Correlation of fetal heart rate decelerations following acoustic stimulation with perinatal outcome.
This was a retrospective study of acoustic stimulation response and perinatal outcome of 688 fetuses undergoing nonstress testing. Acoustic stimulation was performed within 7 days of delivery, and responses were classified based on the presence of an acceleration, deceleration, or both. Responses were correlated with perinatal outcome. Abnormal outcome was defined as: cesarean section for nonreassuring fetal heart rate patterns with an acidotic umbilical artery cord gas; delivery at less than 32 weeks for nonreassuring antenatal fetal testing; meconium aspiration syndrome or mechanical ventilation at 36 weeks or greater; neonatal seizures; 5-minute Apgar score less than 7; and stillbirth. Fetuses who demonstrated deceleration responses were significantly more likely to have abnormal perinatal outcomes when compared with those with acceleration responses (p < 0.001). Although combination acceleration-deceleration responses were more often associated with abnormal perinatal outcome when compared with pure acceleration responses, differences were not significant. A deceleration response following acoustic stimulation is associated with increased risk for adverse perinatal outcome and may merit further evaluation.
Department of Obstetrics and Gynecology, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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Dunston-Boone
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Kuhlman
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Kaufmann
D000161:Acoustic Stimulation; D001034:Apgar Score; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death; D005316:Fetal Distress / Q000175:diagnosis; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity