Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
| Autor: | Tal Biron-Shental, Tzipi Hornik-Lurie, Yael Yagur, Yehuda Tzur, Gil Shechter Maor, Omer Weitzner, Shiran Bookstein Peretz |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Cardiotocography Clinical Decision-Making Risk Assessment Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Medical history Labor Induced 030212 general & internal medicine Israel Retrospective Studies Asphyxia Asphyxia Neonatorum Fetus 030219 obstetrics & reproductive medicine Obstetrics business.industry Vaginal delivery Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Heart Rate Fetal Hydrogen-Ion Concentration Delivery Obstetric Fetal Blood medicine.disease Pediatrics Perinatology and Child Health Cohort Population study Female Risk Adjustment medicine.symptom Acidosis business |
| Zdroj: | Journal of Perinatal Medicine. 49:1089-1095 |
| ISSN: | 1619-3997 0300-5577 |
| Popis: | Objectives This study examined predictive factors, in addition to Category II Fetal Herat Rate (FHR) monitoring that might imply fetal acidosis and risk of asphyxia. Methods This retrospective cohort study compared three groups of patients with Category II FHR monitoring indicating need for imminent delivery. Groups were divided based on fetal cord blood pH: pH≤7.0, 7.0 Results The cohort included 417 women. Nine (2.2%) had cord pH≤7.0, 105 (25.2%) pH 7.0 to 7.2 and 303 (72.6%) ad pH≥7.2. Background characteristics, pregnancy follow-up and intrauterine fetal evaluation prior to delivery were similar in all groups. As expected, more patients in the low pH group had cesarean section (55.6%), than vaginal delivery or vacuum extraction (p=0.02). Five-minute Apgar scores were similar in all groups. Conclusions This retrospective study did not detect a specific parameter that could help predict the prognosis of fetal acidosis and risk of asphyxia. As we only included patients with a Category II tracing that was worrisome enough to lead to imminent delivery, it is reasonable to believe that this is due to patient selection, meaning that when the Category II FHR results in decision for prompt delivery, there is no added value in additional clinical characteristics. The evaluation should be expanded to all patients with Category II tracing for better interpretation tools for Category II FHR monitors, as well as a larger study population. |
| Databáze: | OpenAIRE |
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