The Success of Cardiotocography in predicting Perinatal Outcome

Abstract

Objectives: The determination of the fetal condition during labor is important to minimize fetal death due to asphyxia and the neurological sequelae of fetal hypoxia. This study evaluated the success of fetal cardiotocography in predicting perinatal consequences. Materials and methods: This study enrolled 101 full-term pregnant women admitted for delivery to Vakif Gureba Training and Research Hospital between October 2009 and February 2010. Women were included if they were aged 18-45 years and within 36-41 weeks of gestation. During a 20-min period of fetal monitoring, a change in FHR (fetal heart rate) lasting for 15 s or two elevated runs of 15 beats was evaluated as a reactive NST (non-stress test). The umbilical artery pH was used as the “gold standard” for assessing fetal asphyxia. Results: The mean age of the women included in the study was 27.82 ± 5.29 years, the average parity was1.09 ± 0.96. The pH was normal in 85 neonates, while 13 had fetal asphyxia. No significant difference in umbilical cord blood pH, pO2, or pCO2 was observed between these two groups (p = 0.497, p = 0.722, and p = 0.053, respectively. No significant difference in maternal age, parity, or birth weight was found between the group with fetal distress based on CTG (cardiotocography) and the normal group. Conclusion: Cardiotocography is an important test during labor for labor management, it is insufficient for predicting the perinatal outcome. Therefore, labor should be evaluated on an individualized basis. J Clin Exp Invest 2012; 3(2): 168-171

Keywords

• Apgar score, blood gas analysis, caesarean section, cardiotocography

The Success of Cardiotocography in predicting Perinatal Outcome

Öz

Amaç: Doğum sırasında fetal koşulları belirlemek; asfiksi ve fetal hipoksideki nörolojik sekellere bağlı fetal ölümleri minimuma indirmek için önemlidir. Bu çalışmanın amacı, perinatal sonuçları öngörüde, fetal kardiyotokografinin başarısını değerlendirmektedir. Gereç ve yöntem: Bu çalışmaya Ekim 2009 ve Şubat 2009 tarihleri arasında Vakıf Gureba Eğitim ve Araştırma Hastanesinde doğum yapmayı kabul etmiş, 101 term gebe kadın alındı. 36-41 gebelik haftasında ve 18-45 yaşları arasındaki gebeler çalışmaya dahil edildi. 20 dakikalık fetal izlem periyodunda fetal kalp atımlarında en az iki adet; 15 saniye süren ve 15 atımlık artışları olan olgular, reaktif NST (Non-stress test) olarak kabul edildi. Umblikal arter pH fetal asfiksiyi değerlendirmede ‘altın standart\' olarak kullanıldı. Bulgular: Çalışmaya katılan kadınların ortalama yaşı 27.82 ± 5.29 ve ortalama pariteleri 1.09 ± 0.96 idi. 85 yeni doğanda pH normalken, 13 tanesinde fetal asfiksi görüldü. Bu iki grup arasında göbek kordon kanı (kök hücre kaynağı) pH, pO2, ya da pCO2 da anlamlı değişiklikler gözlenmedi (sırasıyla p = 0.497, p = 0.722, and p = 0.05). Kardiyotokografiye dayalı fetal distres ve normal grup arasında annelik yaşı, parite ya da doğum ağırlığında anlamlı derecede farklılık gözlemlenmedi. Sonuç: Kardiyotografi doğum yönetimi için doğum sırasında önemli bir testtir, ancak perinatal sonuçları öngörmek için yetersizdir. Bu yüzden doğum kişiselleştirmeye dayalı bir şekilde değerlendirilmelidir.

Anahtar Kelimeler

• Apgar skoru, kan gazlari analizi, sezaryen doğum, kardiyotografi

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