The combination of computerized cardiotocography and amniotic fluid index for the prediction of neonatal acidemia at birth: a modified biophysical profile.
OBJECTIVE
To study the combination of computerized cardiotocography (cCTG) and the amniotic fluid index (AFI) in the prediction of neonatal acidemia at birth.


METHODS
A total of 89 singleton third-trimester high-risk pregnancies delivered by Cesarean section, with an AFI evaluated within 24 h from birth, and an antepartum cCTG performed within 6 h from delivery, were studied. The score was the sum of values for AFI (oligo/anhydramnios = 1, normal = 0) and cCTG (Dawes-Redman criteria, not met = 1, met = 0). The endpoint was to predict an abnormal neonatal outcome as defined by an umbilical artery pH of < or = 7.2.


RESULTS
Fifteen neonates had an umbilical artery pH of < 7.2. The combination of cCTG + AFI score was able to predict pH values (< or = 7.20) with an OR = 2.83 (p < 0.02). The diagnostic accuracy of the combination of cCTG + AFI was as follows: sensitivity 80%, specificity 58%, positive predictive value 28%, negative predictive value 83%.


CONCLUSIONS
We suggest that the cCTG + AFI score may be of value in the prediction of neonatal acidemia and help in the management of third-trimester high-risk pregnancies.
Piazze
J J
JJ
2nd Institute of Obstetrics and Gynecology, University La Sapienza of Rome, Italy.
Anceschi
M M
MM
Ruozzi Berretta
A
A
Vitali
S
S
Maranghi
L
L
Amici
F
F
Cosmi
E V
EV
D000138:Acidosis / Q000175:diagnosis*; D000653:Amniotic Fluid; D001784:Blood Gas Analysis; D015148:Cardiotocography / Q000592:standards*; D002585:Cesarean Section; D003936:Diagnosis, Computer-Assisted / Q000592:standards*; D005260:Female; D005312:Fetal Blood / Q000502:physiology; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D018566:Pregnancy, High-Risk; D012372:ROC Curve; D012680:Sensitivity and Specificity