Startseite Impact of fetal blood sampling on vaginal delivery and neonatal outcome in deliveries complicated by pathologic fetal heart rate: a population based cohort study
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Impact of fetal blood sampling on vaginal delivery and neonatal outcome in deliveries complicated by pathologic fetal heart rate: a population based cohort study

  • Werner Stein , Lars Hellmeyer , Björn Misselwitz und Stephan Schmidt
Veröffentlicht/Copyright: 1. Dezember 2006

Abstract

Objective: To compare the impact of electronic fetal monitoring (EFM) alone vs. EFM with additional fetal blood sampling (FBS) in vaginal deliveries complicated by pathologic fetal heart rate (FHR).

Methods: All deliveries in Hesse between 1990 and 2000 were evaluated for participation in this study. Inclusion criteria comprised (1) pathologic fetal heart rate, (2) singleton pregnancy, (3) cephalic presentation, (4) vaginal delivery, and (5) gestational age at delivery of more than 35 weeks' gestation. In order to analyze the meaning of additional risk factors at birth for the effectiveness of FBS two subgroups were selected depending on the presence of additional risk factors at birth. To examine the impact of FBS in deliveries with pathologic FHR on the mode of delivery and on neonatal outcome, univariate regression analysis was performed and odds ratios (OR) and their corresponding 95% confindence intervals (95% CI) were calculated.

Results: The study population comprised 49,560 deliveries, among deliveries complicated by pathologic FHR, 26% underwent FBS. Deliveries with pathologic FHR and controlled by FBS, with no additional antepartum risk factors, were associated with an increase in spontaneous births OR 1.41 (95% CI 1.27–1.58), and in the presence of additional risk factors OR 1.24 (1.19–1.30). Short-term neonatal outcome parameters were characterized by a lower frequency of severe fetal acidosis (umbilical artery pH <7.0) OR 0.55 (0.42–0.72), and Apgar score <5 after 5 min, OR 0.71 (0.55–0.90).

Conclusion: In vaginal deliveries with pathologic FHR the use of FBS as an additional means of intrapartum fetal surveillance is associated with less vaginal operative deliveries, and with an improved short-term neonatal outcome.

:

Corresponding author: Dr. Werner Stein Center of Gynecology and Obstetrics Georg-August-University of Goettingen Robert-Koch-Straße 40 D-37075 Goettingen Germany

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Published Online: 2006-12-01
Published in Print: 2006-12-01

©2006 by Walter de Gruyter Berlin New York

Artikel in diesem Heft

  1. WAPM-Newsletter No 2/2006 ACTIVITIES OF THE “INTERNATIONAL ACADEMY OF PERINATAL MEDICINE”
  2. Editorial
  3. Neurosonography in the second half of fetal life: a neonatologist's point of view
  4. Normal and abnormal transformation of the spiral arteries during pregnancy
  5. Lessons learned from maternal deaths at an East African health center
  6. Maternal venous procalcitonin levels do not correlate with umbilical cord blood and venous blood concentrations in the neonate
  7. Increased cortisol concentrations in the cord blood of newborns whose mothers smoked during pregnancy
  8. The assessment of fetal behavior of growth restricted fetuses by 4D sonography
  9. Impact of fetal blood sampling on vaginal delivery and neonatal outcome in deliveries complicated by pathologic fetal heart rate: a population based cohort study
  10. Postnatal growth failure in preterm infants: ascertainment and relation to long-term outcome
  11. Impact of breast-feeding on psychomotor and neuropsychological development in children of diabetic mothers: role of the late neonatal period
  12. Factors associated with hypospadias in Asian newborn babies
  13. Spontaneous dichorionic triamniotic triplet pregnancy affected by TTTS: follow-up from diagnosis to three months of extrauterine life
  14. Antibiotic therapy for preterm premature rupture of membranes
  15. Reply
  16. Delivery of a healthy child 30 weeks after resuscitation for thromboembolism and treatment with danaparoid: 5-year follow up
  17. Seasonality of birth and acute lymphoblastic leukemia
  18. Errata
  19. Congress Calendar
  20. Index Volume 34 (2006)
  21. Index - Subjects
  22. Index - Authors
  23. Acknowledgement
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