Paula Pinto1,2, Cristina Costa-Santos3, Diogo Ayres-de-Campos2,4,5, João Bernardes2,3,4,6. 1. a Serviço de Ginecologia e Obstetrícia, Hospital Nélio Mendonça , Funchal , Portugal . 2. b Departamento de Obstetrícia e Ginecologia , Faculdade de Medicina da Universidade do Porto , Porto , Portugal . 3. c CINTESIS -- Centre for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto , Porto , Portugal . 4. d Serviço de Ginecologia e Obstetrícia, Centro Hospitalar São João , Porto , Portugal . 5. e INEB -- Institute of Biomedical Engineering , Porto , Portugal , and. 6. f Departamento da Mulher, do Jovem e da Criança , Hospital Pedro Hispano, Unidade Local de Saude de Matosinhos , Matosinhos , Portugal.
Abstract
OBJECTIVE: To assess combined maternal (MHR) and fetal heart rate (FHR) recordings during labor, in relation with maternal-fetal attachment and prediction of newborn acidemia. STUDY DESIGN: Fifty-nine simultaneous MHR and FHR recordings were acquired in the final minutes of labor. Computer analysis followed the FIGO guidelines with estimation of MHR and FHR baselines, accelerations, decelerations, short- (STV) and long-term variabilities. MHR and FHR characteristics, their differences and correlations were assessed in relation to labor progression and to newborn umbilical artery blood (UAB) pH lower than 7.15 and 7.20. To assess prediction of acidemia, areas under ROC curves (auROC) were calculated. RESULTS: Progression of labor was associated with a significant increase in MHR accelerations and FHR decelerations both in the non-acidemic and acidemic fetuses (p < 0.01). At the same time there was an increase in MHR-FHR correlations and differences in accelerations and decelerations in acidemic fetuses. The auROC ranged between 0.50 for FHR accelerations and 0.77 for MHR baseline plus FHR STV. CONCLUSIONS: MHR and FHR respond differently during labor with signs of increased maternal-fetal attachment during labor progression in acidemic fetuses. Combined MHR-FHR analysis may help to improve prediction of newborn acidemia compared with FHR analysis alone.
OBJECTIVE: To assess combined maternal (MHR) and fetal heart rate (FHR) recordings during labor, in relation with maternal-fetal attachment and prediction of newborn acidemia. STUDY DESIGN: Fifty-nine simultaneous MHR and FHR recordings were acquired in the final minutes of labor. Computer analysis followed the FIGO guidelines with estimation of MHR and FHR baselines, accelerations, decelerations, short- (STV) and long-term variabilities. MHR and FHR characteristics, their differences and correlations were assessed in relation to labor progression and to newborn umbilical artery blood (UAB) pH lower than 7.15 and 7.20. To assess prediction of acidemia, areas under ROC curves (auROC) were calculated. RESULTS: Progression of labor was associated with a significant increase in MHR accelerations and FHR decelerations both in the non-acidemic and acidemic fetuses (p < 0.01). At the same time there was an increase in MHR-FHR correlations and differences in accelerations and decelerations in acidemic fetuses. The auROC ranged between 0.50 for FHR accelerations and 0.77 for MHR baseline plus FHR STV. CONCLUSIONS: MHR and FHR respond differently during labor with signs of increased maternal-fetal attachment during labor progression in acidemic fetuses. Combined MHR-FHR analysis may help to improve prediction of newborn acidemia compared with FHR analysis alone.