Predicting survival of periviable fetuses using NICHD fetal heart rate categories
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Theodore Mark Hale
,
Manonmani Arul
Abstract
Objective: To evaluate whether National Institute of Child Health and Human Health and Development (NICHD) fetal heart rate categories were predictive of neonatal survival in periviable pregnancies.
Methods: We reviewed the charts of 57 infants delivered at 23 and 24 weeks' gestation. Fetal heart rate tracings were evaluated following the NICHD 2008 criteria, using the acceleration height of 10 bpm and duration of 10 s. Multiple logistic regression analyses were performed using survival, fetal morbidities, and cord pH <7.1 as dependent variables. Independent variables included fetal heart rate category, mode of delivery, resuscitation, and histological chorioamnionitis. Outcomes of infants delivered at 23 and 24 weeks were also compared.
Results: In 23-week pregnancies, fetal heart rate category 2 was associated with improved short-term survival compared to category 3 (OR 1.3, 95% CI 0.11–15.7). Cesarean delivery and histological chorioamnionitis were not predictive of survival [(OR 0.5, 95% CI 0.04–7.1, and OR 0.4, 95% CI 0.02–6.85), respectively]. Long-term survival for infants born at 23 and 24 weeks was 8% and 56%, respectively.
Conclusions: The NICHD fetal heart rate category during labor may be associated with survival for infants born at 23 and 24 weeks of gestation. Cesarean delivery was not associated with improved survival.
©2011 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Publisher's note
- Publisher's Note
- Review articles
- 3D and 4D sonography and magnetic resonance in the assessment of normal and abnormal CNS development: alternative or complementary
- Selective reduction in twins and multiple pregnancies
- Original articles – Obstetrics
- Do uterotrophic drugs increase the risk of fatal hemorrhagic brain stroke?
- Parental factors affecting the weights of the placenta and the offspring
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- Original articles – Fetus
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- NCI classification of thrombocytopenia in extremely preterm neonates and its association with mortality and morbidity
- Epidemiology of congenital syphilis in a South Bronx population: a follow-up study
- Quantitative ultramicrotest for newborn screening of galactosemia in Cuba
- Expression of soluble Fas in the cerebrospinal fluid of preterm infants with posthemorrhagic hydrocephalus and cystic white matter damage
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- Letter to the Editors
- Perimortem instrumental vaginal delivery
- Human sex ratio at birth and related factors
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