Bogdanovic Gordana, Babovic Adnan, Rizvanovic Mirzeta, Ljuca Dzenita, Grgic Gordana, Djuranovic-Milicic Jadranaka
Med Arch. 2014;68(2):102-5. doi: 10.5455/medarh.2014.68.102-105.
The objective of the study was to examine whether cardiotocography can (CTG) predict asphyxia of the embryo, manifested as hypoxic-ischemic encephalopathy (HIE), and to what extent one can rely on CTG record.
Retrospective research was carried out at the Clinic for Gynecology and Obstetrics UKC Tuzla and medical documentation from the history of mothers and newborns was used. The study group consisted of 68 pregnancies and newborns who developed HIE. The control group consisted of 40 pregnancies, which resulted in birth of healthy newborns--without signs of asphyxia. CTG records were analyzed, Apgar score, the ways of finishing delivery.
Pathological CTG records (bradycardia 100, tachycardia 180, silent type of curve, late decelerations) were found in 45 (66.17%) cases of the study group in comparison to 11 (27.5%) in the control group. In the study group Apgar score in 5th minute lower than 7 had 17.46% newborns and the highest incidence of the normally finished deliveries. We conclude that cardiotocography is one of the reliable methods of fetal monitoring in pregnancy and delivery, and that pathological CTG record very likely indicates the possible presence of perinatal asphyxia.
Achieving a low degree of correlation between pathological intrapartum cardiotocography findings and long-term outcome of children can be achieved by rapid and adequate obstetric intervention and the relatively short duration of fetal acidosis, and optimal procedures during intensive care of newborns.
本研究的目的是检验产时胎心监护(CTG)能否预测表现为缺氧缺血性脑病(HIE)的胎儿窒息,以及能在多大程度上依赖CTG记录。
在图兹拉大学临床中心妇产科进行回顾性研究,并使用母亲和新生儿病史的医疗记录。研究组由68例发生HIE的妊娠和新生儿组成。对照组由40例妊娠组成,其分娩的新生儿健康,无窒息迹象。分析CTG记录、阿氏评分及分娩方式。
研究组45例(66.17%)出现病理性CTG记录(心动过缓100次/分、心动过速180次/分、曲线寂静型、晚期减速),而对照组为11例(27.5%)。研究组中出生后5分钟阿氏评分低于7分的新生儿占17.46%,顺产发生率最高。我们得出结论,产时胎心监护是孕期和分娩期间胎儿监测的可靠方法之一,病理性CTG记录很可能提示围产期窒息的可能存在。
通过快速适当的产科干预、胎儿酸中毒持续时间相对较短以及新生儿重症监护期间的优化程序,可以使产时病理性胎心监护结果与儿童长期预后之间的相关性降低。