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Acidemia at birth in the vigorous infant as a trigger incident to assess intrapartum care with regard to CTG patterns
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2013 (English)In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 26, no 11, 1094-1098 p.Article in journal (Refereed) Published
Abstract [en]

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.
Keyword [en]
Acidemia, asphyxia, cardiotocography, labour, metabolic acidemia, second stage quality of care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-204989DOI: 10.3109/14767058.2013.770457ISI: 000320816800009OAI: oai:DiVA.org:uu-204989DiVA: diva2:641318
Available from: 2013-08-16 Created: 2013-08-13 Last updated: 2017-12-06Bibliographically approved

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Jonsson, MariaLindeberg, Solveig NordenHanson, Ulf

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