OBJECTIVE: The purpose of this study was to determine whether electronic fetal monitoring can identify fetuses with metabolic acidosis and hypoxic-ischemic encephalopathy. STUDY DESIGN: The cases were 107 nonanomalous chromosomally normal fetuses with an umbilical arterial pH < 7.0 and base excess < or = 12 mmol/L. Controls were the subsequent delivery that was matched by gestational age and mode of delivery. The last hour of electronic fetal monitoring before delivery was evaluated by 3 obstetricians who were blinded to outcome. RESULTS: Cases had a significant increase in late and prolonged decelerations/hour and late decelerations/contractions. Those fetuses with hypoxic-ischemic encephalopathy had significant increases in bradycardia, decreased variability, and nonreactivity but no difference in late or variable decelerations/hour. For the identification of hypoxic-ischemic encephalopathy, the sensitivity, specificity, and positive and negative predictive values were 15.4%, 98.9%, 66.7%, and 89.4%, respectively, for bradycardia; 53.8%, 79.8%, 26.9%, and 92.6%, respectively, for decreased variability; 92.3%, 61.7%, 2.7%, and 82.9%, respectively, for nonreactivity; and 7.7%, 98.9%, 50.0%, and 88.6%, respectively, for all 3 abnormalities combined. CONCLUSION: Fetal metabolic acidosis and hypoxic-ischemic encephalopathy are associated with significant increases in electronic fetal monitoring abnormalities, but their predictive ability to identify these conditions is low.
OBJECTIVE: The purpose of this study was to determine whether electronic fetal monitoring can identify fetuses with metabolic acidosis and hypoxic-ischemicencephalopathy. STUDY DESIGN: The cases were 107 nonanomalous chromosomally normal fetuses with an umbilical arterial pH < 7.0 and base excess < or = 12 mmol/L. Controls were the subsequent delivery that was matched by gestational age and mode of delivery. The last hour of electronic fetal monitoring before delivery was evaluated by 3 obstetricians who were blinded to outcome. RESULTS: Cases had a significant increase in late and prolonged decelerations/hour and late decelerations/contractions. Those fetuses with hypoxic-ischemicencephalopathy had significant increases in bradycardia, decreased variability, and nonreactivity but no difference in late or variable decelerations/hour. For the identification of hypoxic-ischemicencephalopathy, the sensitivity, specificity, and positive and negative predictive values were 15.4%, 98.9%, 66.7%, and 89.4%, respectively, for bradycardia; 53.8%, 79.8%, 26.9%, and 92.6%, respectively, for decreased variability; 92.3%, 61.7%, 2.7%, and 82.9%, respectively, for nonreactivity; and 7.7%, 98.9%, 50.0%, and 88.6%, respectively, for all 3 abnormalities combined. CONCLUSION:Fetal metabolic acidosis and hypoxic-ischemicencephalopathy are associated with significant increases in electronic fetal monitoring abnormalities, but their predictive ability to identify these conditions is low.
Authors: Alex Zwanenburg; Ben Jm Hermans; Peter Andriessen; Hendrik J Niemarkt; Reint K Jellema; Daan Rmg Ophelders; Rik Vullings; Tim Gam Wolfs; Boris W Kramer; Tammo Delhaas Journal: Pediatr Res Date: 2016-02-11 Impact factor: 3.756
Authors: Christopher S Ennen; Thierry A G M Huisman; William J Savage; Frances J Northington; Jacky M Jennings; Allen D Everett; Ernest M Graham Journal: Am J Obstet Gynecol Date: 2011-06-15 Impact factor: 8.661
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