Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to cardiotocography to predict fetal acidosis in labor / A multi-center, case controlled study
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Håkan Norén
Abstract
Objective: To assess the relationship between scalp pH (FBS) and ST analysis in situations of acidosis with special emphasis on the timing of cardiotocography (CTG), FBS and ST changes during labor.
Study design: From a European Union multicenter study on clinical implementation of the STAN methodology, 911 cases were identified where a scalp-pH had been obtained. In 53 cases, marked cord artery acidosis was found (cord artery pH<7.06) and 44 cases showed moderate acidemia at birth (pH 7.06–7.09). Comparisons were made with 97 control cases (pH≥7.20).
Results: Of those cases with FHR+ST events recorded within 16 min of delivery, 61% (17/28) had a cord artery pH≥7.20. The corresponding figure for cases where STAN indications occurred for more than 16 min was 19% (13/69) (OR 6.66, 2.53–17.55, P<0.001). Out of the 121 cases with an abnormal CTG, 84 (69%) showed a cord artery pH of <7.10. STAN indicated abnormality in 83% (70 out of 84). The corresponding figure for scalp pH<7.20 was 43% (36/84). In the case of CTG changes at the start of an adequate recording STAN guidelines provided information on developing acidosis in all cases but one (16 out of 17) in the marked acidosis group. STAN guidelines indicated abnormality prior to an abnormal FBS in 14 out of 17 cases. The median duration between STAN indications to intervention and an abnormal FBS was 29 (95% CI 11–74) min.
Conclusions: ST analysis, as an adjunct to CTG, identifies adverse fetal conditions during labor similar to that of FBS but on a more consistent basis. The timing of CTG+ST changes relates to the level of acidosis at birth.
©2007 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Intrauterine growth restriction and risk for arterial hypertension: a causal relationship?
- Clinical-radiological features of fractures in premature infants – a review
- Scientific and religious controversies about the beginning of human life: the relevance of the ethical concept of the fetus as a patient
- The status of the embryo in Buddhism: opinions on scientific and religious controversies about the beginning of human life
- The calcium binding protein, S100B, is increased in the amniotic fluid of women with intra-amniotic infection/inflammation and preterm labor with intact or ruptured membranes
- Validity of amniotic fluid index in preterm rupture of membranes
- Activity of adenosine deaminase in mothers who have conceived a fetus with central nervous system malformations
- Ductus venosus Doppler measurement during labor
- Fetal scalp pH and ST analysis of the fetal ECG as an adjunct to cardiotocography to predict fetal acidosis in labor / A multi-center, case controlled study
- Comparison of two- and three-dimensional ultrasonography in lung volume measurement of normal fetuses
- MRI and multiplanar 3D ultrasound compared in the prenatal assessment of enlarged posterior fossa
- Monochorionic twins in which at least one fetus has a congenital heart disease with or without twin-twin transfusion syndrome
- Enriched post-discharge formula versus term formula for bone strength in very low birth weight infants: a longitudinal pilot study
- Which information will be given to parents of preterm infants – a comparison of estimates and local data
- Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model
- Impact of being small-for-gestational age on survival and long-term outcome of extremely premature infants born at 23–27 weeks' gestation
- Gastroschisis: brief early history
- Reply
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