دورية أكاديمية
Intrapartum electronic fetal heart rate monitoring and the identification of metabolic acidosis and hypoxic-ischemic encephalopathy.
| العنوان: | Intrapartum electronic fetal heart rate monitoring and the identification of metabolic acidosis and hypoxic-ischemic encephalopathy. |
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| المؤلفون: | Larma JD; Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Silva AM, Holcroft CJ, Thompson RE, Donohue PK, Graham EM |
| المصدر: | American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2007 Sep; Vol. 197 (3), pp. 301.e1-8. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 0370476 Publication Model: Print Cited Medium: Internet ISSN: 1097-6868 (Electronic) Linking ISSN: 00029378 NLM ISO Abbreviation: Am J Obstet Gynecol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2005->: New York : Elsevier Original Publication: St. Louis. |
| مواضيع طبية MeSH: | Acidosis/*diagnosis , Cardiotocography/*instrumentation , Hypoxia-Ischemia, Brain/*diagnosis, Adult ; Blood Gas Analysis ; Case-Control Studies ; Female ; Fetal Blood/chemistry ; Gestational Age ; Heart Rate, Fetal/physiology ; Humans ; Infant, Newborn ; Oxygen/blood ; Predictive Value of Tests ; Pregnancy ; Sensitivity and Specificity ; Single-Blind Method ; Umbilical Arteries |
| مستخلص: | Objective: The purpose of this study was to determine whether electronic fetal monitoring can identify fetuses with metabolic acidosis and hypoxic-ischemic encephalopathy. Study Design: The cases were 107 nonanomalous chromosomally normal fetuses with an umbilical arterial pH < 7.0 and base excess < or = 12 mmol/L. Controls were the subsequent delivery that was matched by gestational age and mode of delivery. The last hour of electronic fetal monitoring before delivery was evaluated by 3 obstetricians who were blinded to outcome. Results: Cases had a significant increase in late and prolonged decelerations/hour and late decelerations/contractions. Those fetuses with hypoxic-ischemic encephalopathy had significant increases in bradycardia, decreased variability, and nonreactivity but no difference in late or variable decelerations/hour. For the identification of hypoxic-ischemic encephalopathy, the sensitivity, specificity, and positive and negative predictive values were 15.4%, 98.9%, 66.7%, and 89.4%, respectively, for bradycardia; 53.8%, 79.8%, 26.9%, and 92.6%, respectively, for decreased variability; 92.3%, 61.7%, 2.7%, and 82.9%, respectively, for nonreactivity; and 7.7%, 98.9%, 50.0%, and 88.6%, respectively, for all 3 abnormalities combined. Conclusion: Fetal metabolic acidosis and hypoxic-ischemic encephalopathy are associated with significant increases in electronic fetal monitoring abnormalities, but their predictive ability to identify these conditions is low. |
| التعليقات: | Comment in: Am J Obstet Gynecol. 2008 Mar;198(3):343; author reply 343-4. (PMID: 18313460) |
| المشرفين على المادة: | S88TT14065 (Oxygen) |
| تواريخ الأحداث: | Date Created: 20070911 Date Completed: 20070919 Latest Revision: 20131121 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.ajog.2007.06.053 |
| PMID: | 17826429 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1097-6868 |
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| DOI: | 10.1016/j.ajog.2007.06.053 |