Περίληψη:
Objective: To investigate the efficacy and safety of intrapartum fetal
pulse oximetry, as a predictor of metabolic acidosis at birth of fetuses
with intrauterine growth retardation (IUGR). Study Design: We studied 18
IUGR fetuses (group I) and a control group of 30 appropriate for
gestational age (AGA) fetuses (group II) during labor. Both groups had
abnormal fetal heart rate tracings and were monitored simultaneously
throughout labor with cardiotocography and fetal pulse oximetry. Apgar
scores, pH and base excess of fetal blood obtained from the umbilical
artery after delivery were compared in both groups. Setting: The Fetal
Surveillance Unit of the 2nd Department of Obstetrics and Gynecology,
Aretaieion Hospital, Medical. School, Athens University. Results: In
IUGR fetuses, when their oxygen saturation value (FSPO2) was less than
34%, cord artery pH was 7.10 +/- 0.04, base excess-13 +/- -1 mmol/l and
Apgarscores less than or equal to 5 at the 5th min, and when FSPO2 was
over 35%, artery pH was 7.29 +/- 0.08, base excess -8 +/- -2 mmol/l and
Apgar scores greater than or equal to 7 at the 5th minute. In cases of
drops of FSPO2 below 30% for more than 2 min, labor was completed
operatively and cord pH was 7.00 +/- 0.04, base excess -15 +/- -2 mmol/l
and Apgar scores less than or equal to 5 at the 5th minute. In AGA
fetuses, when FSPO2 was over 30%, artery pH was over 7.20, base excess
<-11 mmol/l and Apgar scores 2 9 at the 5th minute; in contrast, when
FSPO2 was <30% for 2 min, a cesarean section was performed and cord pH
was less than or equal to 7.02, base excess greater than or equal to -13
mmol/l and Apgarscores less than or equal to 4 at the 5th minute.
Conclusions: In IUGR fetuses, FSPO2 values less than 34% represent an
acidotic status, while values of greater than or equal to 35% are well
tolerated. Fetal pulse oximetry proved reliable, according to umbilical
cord blood measurements and Apgar scores, reducing cesarean deliveries
in cases of nonreassuring cardiotocographic patterns in IUGR fetuses.
Copyright (C) 2003 S. Karger AG, Basel.
Συγγραφείς:
Siristatidis, C
Salamalekis, E
Vitoratos, N
Loghis, C and
Salloum, J
Kassanos, D
Panayotopoulos, N
Creatsas, G
