Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
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Yael Yagur
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Omer Weitzner
Abstract
Objectives
This study examined predictive factors, in addition to Category II Fetal Herat Rate (FHR) monitoring that might imply fetal acidosis and risk of asphyxia.
Methods
This retrospective cohort study compared three groups of patients with Category II FHR monitoring indicating need for imminent delivery. Groups were divided based on fetal cord blood pH: pH≤7.0, 7.0<pH<7.2 and pH≥7.2. Demographics, medical history, delivery data and early neonatal outcomes were reviewed.
Results
The cohort included 417 women. Nine (2.2%) had cord pH≤7.0, 105 (25.2%) pH 7.0 to 7.2 and 303 (72.6%) ad pH≥7.2. Background characteristics, pregnancy follow-up and intrauterine fetal evaluation prior to delivery were similar in all groups. As expected, more patients in the low pH group had cesarean section (55.6%), than vaginal delivery or vacuum extraction (p=0.02). Five-minute Apgar scores were similar in all groups.
Conclusions
This retrospective study did not detect a specific parameter that could help predict the prognosis of fetal acidosis and risk of asphyxia. As we only included patients with a Category II tracing that was worrisome enough to lead to imminent delivery, it is reasonable to believe that this is due to patient selection, meaning that when the Category II FHR results in decision for prompt delivery, there is no added value in additional clinical characteristics. The evaluation should be expanded to all patients with Category II tracing for better interpretation tools for Category II FHR monitors, as well as a larger study population.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: The study was conducted according to good clinical practice guidelines and was approved by the Meir medical center Institutional Review Board. Due to retrospective nature of the study, informed consent for participation was not required.
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© 2021 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
- Commentary
- Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
- WAPM Recommendations
- WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
- Corner of Academy
- Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
- Original Articles – Obstetrics
- The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
- Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
- Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
- Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
- Risk of metformin failure in the treatment of women with gestational diabetes
- Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
- New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
- Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
- Maternal and neonatal outcomes in women with disorders of lipid metabolism
- The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration
- Original Articles – Neonates
- The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
- Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
- Impact of paternal presence and parental social-demographic characteristics on birth outcomes
- Letter to the Editor
- Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
Articles in the same Issue
- Frontmatter
- Review
- Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review
- Commentary
- Professional integrity in maternal – fetal innovation and research: an essential component of perinatal medicine
- WAPM Recommendations
- WAPM-World Association of Perinatal Medicine Practice Guidelines: Fetal central nervous system examination
- Corner of Academy
- Education in developing countries and reducing maternal mortality: a forgotten piece of the puzzle?
- Original Articles – Obstetrics
- The contemporary value of dedicated preterm birth clinics for high-risk singleton pregnancies: 15-year outcomes from a leading maternal centre
- Chorioamnionitis after premature rupture of membranes in nulliparas undergoing labor induction: prostaglandin E2 vs. oxytocin
- Maternal and fetal outcomes in pregnancies with obstructive sleep apnea
- Assessing the involvement of the placental microbiome and virome in preeclampsia using non coding RNA sequencing
- Risk of metformin failure in the treatment of women with gestational diabetes
- Can we improve our ability to interpret category II fetal heart rate tracings using additional clinical parameters?
- New obstetric systemic inflammatory response syndrome criteria for early identification of high-risk of sepsis in obstetric patients
- Bacteria in the amniotic fluid without inflammation: early colonization vs. contamination
- Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome
- Maternal and neonatal outcomes in women with disorders of lipid metabolism
- The use of PAMG-1 testing in patients with preterm labor, intact membranes and a short sonographic cervix reduces the rate of unnecessary antenatal glucocorticoid administration
- Original Articles – Neonates
- The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia
- Are neonatal outcomes of triplet pregnancies different from those of singletons according to gestational age?
- Impact of paternal presence and parental social-demographic characteristics on birth outcomes
- Letter to the Editor
- Comment on: “amniotic fluid embolism – implementation of international diagnosis criteria and subsequent pregnancy recurrence risk”
