Geva Yael, Yaniv Salem Shimrit, Geva Neta, Rotem Reut, Talmor Meital, Shema Noam, Shany Eilon, Weintraub Adi Y
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Department of Neonatology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Int J Gynaecol Obstet. 2023 Jun;161(3):1061-1068. doi: 10.1002/ijgo.14638. Epub 2023 Jan 9.
To investigate whether an association exists between deceleration and acceleration areas on continuous fetal cardiotocography (CTG) and neonatal encephalopathy (NE).
A single center, retrospective case-control study was conducted to compare CTG characteristics of low-risk pregnancies (35 weeks of gestation or more), complicated by moderate to severe NE with two matched controls for every case. Controls were matched by gestational age and cord blood pH. We analyzed the intrapartum CTG recordings by calculation of the deceleration and acceleration areas and the ratio between the two.
During the period between 2013 and 2019, we identified 95 cases of low-risk pregnancies that were complicated by moderate to severe NE in our center. Thirty-three (34.7%) deliveries were excluded, mostly because of an insufficient duration of the CTG recordings. The remaining 62 cases were matched with 123 controls. We found that NE was significantly associated with an increased total deceleration area, a decreased total acceleration area, and a lower acceleration-to-deceleration ratio.
NE was significantly associated with increased total deceleration area, decreased total acceleration area, and a lower acceleration-to-deceleration ratio, independent of cord blood pH. Development of a computerized real-time analysis of fetal heart rate tracings may contribute to making these measurements a more valid clinical tool.
探讨连续胎儿电子监护（CTG）中的减速和加速区域与新生儿脑病（NE）之间是否存在关联。
进行一项单中心回顾性病例对照研究，以比较低风险妊娠（妊娠35周及以上）合并中度至重度NE的CTG特征，每例病例匹配两个对照。对照按孕周和脐血pH值进行匹配。我们通过计算减速和加速区域以及两者之间的比值来分析产时CTG记录。
在2013年至2019年期间，我们中心共识别出95例低风险妊娠合并中度至重度NE的病例。33例（34.7%）分娩被排除，主要原因是CTG记录时间不足。其余62例病例与123例对照进行匹配。我们发现NE与总减速区域增加、总加速区域减少以及加速与减速比值降低显著相关。
NE与总减速区域增加、总加速区域减少以及加速与减速比值降低显著相关，与脐血pH值无关。开发胎儿心率描记图的计算机实时分析可能有助于使这些测量成为更有效的临床工具。
