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Intrapartum cardiotocography (CTG) and ST-analysis of labor in diabetic patients

Yli, Branka M.; Källén, Karin LU ; Khoury, Janette; Stray-Pedersen, Babill and Amer-Wahlin, Isis (2011) In Journal of Perinatal Medicine 39(4). p.457-465
Abstract
Aim: To determine the prevalence and types of intrapartum cardiotocography (CTG) patterns and investigate their relationship to moderate acidemia in term fetuses of diabetic mothers. Also, to assess if the combination of fetal electrocardiogram (FECG) and those CTG patterns strengthens the association with moderate acidemia. Material and methods: The material for this study is obtained from the Swedish randomized control trial and the European Union ST-analysis trial. We developed an analytical model for CTG patterns based on the progress in CTG changes, in a longitudinal periodic manner. The model was then combined with information regarding changes in ST interval that indicate threatening asphyxia, and the findings were analyzed to... (More)
Aim: To determine the prevalence and types of intrapartum cardiotocography (CTG) patterns and investigate their relationship to moderate acidemia in term fetuses of diabetic mothers. Also, to assess if the combination of fetal electrocardiogram (FECG) and those CTG patterns strengthens the association with moderate acidemia. Material and methods: The material for this study is obtained from the Swedish randomized control trial and the European Union ST-analysis trial. We developed an analytical model for CTG patterns based on the progress in CTG changes, in a longitudinal periodic manner. The model was then combined with information regarding changes in ST interval that indicate threatening asphyxia, and the findings were analyzed to determine correlation with the presence of moderate acidemia at birth. Results: This study involved data of 413 diabetic mothers. A preterminal CTG was more common in the diabetes mellitus (DM) group (6/70, 8.6%) than in the gestational diabetes (GD) group (3/307, 1.0%; P=0.003). For diabetic mothers (i.e., DM+GD) with a normal CTG at the start of monitoring, the presence of FECG data indicating asphyxia significantly increased the likelihood of an umbilical artery pH < 7.15 at birth wodds ratio (OR) = 3.65, 95% confidence interval (CI) = 1.33-10.05]. Among labors where the CTG was non-reassuring at the start of monitoring, no significant association was found between pH < 7.15 and indication to intervene according to FECG information (OR = 1.51, 95% CI = 0.33-7.0). Conclusions: A preterminal CTG is more common in the fetuses of DM than GD mothers during labor. When CTG was normal at the start of recording, the addition of FECG information gave a significant add on information to predict moderate acidemia. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiotocography, CTG analytical model, fetal electrocardiogram, gestational diabetes, maternal diabetes mellitus, STAN, umbilical artery
in
Journal of Perinatal Medicine
volume
39
issue
4
pages
457 - 465
publisher
De Gruyter
external identifiers
  • wos:000292642200017
  • scopus:79960253735
ISSN
1619-3997
DOI
10.1515/JPM.2011.046
language
English
LU publication?
yes
id
211ad5a6-7a1e-4e7e-89ea-3bffae70581f (old id 2094049)
date added to LUP
2011-09-02 08:35:17
date last changed
2017-02-22 10:46:23
@article{211ad5a6-7a1e-4e7e-89ea-3bffae70581f,
  abstract     = {Aim: To determine the prevalence and types of intrapartum cardiotocography (CTG) patterns and investigate their relationship to moderate acidemia in term fetuses of diabetic mothers. Also, to assess if the combination of fetal electrocardiogram (FECG) and those CTG patterns strengthens the association with moderate acidemia. Material and methods: The material for this study is obtained from the Swedish randomized control trial and the European Union ST-analysis trial. We developed an analytical model for CTG patterns based on the progress in CTG changes, in a longitudinal periodic manner. The model was then combined with information regarding changes in ST interval that indicate threatening asphyxia, and the findings were analyzed to determine correlation with the presence of moderate acidemia at birth. Results: This study involved data of 413 diabetic mothers. A preterminal CTG was more common in the diabetes mellitus (DM) group (6/70, 8.6%) than in the gestational diabetes (GD) group (3/307, 1.0%; P=0.003). For diabetic mothers (i.e., DM+GD) with a normal CTG at the start of monitoring, the presence of FECG data indicating asphyxia significantly increased the likelihood of an umbilical artery pH &lt; 7.15 at birth wodds ratio (OR) = 3.65, 95% confidence interval (CI) = 1.33-10.05]. Among labors where the CTG was non-reassuring at the start of monitoring, no significant association was found between pH &lt; 7.15 and indication to intervene according to FECG information (OR = 1.51, 95% CI = 0.33-7.0). Conclusions: A preterminal CTG is more common in the fetuses of DM than GD mothers during labor. When CTG was normal at the start of recording, the addition of FECG information gave a significant add on information to predict moderate acidemia.},
  author       = {Yli, Branka M. and Källén, Karin and Khoury, Janette and Stray-Pedersen, Babill and Amer-Wahlin, Isis},
  issn         = {1619-3997},
  keyword      = {Cardiotocography,CTG analytical model,fetal electrocardiogram,gestational diabetes,maternal diabetes mellitus,STAN,umbilical artery},
  language     = {eng},
  number       = {4},
  pages        = {457--465},
  publisher    = {De Gruyter},
  series       = {Journal of Perinatal Medicine},
  title        = {Intrapartum cardiotocography (CTG) and ST-analysis of labor in diabetic patients},
  url          = {http://dx.doi.org/10.1515/JPM.2011.046},
  volume       = {39},
  year         = {2011},
}