Absence of fetal heart rate cycling on the intrapartum cardiotocograph (CTG) is associated with intrapartum pyrexia and lower Apgar scores
| Autor: | Katherine Lau, Edwin Chandraharan, Susana Pereira, Carlotta Modestini, David Wertheim |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty Cardiotocography Fever alliedhealth Fetal heart Chorioamnionitis Fetal monitoring 03 medical and health sciences 0302 clinical medicine Pregnancy Humans Medicine reproductive and urinary physiology Fetus 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics Intrapartum Pyrexia Infant Newborn Obstetrics and Gynecology Heart Rate Fetal medicine.disease female genital diseases and pregnancy complications Quiet sleep Fetal heart rate embryonic structures Pediatrics Perinatology and Child Health Apgar Score Female sense organs Acidosis business 030217 neurology & neurosurgery |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 35:7980-7985 |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.1080/14767058.2021.1940130 |
| Popis: | Cycling consists of alternating periods of reduced and normal fetal heart variability, reflecting changes in fetal behavioral states. Occurrence of active and quiet sleep cycles is considered to be a hallmark of fetal autonomic nervous system integrity, demonstrating healthy interaction between the parasympathetic and sympathetic nervous systems. Cycling is an overlooked feature in most international cardiotocography (CTG) guidelines. The authors tested the hypothesis that fetuses showing no cycling in the intrapartum period have poorer outcomes. To investigate whether the absence of cycling at the commencement of intrapartum fetal monitoring is associated with poorer neonatal outcomes (umbilical arterial cord pH, Apgar scores and neonatal unit admission). Analysis of a database of sequentially acquired intrapartum CTG traces from a single center. Only cases of singleton pregnancies over 36 weeks gestation in cephalic presentation with recorded umbilical artery cord pH were considered. Neonatal outcomes were assessed based on umbilical cord artery pH, Apgar ≤7 at 5 min and unexpected admission to the neonatal unit. Intrapartum pyrexia, presence of meconium-stained amniotic fluid and mode of delivery were also recorded. A total of 684 cases were analyzed. Absence of cycling from the beginning of the intrapartum CTG recording was noted in 5% of cases. Cases with no cycling were more likely to have maternal pyrexia (≥37.8 °C) ( = .006) and Apgars ≤7 at 5 min ( = .04). There was an association between increasing baseline fetal heart rate and the proportion of cases with no cycling. There was no significant difference between the two groups with regard to the mode of delivery or umbilical cord arterial pH |
| Databáze: | OpenAIRE |
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