Cardiotocography Dotaz Zobrazit nápovědu
- MeSH
- děložní kontrakce MeSH
- fetální srdce patofyziologie MeSH
- kardiotokografie * MeSH
- lidé MeSH
- předčasná porodní činnost patofyziologie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- kardiotokografie * přístrojové vybavení MeSH
- lidé MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
OBJECTIVE: The increase of cardiotocographic abnormalities, such as late decelerations, bradycardia and reduced variability have been reported with epidural analgesia (EDA) in some studies. The aim of our study was to assess the influence of epidural analgesia on the incidence of the pathological cardiotocographic patterns. DESIGN: A clinical study. SETTING: Department of Obstetrics and Gynaecology, Jessenius Medical Faculty of Comenius University, Martin, Slovak Republic. METHODS: Clinical group consists of 200 parturients, who borne in our department from 1997 to 2000. The epidural group of parturients (n = 100) borne under epidural analgesia, the control group of (n = 100) borne under other resp. no analgesic method. We compared BFHR, variability and the incidence of accelerations and decelerations in CTG between both groups. All cardiotocographic patterns were evaluated by Fischer score. For statistic evaluation was used Student t-test. RESULTS: We did not find any statistically significant differences in Fischer score between epidural and control group. CONCLUSION: The epidural labour analgesia is safe method of ease pain during labour. In our study we confirmed, that EDA is not responsible for the increase of pathological cardiotocographic patterns.
- MeSH
- hypoxie plodu diagnóza MeSH
- kardiotokografie * MeSH
- kojenecká mortalita * MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Československo epidemiologie MeSH
- MeSH
- kardiotokografie metody normy MeSH
- lidé MeSH
- porodní děj MeSH
- srdeční frekvence plodu MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- MeSH
- hypoxie plodu diagnóza MeSH
- kardiotokografie * MeSH
- kojenecká mortalita * MeSH
- lidé MeSH
- novorozenec MeSH
- odumření plodu epidemiologie MeSH
- statistické modely MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
OBJECTIVE: Judging the validity of CTG monitoring as a method of acute foetal hypoxia diagnosis (AFH), quantifying the number of cesarean section (SC), performed from the indication of acute fetal hypoxia and point out a number of surgeries based on false positive CTG results. DESIGN: Retrospective study. SETTING: 1st Department of Obsterics and Gynaecology Faculty of Medicine MU, Brno. METHODS: 100 women, patients of the 1st Department of Obstetrics and Gynaecology in Obilní trh, Brno, who had cesarean section due to foetal hypoxia indicated on the base of pathological or suspect CTG, were involved in the collection. In the next stage newborns were divided into 2 clinical groups: "Acidosis" and "Normal" depending on the pH value from a. umbilicalis and statistically analysed. RESULTS: From 100% suspect or pathological CTG, only 36.19% were valid (newborns showed depression after birth). Remaining 63.18% of newborns, although showed CTG signs of hypoxia were born normal and probably were not necessary to be born by cesarean section. CONCLUSION: Although CTG investigation is in most places the only "objective" method for diagnosis of AFH, this investigation cannot precisely determinate whether hypoxia is present or it is not. For true objectivity of foetal intrauterine condition and correct indication of SC is suitable to use further diagnostic methods of AFH in future, for example intrapartal foetal pulse oximetry or blood analysis from foetal scalp.
- MeSH
- akutní nemoc MeSH
- císařský řez * MeSH
- falešně pozitivní reakce MeSH
- hypoxie plodu diagnóza MeSH
- kardiotokografie * MeSH
- lidé MeSH
- novorozenec MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- distres plodu diagnóza MeSH
- dospělí MeSH
- elektrokardiografie * MeSH
- kardiotokografie * MeSH
- lidé MeSH
- monitorování plodu * MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
OBJECTIVE: To evaluate by analysis of the most serious obstetric cases during a five-year period the contribution of ante-partum CTG and Doppler flowmetry in the diagnosis of foetal risk and to assess the part of risk factors of hypoxia during pregnancy. DESIGN: Retrospective epidemiological analysis. SETTING: Gynaecological and Obstetric Clinic Medical Faculty Palacký University and Faculty Hospital Olomouc. METHOD: In a retrospective analysis based on 6494 deliveries during a five-year period (1996-2000) the authors evaluate a selected sample of 1087 most serious conditions with the diagnosis of imminent foetal hypoxia. In the evaluated group 90.3% of the women had a cardiotocographic examination, 50.8% Doppler flowmetry with assessment of umbilical RI and PI indexes. The diagnosis of neonatal hypoxia was based on evaluation according to Apgar score < 7 and pH of arterial blood < 7.20. The authors compare both diagnostic methods with a common gold standard as regards their ability to predict hypoxia. In the logistic regression model they evaluate risk factors of pregnancy in relation to foetal hypoxia. RESULTS: Clinical manifestations of hypoxia were recorded in 114 neonates (10.5%). Perinatal deaths occurred in 46 infants, 16 were stillborn. Pathological ante-partum CCTG findings are associated with more active approaches (earlier termination of pregnancy, SC, preinduction by prostaglandins). Pathological ante-partum CTG and flowmetry was paradoxically more frequently associated with a better condition of the neonate. Pathological findings of ante-partum CTG were significantly less frequent in neonates with hypoxia than those without it (27%) vs. (40.9%), (relative risk 0.56 [95% CL 0.36-0.88], P = 0.01) while pathological findings of umbilical flowmetry were insignificantly more frequent (34.9%) vs. (33%), (relative risk 1.08 [95% Cl 0.59-1.97], P = 0.9). Both examinations were made in 547 (50.3%) women of the whole group, in 43 (7.9%) hypoxia of the foetus developed. Sensitivity: CTG 32.6%, Doppler 34.9%, Specificity: CTG 51.4%, Doppler 67.3%. Falsely positive CTG 48.6%, Doppler 32.7%. Analysis of risk factors of pregnancy in relation to foetal hypoxia defines by retrospective elimination as significant risks haemorrhage during pregnancy (n = 76, OR 2.35 [95% Cl 1.31-4.23], P = 0.01) and premature delivery (n = 258, OR 2.02 [95% Cl 1.34-3.05], P = 0.0004). CONCLUSION: The value of ante-partum CTG and Doppler flowmetry in the prognosis of neonatal hypoxia is low. The lower rate of pathological findings in affected neonates is probably associated with the fact that part of the hypoxias develop during delivery and cannot be predicted before delivery. The high number of falsely positive findings may by due by the adaptational abilities and reserves of the infant, by a more active approach when there are signs of danger and incorrect interpretation of findings. Premature delivery and haemorrhage are significant risks of neonatal hypoxia.
- MeSH
- dospělí MeSH
- hypoxie plodu diagnóza MeSH
- kardiotokografie * MeSH
- lidé MeSH
- novorozenec MeSH
- pupečník krevní zásobení MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senzitivita a specificita MeSH
- těhotenství MeSH
- ultrasonografie dopplerovská * MeSH
- ultrasonografie prenatální * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
UNLABELLED: Monitoring of fetal heart rate is one of the basic components of obstetrical care, in which the cardiotocography remains the gold standard and screening method in early diagnosis of fetal hypoxia, even after introduction of other selective methods of intrauterine monitoring of fetal well-being. The review article is divided into several parts: pathophysiology of fetal oxygenation, fetal heart rate and changes of fetal hemodynamics, and rules for fetal heart rate auscultation. The main principles of cardiotocographic monitoring and evaluation of ante- and intrapartrum recordings according to the FIGO criteria from 1986 and evaluation of intrapartum recordings according to the 2015 FIGO recommendations are mentioned. At the end a comparative table of 1986 FIGO and 2015 FIGO criteria is presented. DESIGN: Review.
- Klíčová slova
- CTG classification - FIGO 1986, FIGO 2015, auscultation of fetal heart, cardiotocography (CTG), diagnosis of fetal hypoxia, fetal monitoring in utero.,
- MeSH
- časná diagnóza MeSH
- hypoxie plodu diagnóza MeSH
- kardiotokografie * MeSH
- lidé MeSH
- novorozenec MeSH
- prognóza MeSH
- srdeční frekvence plodu * MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH