Acidemia at birth in the vigorous infant as a trigger incident to assess intrapartum care with regard to CTG patterns
2013 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, Vol. 26, no 11, 1094-1098 p.Article in journal (Refereed) Published
Objective: To evaluate if acidemia in vigorous infants is a useful variable in the assessement of intrapartm care with regard to cardiotocographic (CTG) patterns during the second stage. Methods: Cases (n = 241) were infants with an umbilical artery pH<7.05, controls (n 482) were infants with pH >= 7.05. Apgar score was >= 7 at 5 min in both groups. CTGs during the last two hours of labor were assessed and neonatal outcomes compared. A sub-analysis of cases with metabolic acidemia: pH<7.00 and base deficit >= 12 mmol/L and acidemia: 7.00<pH<7.05 was performed. Results: 63% of cases had a pathological CTG versus 26% of controls (p<0.001). Patterns with severe variable decelerations had a significantly longer duration in cases. Metabolic acidemia was significantly associated with severe variable decelerations and decreased variability. Infants to cases were admitted to neonatal care in 19% versus 2% of controls (p<0.001). With metabolic acidemia, 32% were admitted. Conclusion: An umbilical artery pH<7.05 at birth of vigorous infants may be a useful variable for quality control of intrapartum management with regard to the assessment of second-stage CTGs. Differences in duration of pathological patterns indicate passiveness in acidemic cases.
Place, publisher, year, edition, pages
2013. Vol. 26, no 11, 1094-1098 p.
Acidemia, asphyxia, cardiotocography, labour, metabolic acidemia, second stage quality of care
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-204989DOI: 10.3109/14767058.2013.770457ISI: 000320816800009OAI: oai:DiVA.org:uu-204989DiVA: diva2:641318