal scalp pH and base excess for fetal acidosis and poor neonatal outcome
| Autor: | Georgios Galazios, George Farmakides, Alexander Tobias Teichmann, Roland Csorba, Zacharoula Koukouli, Barbara Niesigk, Panagiotis Tsikouras, B Manav |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Gestational Age Klinikai orvostudományok Sensitivity and Specificity Young Adult 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Pregnancy medicine.artery Humans Medicine 030212 general & internal medicine Retrospective Studies Acidosis Scalp 030219 obstetrics & reproductive medicine business.industry Obstetrics Infant Newborn Obstetrics and Gynecology Gestational age Umbilical artery Orvostudományok Hydrogen-Ion Concentration Fetal Blood body regions medicine.anatomical_structure ROC Curve Predictive value of tests Anesthesia Pediatrics Perinatology and Child Health Apgar Score Female Apgar score Base excess medicine.symptom business Intrapartum Cardiotocography |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 31:3166-3171 |
| ISSN: | 1476-4954 1476-7058 |
| Popis: | The objective of this study is to assess retrospectively the predictive value of fetal scalp pH and base excess (BE) for fetal acidosis and poor neonatal outcome in term, low-risk, spontaneous deliveries with suspicious or pathological intrapartum cardiotocography (CTG) tracings.Umbilical artery pH and BE values obtained immediately after delivery and Apgar score were the outcomes under consideration. Statistics included receiver-operating characteristic curve (ROC) and multiple logistic regression analysis.Four hundred and six deliveries were included in the study. Scalp pH 7.20 predicted umbilical pH ≤7.1 with 64.3% sensitivity and 92.9% specificity (p .001). The corresponding positive-predictive value (PPV) was 24.3% and the negative-predictive value (NPV) was 98.6%. Scalp BE ≤ -7 mmol/l (a cut-off value provided by ROC curve analysis) predicted Apgar score ≤ 7 at 5 min with 61.9% sensitivity and 91.7% specificity (p .001). The corresponding PPV and NPV were 29.5 and 97.7%, respectively. Neither scalp pH nor BE was significantly associated with umbilical BE values. Infants with intrapartum BE ≤ -7 mmol/l were 30 times on an average more likely to get a low Apgar score, independently of intrapartum pH values.Our study supports the consideration of both scalp pH and BE values, when fetal blood sampling (FBS) is used. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|