[Heart rate accelerations in the fetus during fetal blood sampling sub partu].
Fetal heart rate acceleration is often observed when fetal blood sampling (FBS) is performed during labour. The aim of this study was to examine the influence of the occurrence of a fetal heart rate acceleration on the fetal condition immediately after the FBS incision during labour. 117 pregnant patients with a total of 210 FBS were included in the study. Particular attention was given as to whether an acceleration > or = 15 bpm and > or = 15 sec occurred immediately after the FBS incision. So 2 groups were formed: reactive (159 cases with acceleration) and non-reactive (51 cases without acceleration). No FBS acceleration was observed in any case with acidosis during labour. Therefore the occurrence of an FBS acceleration can be regarded as a reliable predictor of a fetal pH value of > or = 7.20 during labour. The test sensitivity amounts to 77% and the specificity and the positive predictive value are 100%. If an acceleration occurred immediately after the FBS incision, in 6% of the cases (negative predictive value) an acidosis with a pH value of < 7.20 was registered. The cesarean section rate increases by more than double from 13% to 33% when no FBS acceleration occurs.
Tzanov
G
G
Abteilung für Gerburtsmedizin, Virchow-Klinikum-Berlin.
Büscher
U
U
Dudenhausen
J W
JW
D000142:Acidosis, Respiratory / Q000175:diagnosis* / Q000503:physiopathology; D000328:Adult; D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000503:physiopathology; D001800:Blood Specimen Collection; D015148:Cardiotocography; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies