Esposito Francesca G, Tagliaferri Salvatore, Giudicepietro Antonia, Giuliano Natascia, Maruotti Giuseppe M, Saccone Gabriele, Signorini Maria G, Magenes Giovanni, Campanile Marta, Zullo Fulvio
Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, Naples, Italy.
Department of Electronics, Information and Bioengineering (DEIB), Politecnico of Milan, Milan, Italy.
J Obstet Gynaecol Res. 2019 Jul;45(7):1343-1351. doi: 10.1111/jog.13981. Epub 2019 May 16.
The early-onset intrauterine growth restriction (IUGR) is associated with severe placental insufficiency and Doppler abnormalities. The late-onset IUGR is associated with mild placental insufficiency and normal Doppler velocimetry. The computerized cardiotocographic (cCTG) monitoring is used to evaluate the fetal well-being in pregnancies complicated by IUGR. Our aim was to investigate the cardiotocographic characteristics of IUGR fetuses and to identify every cCTG difference between Healthy and IUGR fetuses.
Four hundred thirty pregnant women were enrolled starting from the 28th week of gestation until the time of delivery: 200 healthy and 230 IUGR fetuses. Fetal heart rate (FHR) baseline (FHR), short-term variability (STV), long-term irregularity (LTI), delta, interval index (II), approximate entropy (ApEn), high frequency (HF), low frequency (LF), movement frequency (MF), LF/(HF + MF) ratio (LF/(HF + MF)) and number of decelerations were examined. Newborn baby data were also collected.
The parameters of short- and medium-term variability discriminate between IUGR and healthy fetuses before 36 weeks including FHR, STV, LTI and delta discriminate between each subgroup of IUGR were compared to each one of the other two (P < 0.05).
cCTG is a useful tool for the evaluation of chronic hypoxemia, which causes a delay in the maturation of all components of the autonomic and central nervous system. However, cCTG requires integration with fetal ultrasound and Doppler vessels evaluation to improve the ability to predict the neonatal outcome.
早发型宫内生长受限（IUGR）与严重胎盘功能不全及多普勒异常有关。晚发型IUGR与轻度胎盘功能不全及正常多普勒血流速度测定有关。计算机化心动图（cCTG）监测用于评估合并IUGR的妊娠中的胎儿健康状况。我们的目的是研究IUGR胎儿的心动图特征，并确定健康胎儿与IUGR胎儿之间的每个cCTG差异。
从妊娠第28周开始直至分娩，招募了430名孕妇：200名健康胎儿和230名IUGR胎儿。检查了胎儿心率（FHR）基线（FHR）、短期变异性（STV）、长期不规则性（LTI）、δ、间隔指数（II）、近似熵（ApEn）、高频（HF）、低频（LF）、运动频率（MF）、LF/（HF + MF）比值（LF/（HF + MF））和减速次数。还收集了新生儿数据。
在36周之前，短期和中期变异性参数可区分IUGR胎儿和健康胎儿，包括FHR、STV、LTI和δ，IUGR各亚组之间进行了比较（P < 0.05）。
cCTG是评估慢性低氧血症的有用工具，慢性低氧血症会导致自主神经系统和中枢神经系统所有成分的成熟延迟。然而，cCTG需要与胎儿超声和多普勒血管评估相结合，以提高预测新生儿结局的能力。
