Document Detail


Correlation of arterial fetal base deficit and lactate changes with severity of variable heart rate decelerations in the near-term ovine fetus.
MedLine Citation:
PMID:  23107611     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Recent guidelines classify variable decelerations (VAR) without detail as to degree of depth. We hypothesized that VAR severity is highly correlated with fetal base deficit (BD) accumulation. STUDY DESIGN: Seven near-term fetal sheep underwent series of graded umbilical cord occlusions (UCO) resulting in mild (30 bpm decrease), moderate (60 bpm decrease) or severe (decrease of 90 bpm to baseline <70 bpm) VAR at 2.5 min intervals. RESULTS: Mild, moderate and severe variable decelerations increased fetal BD (0.21±0.03, 0.27±0.03, and 0.54±0.09 mEq/L per min) in direct proportion to severity. During recovery, fetal BD cleared at 0.12 mEq/l per min. CONCLUSION: In this model, ovine fetuses can tolerate repetitive mild and moderate VAR with minimal change in BD and lactate. In contrast, repetitive severe VAR may result in significant BD increases, dependent upon frequency. Modified guideline differentiation of mild/moderate versus severe VAR may aid in the interpretation of fetal heart rate tracings and optimization of clinical management paradigms.
Authors:
Michael G Ross; Marquis Jessie; Kevin Amaya; Brad Matushewski; L Daniel Durosier; Martin G Frasch; Bryan S Richardson
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-26
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  -     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Mosby, Inc.
Affiliation:
Department of Obstetrics & Gynecology, LA BioMed at Harbor-UCLA Med. Ctr., Torrance, CA. Electronic address: mikeross@ucla.edu.
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