Document Detail


Unselected low-risk pregnancies and the effect of continuous intrapartum fetal heart rate monitoring on umbilical blood gases and cerebral palsy.
MedLine Citation:
PMID:  14749646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our purpose was to evaluate the clinical validity of electronic fetal heart rate monitoring to detect fetal acidemia and to evaluate the prevalence of cerebral palsy in unselected low-risk pregnancies. STUDY DESIGN: We selected two secondary and two tertiary level institutions in which 10,030 infants were born. Among them, 5546 of the pregnancies were low-risk pregnancies by antepartum evaluation. The fetal heart rate patterns were interpreted according to the guidelines of the National Institute of Child Health and Human Development. The correlations between the fetal heart rate pattern and umbilical blood gases and the fetal heart rate pattern and cerebral palsy were studied. Spastic cerebral palsy was diagnosed at > or =1 year by pediatric neurologists. Statistics included unpaired t test, contingency table with chi(2) and Fisher tests, and one-way analysis of variance with Bonferroni/Dunn test. RESULTS: On the basis of the severity of decelerations, frequency of decelerations, and decreased variability, umbilical pH, and Po(2) level were decreased accordingly, and incidence of pH<7.1 was increased. Sensitivity and false-positive rate of nonreassuring fetal heart rate patterns for fetal acidemia were 63% and 89%. There were nine cerebral palsy cases: six of the cases were preexisting asphyxia before monitoring was initiated, two of the cases were cytomegaloviral infections, and one of the cases was a maternal amniotic fluid embolism. CONCLUSION: In low-risk pregnancies, intrapartum fetal heart rate monitoring was useful to detect fetal acidemia. Cerebral palsy caused by intrapartum asphyxia was restricted to unavoidable accidents under continuous fetal heart rate monitoring.
Authors:
Hiroshi Sameshima; Tsuyomu Ikenoue; Tomoaki Ikeda; Masato Kamitomo; Satoshi Ibara
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  190     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-29     Completed Date:  2004-02-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  118-23     Citation Subset:  AIM; IM    
Affiliation:
Perinatal Center and the Department of Obstetrics and Gynecology, Miyazaki Medical College, Kiyotake, Miyazaki, Japan. hsameshima@fc.miyazaki-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Acids / blood*
Blood Gas Analysis*
Cerebral Palsy / epidemiology*,  etiology,  virology
Cytomegalovirus Infections / complications
False Positive Reactions
Female
Fetal Hypoxia / complications
Fetal Monitoring*
Heart Rate, Fetal*
Humans
Japan / epidemiology
Labor, Obstetric*
Pregnancy
Prevalence
Risk Factors
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Acids

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


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