[Combination of the computerized analysis of fetal heart rate and amniotic fluid index in the prediction of neonatal acidemia: a modified biophysical profile].
OBJECTIVE
To study the use of a modification of the classical biophysical profile by the combination of computerized analysis of fetal heart rate (cCTG) and the amniotic fluid index (AFI) in the prediction of neonatal acidemia at birth.


METHODS
We considered 89 singleton third trimester high risk pregnancies delivered by cesarean section, with an AFI evaluated within 24 hrs from birth, and an antepartum cCTG performed within 6 hrs from delivery. We assigned values for AFI (oligo/anhydramnios = 1, normal = 0) and cCTG (Dawes-Redman criteria, not satisfied = 1, satisfied = 0). The endpoint was to predict an abnormal neonatal outcome as defined by an umbilical artery (UA) pH < or = 7.2.


RESULTS
Fifteen neonates presented an UA pH < or = 7.2. By performing a logistic regression, we found that cCTG + AFI score (abnormal value 1-2) was able to significantly predict a pH value (< or = 7.20) with an Odds Ratio = 2.83 (p < 0.02). The diagnostic accuracy of the combination of cCTG + AFI was as follows: sensitivity: 80%, specificity: 58%.


CONCLUSIONS
We suggest that the combination of cCTG + AFI included in the simple score we propose, may be of value in the prediction of neonatal acidemia and help in the management of third trimester high risk pregnancies.
Piazze
J
J
II Istituto Clinica Ostetrica e Ginecologica, Università La Sapienza di Roma, Italia. jjpiazze2000@hotmail.com
Anceschi
M
M
Vitali
S
S
Amici
F
F
Marini
T
T
Kashami
A
A
Berretta
A R
AR
Sali
E
E
Cosmi
E V
EV
D000653:Amniotic Fluid; D055592:Biophysical Phenomena; D001703:Biophysics; D015148:Cardiotocography / Q000379:methods; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis