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Published in: Archives of Gynecology and Obstetrics 2/2008

01-08-2008 | Original Article

Fetal acidemia prediction through short-term variation assessed by antepartum computerized cardiotocography in pregnant women with hypertension syndrome

Authors: Guaraci Silveira Garcia, Coríntio Mariani Neto, Edward Araujo Júnior, Ricardo Lima Garcia, Luciano Marcondes Machado Nardozza, Antonio Fernades Moron

Published in: Archives of Gynecology and Obstetrics | Issue 2/2008

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Abstract

Objective

To establish a cut-off value for short-term variation (STV) assessed by computerized cardiotocography (CTG) as a single parameter in the prediction of acidemia at birth.

Methods

Cross-sectional study performed on 41 single gestations with diagnosis of hypertension syndrome after the 27th week and delivered by elective cesarean. Computerized CTG examinations were 20-min long at most, and were performed up to 24 before delivery. Immediately after delivery, blood samples were collected from the umbilical cord vessels to determine pH. To establish a cut-off value, a receiver operator characteristics (ROC) curve was created with STV as independent variable and umbilical artery pH as dependent variable. Later, sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were calculated for the cut-off value obtained.

Results

A significant correlation was found between STV and acidemia at birth, and STV values ≤5.25 ms were significantly capable of predicting acidemia (pH < 7.20) (S = 57.1%; E = 85.2%; PPV = 66.6%; NPV = 79.3%; P < 0.05).

Conclusions

STV values of ≤5.25 ms could predict acidemia at birth in pregnant women with hypertension syndrome.
Literature
1.
go back to reference Bernardes J, Costa-Pereira A, Ayres-de-Campos D, van Geijn HP, Pereira-Leite L (1997) Evaluation of interobserver agreement of cardiotocograms. Int J Gynaecol Obstet 57:33–37PubMedCrossRef Bernardes J, Costa-Pereira A, Ayres-de-Campos D, van Geijn HP, Pereira-Leite L (1997) Evaluation of interobserver agreement of cardiotocograms. Int J Gynaecol Obstet 57:33–37PubMedCrossRef
2.
go back to reference ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999 (replaces Technical Bulletin Number 188, January 1994). Clinical management guidelines for obstetrician-gynecologists (2000) Int J Gynaecol Obstet 68:175–185 ACOG practice bulletin. Antepartum fetal surveillance. Number 9, October 1999 (replaces Technical Bulletin Number 188, January 1994). Clinical management guidelines for obstetrician-gynecologists (2000) Int J Gynaecol Obstet 68:175–185
3.
go back to reference Street P, Dawes GS, Moulden M, Redman CW (1991) Short-term variation in abnormal antenatal fetal rate records. Am J Obstet Gynecol 165:515–523PubMed Street P, Dawes GS, Moulden M, Redman CW (1991) Short-term variation in abnormal antenatal fetal rate records. Am J Obstet Gynecol 165:515–523PubMed
4.
go back to reference Guzman ER, Vintzileos AM, Martins M, Benito C, Houlihan C, Hanley M (1996) The efficacy of individual computer heart rate indices in detecting acidemia at birth in growth-restricted fetuses. Obstet Gynecol 87:969–974PubMedCrossRef Guzman ER, Vintzileos AM, Martins M, Benito C, Houlihan C, Hanley M (1996) The efficacy of individual computer heart rate indices in detecting acidemia at birth in growth-restricted fetuses. Obstet Gynecol 87:969–974PubMedCrossRef
5.
go back to reference Strachan BK, Sahota DS, van Wijngaarden WJ, James DK, Chang AM (2001) Computerized analysis of the fetal heart rate and relation to acidemia at delivery. BJOG 108:848–852PubMedCrossRef Strachan BK, Sahota DS, van Wijngaarden WJ, James DK, Chang AM (2001) Computerized analysis of the fetal heart rate and relation to acidemia at delivery. BJOG 108:848–852PubMedCrossRef
6.
go back to reference Dawes GS, Redman CW (1995) Sonicaid System 8002: Objective CTG analysis system user guide. Oxford Instruments Medical System Division, Oxford Dawes GS, Redman CW (1995) Sonicaid System 8002: Objective CTG analysis system user guide. Oxford Instruments Medical System Division, Oxford
7.
8.
go back to reference Anceschi MM, Piazze JJ, Ruozi-Berretta A, Cosmi E, Cerekja A, Maranghi L, Cosmi EV (2003) Validity of short-term variation (STV) in detection of fetal acidemia. J Perinat Med 31:231–236PubMedCrossRef Anceschi MM, Piazze JJ, Ruozi-Berretta A, Cosmi E, Cerekja A, Maranghi L, Cosmi EV (2003) Validity of short-term variation (STV) in detection of fetal acidemia. J Perinat Med 31:231–236PubMedCrossRef
9.
go back to reference ASSHP (1993) Management of hypertension in pregnancy: executive summary. Australasian Society for the Study of Hypertension in Pregnancy. Med J Aust 158:700–702 ASSHP (1993) Management of hypertension in pregnancy: executive summary. Australasian Society for the Study of Hypertension in Pregnancy. Med J Aust 158:700–702
10.
go back to reference D’Elia A, Pighetti M, Vanacore F, Fabbrocini G, Arpaia L (2005) Vibroacoustic stimulation in normal term human pregnancy. Early Hum Dev 81:449–453PubMedCrossRef D’Elia A, Pighetti M, Vanacore F, Fabbrocini G, Arpaia L (2005) Vibroacoustic stimulation in normal term human pregnancy. Early Hum Dev 81:449–453PubMedCrossRef
11.
go back to reference Dawes GS, Moulden M, Redman CW (1996) Improvements in computerized fetal heart rate analysis antepartum. J Perinat Med 24:25–36PubMed Dawes GS, Moulden M, Redman CW (1996) Improvements in computerized fetal heart rate analysis antepartum. J Perinat Med 24:25–36PubMed
12.
go back to reference Riley RJ, Johnson JW (1993) Collecting and analyzing cord blood gases. Clin Obstet Gynecol 36:13–23PubMedCrossRef Riley RJ, Johnson JW (1993) Collecting and analyzing cord blood gases. Clin Obstet Gynecol 36:13–23PubMedCrossRef
13.
go back to reference Vintzileos AM, Fleming AD, Scorza WE, Wolf EJ, Balducci J, Campbell WA, Rodis JF (1991) Relationship between fetal biophysical activities and umbilical cord blood gas values. Am J Obstet Gynecol 165:707–713PubMed Vintzileos AM, Fleming AD, Scorza WE, Wolf EJ, Balducci J, Campbell WA, Rodis JF (1991) Relationship between fetal biophysical activities and umbilical cord blood gas values. Am J Obstet Gynecol 165:707–713PubMed
14.
go back to reference Ray M, Freeman R, Pine S, Hesselgesser R (1972) Clinical experience with the oxytocin challenge test. Am J Obstet Gynecol 114:1–9PubMed Ray M, Freeman R, Pine S, Hesselgesser R (1972) Clinical experience with the oxytocin challenge test. Am J Obstet Gynecol 114:1–9PubMed
15.
go back to reference Evertson LR, Gauthier RJ, Schifrin BS, Paul RH (1979) Antepartum fetal heart rate testing. I. Evolution of the nonstress test. Am J Obstet Gynecol 133:29–33PubMed Evertson LR, Gauthier RJ, Schifrin BS, Paul RH (1979) Antepartum fetal heart rate testing. I. Evolution of the nonstress test. Am J Obstet Gynecol 133:29–33PubMed
16.
go back to reference Lotgering FK, Wallenburg HC, Schouten HJ (1982) Interobserver and intraobserver variation in the assessment of antepartum cardiotocograms. Am J Obstet Gynecol 144:701–705PubMed Lotgering FK, Wallenburg HC, Schouten HJ (1982) Interobserver and intraobserver variation in the assessment of antepartum cardiotocograms. Am J Obstet Gynecol 144:701–705PubMed
17.
go back to reference Flynn AM, Kelly J, Matthews K, O’Conor M, Viegas O (1982) Predictive value of, and observer variability in, several ways of reporting antepartum cardiotocographs. Br J Obstet Gynaecol 89:434–440PubMed Flynn AM, Kelly J, Matthews K, O’Conor M, Viegas O (1982) Predictive value of, and observer variability in, several ways of reporting antepartum cardiotocographs. Br J Obstet Gynaecol 89:434–440PubMed
18.
go back to reference Bracero LA, Morgan S, Byrne DW (1999) Comparison of visual and computerized interpretation of nonstress test results in a randomized controlled trial. Am J Obstet Gynecol 181:1254–1258PubMedCrossRef Bracero LA, Morgan S, Byrne DW (1999) Comparison of visual and computerized interpretation of nonstress test results in a randomized controlled trial. Am J Obstet Gynecol 181:1254–1258PubMedCrossRef
19.
go back to reference Anceschi MM, Piazze JJ, Vozzi G, Ruozi Berreta A, Figliolini C, Vigna R, Cosmi EV (1999) Antepartum computerized CTG and neonatal acid-base status at birth. Int J Gynaecol Obstet 65:267–272PubMedCrossRef Anceschi MM, Piazze JJ, Vozzi G, Ruozi Berreta A, Figliolini C, Vigna R, Cosmi EV (1999) Antepartum computerized CTG and neonatal acid-base status at birth. Int J Gynaecol Obstet 65:267–272PubMedCrossRef
20.
go back to reference Silverman F, Suidan J, Wasserman J, Antoine C, Young BK (1985) The Apgar score: is it enough? Obstet Gynecol 66:331–336PubMed Silverman F, Suidan J, Wasserman J, Antoine C, Young BK (1985) The Apgar score: is it enough? Obstet Gynecol 66:331–336PubMed
21.
go back to reference Marrin M, Paes BA (1988) Birth asphyxia: does the Apgar score have diagnostic value? Obstet Gynecol 72:120–123PubMed Marrin M, Paes BA (1988) Birth asphyxia: does the Apgar score have diagnostic value? Obstet Gynecol 72:120–123PubMed
22.
go back to reference Bretscher J, Saling E (1967) pH values in the human fetus during labor. Am J Obstet Gynecol 97:906–911PubMed Bretscher J, Saling E (1967) pH values in the human fetus during labor. Am J Obstet Gynecol 97:906–911PubMed
23.
go back to reference Andres RL, Saade G, Gilstrap LC, Wilkins I, Witlin A, Zlatnik F, Hankins GV (1999) Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal acidemia. Am J Obstet Gynecol 181:867–871PubMedCrossRef Andres RL, Saade G, Gilstrap LC, Wilkins I, Witlin A, Zlatnik F, Hankins GV (1999) Association between umbilical blood gas parameters and neonatal morbidity and death in neonates with pathologic fetal acidemia. Am J Obstet Gynecol 181:867–871PubMedCrossRef
24.
go back to reference Dawes GS, Moulden M, Redman CW (1991) System 8000: computerized antenatal FHR analysis. J Perinat Med 19:47–51PubMedCrossRef Dawes GS, Moulden M, Redman CW (1991) System 8000: computerized antenatal FHR analysis. J Perinat Med 19:47–51PubMedCrossRef
Metadata
Title
Fetal acidemia prediction through short-term variation assessed by antepartum computerized cardiotocography in pregnant women with hypertension syndrome
Authors
Guaraci Silveira Garcia
Coríntio Mariani Neto
Edward Araujo Júnior
Ricardo Lima Garcia
Luciano Marcondes Machado Nardozza
Antonio Fernades Moron
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 2/2008
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-007-0537-8

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