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Acidemia at birth in the vigorous infant as a trigger incident to assess intrapartum care with regard to CTG patterns.
MedLine Citation:
PMID:  23350711     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective To evaluate if acidemia in vigorous infants is useful in the assessment of intrapartum care with regard to cardiotocographic (CTG) patterns during the second stage. Methods Cases (n=241) were infants with an umbilical artery pH < 7.05, controls (n= 482) were infants with pH ≥ 7.05. Apgar score was ≥ 7 at five minutes in both groups. CTGs during the last two hours of labour were assessed and neonatal outcomes compared. A sub analysis of cases with metabolic acidemia: pH < 7.00 and base deficit ≥ 12mmol/L and, acidemia: 7.00 < pH < 7.05 was performed. Results 63% of cases had a pathological CTG versus 26% of controls (p <0.001). Patterns with severe variable decelerations had a significantly longer duration in cases. Metabolic acidemia was significantly associated with severe variable decelerations and, decreased variability. Infants to cases were admitted to neonatal care in 19 % versus 2 % of controls (p <0.001). With metabolic acidemia, 32 % were admitted. Conclusion An umbilical artery pH < 7.05 at birth of vigorous infants may be a useful variable for quality control of intrapartum management with regard to assessment of second stage CTGs. Differences in duration of pathological patterns indicate passiveness in acidemic cases.
Authors:
Maria Jonsson; Solveig Nordén Lindeberg; Ingrid Ostlund; Ulf Hanson
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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