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16-01-2024 | Intrauterine Growth Restriction | Maternal-Fetal Medicine

Correlation between total deceleration area in CTG records and cord blood pH in pregnancies with IUGR

Authors: Neta Geva, Yael Geva, Lior Katz, Yair Binyamin, Reut Rotem, Adi Yehuda Weintraub, Shimrit Yaniv Salem

Published in: Archives of Gynecology and Obstetrics

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Abstract

Purpose

Fetal cardiotocography is the most common method to assess fetal well-being during labor. Nevertheless, its predictive ability for acidemia is limited, both in low-risk and high-risk pregnancies (Nelson et al. in N Engl J Med 334: 613–9, 1996; Rinciples P et al. in Health and Human Development Workshop Report on Electronic Fetal Monitoring : Update on Definitions. no. 2007, 510–515, 2008), especially in high-risk pregnancies, such as those complicated by growth restriction. In this study we aim examine the association between deceleration and acceleration areas and other measure of fetal heart rate in intrapartum fetal monitoring and neonatal arterial cord blood pH in pregnancies complicated by growth restriction.

Materials and methods

A retrospective cohort study of 100 deliveries complicated by growth restriction, delivered during 2018, was conducted. Known major fetal anomalies, non-vertex presentation and elective cesarean deliveries were excluded. Total deceleration and acceleration areas were calculated as the sum of the areas within the deceleration and acceleration, respectively.

Results

In deliveries complicated by growth restriction, cord blood pH is significantly associated with total deceleration area (p = 0.05) and correlates with cumulative duration of the decelerations (Spearman’s rank −0.363, p < 0.05), and total acceleration area (−0.358, p < 0.05). By comparing the cord blood pH in deliveries with a total deceleration area that was above and below the median total deceleration area, we demonstrated a significant difference between the categories.

Conclusions

Cord blood pH significantly correlates with total deceleration area and other fetal monitoring characteristics in neonates with growth restriction. Future studies using real-time, machine-learning based techniques of fetal heart rate monitoring, may provide population specific threshold values that will support bedside clinical decision making and perhaps achieve better outcomes.
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Metadata
Title
Correlation between total deceleration area in CTG records and cord blood pH in pregnancies with IUGR
Authors
Neta Geva
Yael Geva
Lior Katz
Yair Binyamin
Reut Rotem
Adi Yehuda Weintraub
Shimrit Yaniv Salem
Publication date
16-01-2024
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-023-07240-0