Abstract

To study the correlation between cardiotocography parameters and perinatal outcome in pregnancies with absent or reversed end-diastolic velocity (AERDV) in the umbilical arteries. One hundred and twenty-seven cases presenting with AREDV followed between 1993 and 2000 were selected for analysis. The last cardiotocographic tracing performed on the day of delivery was reviewed and the following parameters were considered: magnitude of long-term variability, presence or absence of acceleration, late deceleration, variable deceleration, prolonged deceleration, pseudo sinusoidal pattern and the classification in normal, suspected and abnormal tracing. A significant (p<0.05) association was found between abnormal tracing and acidemia at birth (pH inferior to 7.20) with 71.9%, first minute Apgar score inferior to seven (73.4%), newborn intubation at delivery (64.1%), and early neonatal death (20.3%). The absence of acceleration was associated (p<0.05) to acidemia at birth (58.8%), first minute Apgar score inferior to seven (67.7%), newborn intubation at delivery (51%) and neonatal death (29.4%). Low FHR variability (<5bpm) was associated to (p<0.05): acidemia at birth (88.5%), newborn intubation at delivery (69.2%), early neonatal death (34.6%) and neonatal death (42.3%). Late decelerations were significantly (p<0,05) related to acidemia at birth.(78.2%). The severe variable deceleration was associated to (p<0.05): acidemia at birth (79.3%), newborn intubation at delivery (69%) and early neonatal death (17.2%). Prolonged deceleration was associated to (p<0.05) newborn intubation at delivery (70.6%). Pseudo sinusoidal pattern was associated to (p<0.05) early neonatal death (60%). The AREDV represents a severe fetal compromise with high risk to neonatal morbidity and mortality, and correlation between cardiotocography abnormalities and adverse perinatal outcome was demonstrated.

Highlights

  • twenty-seven cases presenting with AREDV followed between

  • cardiotocographic tracing performed on the day of delivery was reviewed

  • association was found between abnormal tracing and acidemia at birth

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Summary

Artigo Original CARDIOTOCOGRAFIA EM GESTAÇÕES COM DIÁSTOLE ZERO OU REVERSA

CARDIOTOCOGRAFIA EM GESTAÇÕES COM DIÁSTOLE ZERO OU REVERSA NAS ARTÉRIAS UMBILICAIS: ANÁLISE DOS RESULTADOS PERINATAIS. A classificação adotada para a cardiotocografia foi ativo (normal), hipoativo (suspeito) e inativo (alterado) Os parâmetros analisados foram: variabilidade da FCF, acelerações transitórias, DIP II, DIP umbilical, desaceleração prolongada e padrão pseudo sinusoidal. MÉTODOS No período compreendido entre maio de 1993 e abril de 2000, o setor de Vitalidade Fetal da Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP) acompanhou 249 gestações de alto risco, nas quais constatou-se DZ ou DR à dopplervelocimetria das artérias umbilicais. Os seguintes parâmetros cardiotocográficos foram analisados: classificação da cardiotocografia pelo índice cardiotocométrico, presença de acelerações transitórias, variabilidade da FCF, desacelerações tardias (DIP II), desacelerações variáveis (DIP umbilical), desacelerações prolongadas e padrão pseudo sinusoidal. Foram analisados os seguintes resultados perinatais: idade gestacional no nascimento, pH

Idade gestacional no nascimento
Padrão pseudo sinusoidal presente
Padrão pseudosinusoidal presente ausente
METHODS
RESULTS
CONCLUSION
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