Document Detail


Effect of the interval between onset of sustained fetal bradycardia and cesarean delivery on long-term neonatal neurologic prognosis.
MedLine Citation:
PMID:  20688328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the effect of the interval between onset of sustained fetal bradycardia and cesarean delivery on long-term neonatal neurologic prognosis.
METHOD: A retrospective observational case-series performed with patients who had sudden-onset and sustained (<100 beats per minute) fetal bradycardia during labor. Fetal heart rate was monitored closely until cesarean delivery. The effect of the interval between the onset of bradycardia and delivery on neonatal neurologic prognosis was examined.
RESULTS: Among 2267 deliveries in 2002-2003 at Kitasato University Hospital, 19 pregnancies met the inclusion criteria. Episodes of fetal bradycardia were due to umbilical cord prolapse (n=5), placental abruption (n=4), uterine rupture (n=3), maternal respiratory failure (n=1), and other causes (n=6). Mean onset of fetal bradycardia to delivery interval (BDI) was 20.5±8.9 minutes. Mean decision-to-cesarean delivery interval was 11.4±3.9 minutes. BDI was negatively correlated with umbilical arterial pH at delivery. There were 3 postnatal deaths. Neurologic assessment at the age of 2 years revealed that 15 of 16 children were neurologically normal. When the BDI was less than 25 minutes, all term pregnancies led to normal neonatal neurologic development.
CONCLUSION: In the event of sustained intrapartum fetal bradycardia, delivery by emergency cesarean within 25 minutes improved long-term neonatal neurologic outcome.
Authors:
Emi Kamoshita; Kan Amano; Yuji Kanai; Junko Mochizuki; Yasuhiro Ikeda; Shinzo Kikuchi; Akihiro Tani; Takashi Shoda; Toshiyuki Okutomi; Masahiko Nowatari; Nobuya Unno
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-04
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  111     ISSN:  1879-3479     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-10     Completed Date:  2010-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  23-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Obstetrics and Gynecology, Kitasato University, School of Medicine, Sagamihara City, Kanagawa, Japan. unno@med.kitasato-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Abruptio Placentae / surgery
Bradycardia / etiology*
Cesarean Section*
Developmental Disabilities / prevention & control
Female
Fetal Diseases / etiology*
Heart Rate, Fetal*
Humans
Infant
Infant, Newborn
Pregnancy
Prognosis
Retrospective Studies
Treatment Outcome
Uterine Rupture / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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