Abstract
Objective
Our purpose was to evaluate the clinical validity of electronic fetal heart rate monitoring
to detect fetal acidemia and to evaluate the prevalence of cerebral palsy in unselected
low-risk pregnancies.
Study design
We selected two secondary and two tertiary level institutions in which 10030 infants
were born. Among them, 5546 of the pregnancies were low-risk pregnancies by antepartum
evaluation. The fetal heart rate patterns were interpreted according to the guidelines
of the National Institute of Child Health and Human Development. The correlations
between the fetal heart rate pattern and umbilical blood gases and the fetal heart
rate pattern and cerebral palsy were studied. Spastic cerebral palsy was diagnosed
at ≥1 year by pediatric neurologists. Statistics included unpaired t test, contingency table with χ2 and Fisher tests, and one-way analysis of variance with Bonferroni/Dunn test.
Results
On the basis of the severity of decelerations, frequency of decelerations, and decreased
variability, umbilical pH, and Po2 level were decreased accordingly, and incidence of pH<7.1 was increased. Sensitivity
and false-positive rate of nonreassuring fetal heart rate patterns for fetal acidemia
were 63% and 89%. There were nine cerebral palsy cases: six of the cases were preexisting
asphyxia before monitoring was initiated, two of the cases were cytomegaloviral infections,
and one of the cases was a maternal amniotic fluid embolism.
Conclusion
In low-risk pregnancies, intrapartum fetal heart rate monitoring was useful to detect
fetal acidemia. Cerebral palsy caused by intrapartum asphyxia was restricted to unavoidable
accidents under continuous fetal heart rate monitoring.
Keywords
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Article Info
Publication History
Accepted:
July 23,
2003
Received in revised form:
June 27,
2003
Received:
February 20,
2003
Footnotes
☆Supported in part by Grant-in-Aid for Scientific Research No. (C)-2-13671734 from the Ministry of Education, Culture, Sports, Science, and Technology, Japan and a grant from JAOG Ogyaa Donation Foundation, Japan.
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
