Changes in the ST-interval segment of the fetal electrocardiogram in relation to acid-base status at birth.
(2008) In BJOG: An International Journal of Obstetrics & Gynaecology 115(13). p.1669-1675- Abstract
- Objective To assess the occurrence of ST-interval segment changes of the fetal electrocardiogram (ECG) and cardiotocographic (CTG) abnormalities preceding acidaemia at birth. Design Case-control study. Setting University hospital labour ward. Sample Newborns with severe cord artery metabolic acidaemia (pH < 7.00 and lactate >/= 10 mmol/l; n= 24), moderate metabolic acidaemia (pH 7.00-7.09 and lactate >/= 10; n= 48), acidaemia (pH 7.00-7.09; n= 52), pre-acidaemia (pH 7.10-7.19; n= 265), and controls (pH >/= 7.20; n= 117). Methods Monitoring traces were assessed blinded to outcome. Main outcome measures CTG and ST changes. Results Any ST event occurred significantly more often among cases with severe (79%) and moderate (75%)... (More)
- Objective To assess the occurrence of ST-interval segment changes of the fetal electrocardiogram (ECG) and cardiotocographic (CTG) abnormalities preceding acidaemia at birth. Design Case-control study. Setting University hospital labour ward. Sample Newborns with severe cord artery metabolic acidaemia (pH < 7.00 and lactate >/= 10 mmol/l; n= 24), moderate metabolic acidaemia (pH 7.00-7.09 and lactate >/= 10; n= 48), acidaemia (pH 7.00-7.09; n= 52), pre-acidaemia (pH 7.10-7.19; n= 265), and controls (pH >/= 7.20; n= 117). Methods Monitoring traces were assessed blinded to outcome. Main outcome measures CTG and ST changes. Results Any ST event occurred significantly more often among cases with severe (79%) and moderate (75%) metabolic acidaemia than among controls (50%). The difference was restricted to baseline T/QRS rises and to the second stage of labour, during which any event only occurred significantly more often among cases with severe metabolic acidaemia (62%) than among controls (38%). ST events coincided with abnormal CTG patterns in 67, 44, 40, and 28% of cases with severe and moderate metabolic acidaemia, acidaemia, and pre-acidaemia, respectively, and in 12% of controls. ST events with intermediary CTG were similarly frequent in the case groups (0-6%) as in the controls (4%). The ST guidelines stated intervention in 96, 62, 73, and 49% of case groups and 23% of controls. Conclusions Only two of three cases with severe and less than half of cases with moderate metabolic acidaemia were preceded by ST events coinciding with CTG abnormalities. It is therefore important to intervene for long-lasting, rapidly deteriorating or marked (preterminal) CTG abnormalities, also in the absence of ST events. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1271055
- author
- Melin, M ; Bonnevier, A ; Cardell, Monika LU ; Hogan, L and Herbst, Andreas LU
- organization
- publishing date
- 2008
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BJOG: An International Journal of Obstetrics & Gynaecology
- volume
- 115
- issue
- 13
- pages
- 1669 - 1675
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000260748300012
- pmid:19035941
- scopus:55949092958
- pmid:19035941
- ISSN
- 1471-0528
- DOI
- 10.1111/j.1471-0528.2008.01949.x
- language
- English
- LU publication?
- yes
- id
- c3db32bc-b9b9-49f6-9174-4140ac65d4f2 (old id 1271055)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19035941?dopt=Abstract
- date added to LUP
- 2016-04-04 09:23:13
- date last changed
- 2022-01-29 17:38:30
@article{c3db32bc-b9b9-49f6-9174-4140ac65d4f2, abstract = {{Objective To assess the occurrence of ST-interval segment changes of the fetal electrocardiogram (ECG) and cardiotocographic (CTG) abnormalities preceding acidaemia at birth. Design Case-control study. Setting University hospital labour ward. Sample Newborns with severe cord artery metabolic acidaemia (pH < 7.00 and lactate >/= 10 mmol/l; n= 24), moderate metabolic acidaemia (pH 7.00-7.09 and lactate >/= 10; n= 48), acidaemia (pH 7.00-7.09; n= 52), pre-acidaemia (pH 7.10-7.19; n= 265), and controls (pH >/= 7.20; n= 117). Methods Monitoring traces were assessed blinded to outcome. Main outcome measures CTG and ST changes. Results Any ST event occurred significantly more often among cases with severe (79%) and moderate (75%) metabolic acidaemia than among controls (50%). The difference was restricted to baseline T/QRS rises and to the second stage of labour, during which any event only occurred significantly more often among cases with severe metabolic acidaemia (62%) than among controls (38%). ST events coincided with abnormal CTG patterns in 67, 44, 40, and 28% of cases with severe and moderate metabolic acidaemia, acidaemia, and pre-acidaemia, respectively, and in 12% of controls. ST events with intermediary CTG were similarly frequent in the case groups (0-6%) as in the controls (4%). The ST guidelines stated intervention in 96, 62, 73, and 49% of case groups and 23% of controls. Conclusions Only two of three cases with severe and less than half of cases with moderate metabolic acidaemia were preceded by ST events coinciding with CTG abnormalities. It is therefore important to intervene for long-lasting, rapidly deteriorating or marked (preterminal) CTG abnormalities, also in the absence of ST events.}}, author = {{Melin, M and Bonnevier, A and Cardell, Monika and Hogan, L and Herbst, Andreas}}, issn = {{1471-0528}}, language = {{eng}}, number = {{13}}, pages = {{1669--1675}}, publisher = {{Wiley-Blackwell}}, series = {{BJOG: An International Journal of Obstetrics & Gynaecology}}, title = {{Changes in the ST-interval segment of the fetal electrocardiogram in relation to acid-base status at birth.}}, url = {{https://lup.lub.lu.se/search/files/5310592/1303172.pdf}}, doi = {{10.1111/j.1471-0528.2008.01949.x}}, volume = {{115}}, year = {{2008}}, }