Document Detail


Intrapartum assessment of fetal well-being: any role for a fetal admission test?
MedLine Citation:
PMID:  12962267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether the fetal admission test is predictive of intrapartum complications. METHODS: We studied the fetal heart rate tracings of women in spontaneous labor at 37-42 weeks' gestation from 1 November 2001 to 31 March 2002. The study population was subdivided based on reactivity defined as > or = 15 beats/min for > or = 15 s, reactivity redefined as > or = 10 beats/min for > or = 10 s, variability, presence of late and/or variable decelerations, and reassuring fetal admission test; and compared for various labor outcome variables. Student's t test, the chi2 test and Fisher's exact test were used for analysis. RESULTS: A total of 426 women met our inclusion criteria. There were no differences between groups when compared for maternal age, parity, gestational age, birth weight, labor analgesia and length of labor. Irrespective of the definition of reactivity, women with a non-reactive fetal admission test were more likely to be delivered by Cesarean section, to have fetal distress resulting in Cesarean section and to have a longer neonatal hospital stay. In addition, redefining reactivity improved the specificity, positive and negative predictive values, accuracy, relative risk and likelihood ratio with regard to development of fetal distress. Similar results were obtained when variability and decelerations were used as criteria for comparisons. CONCLUSION: The fetal admission test is useful in predicting the absence of intrapartum fetal distress irrespective of the criterion used for evaluation. Redefined reactivity appears to be most predictive of intrapartum fetal distress.
Authors:
A Elimian; P Lawlor; R Figueroa; V Wiencek; D Garry; J G Quirk
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Publication Detail:
Type:  Comparative Study; Journal Article    
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:  13     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-09-09     Completed Date:  2003-10-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  408-13     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Gynecology and Reproductive Medicine, State University of New York at Stony Brook, Stony Brook, New York 11794-8091, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiotocography*
Cesarean Section / statistics & numerical data*
Cohort Studies
Female
Fetal Distress / diagnosis*,  therapy
Fetal Viability*
Humans
Labor, Obstetric*
Length of Stay / statistics & numerical data
Likelihood Functions
Predictive Value of Tests
Pregnancy
Retrospective Studies
Sensitivity and Specificity

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


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