[The prediction of the condition of newborns on the basis of antepartum CTG monitoring and antepartum doppler flow velocity in umbilical arteries in women delivered by caesarean section].
The aim of the study was the estimation of the condition of newborns delivered by caesarean section depending on antepartum umbilical Doppler flow velocity and CTG monitoring.


METHODS
In 213 pregnant women delivered by caesarean section (from preventive and urgent indications before beginning the labor) fetal monitoring included antepartum CTG and Doppler flow velocity up to 7 days before delivery. The CTG recordings before labour were interpreted using a Fischer's method. Increases PI and S/D ratio above two standard deviations from average values for several pregnancy time intervals and the presence of AEDF and REDF are treated as pathological. The newborn's status was estimated using 5th min. Apgar score and base-acid balance in umbilical artery blood. Statistical analysis was performed by using chP test and logistic regression analysis. Significance levels were taken at p < 0.05.


RESULTS
The diagnostic effectiveness for abnormal antepartum CTG to predict bad condition of newborns is 81.7%. The parallel presence of an abnormal pattern of CTG and high PI and S/D ratios or the presence of AEDF/REDF in the umbilical artery also have a high diagnostic effectiveness (83.3%). There is a high risk of newborns delivered in bad condition connected with a low gestational age. The risk increases up to 16 times if the gestational age is less then 32 week. An abnormal CTG pattern increases the risk over 6 times. A presence of AEDF and REDF increases the risk 5 times.


CONCLUSIONS
(1) The highest diagnostic effectiveness for the delivery newborns in a bad condition is connected with an abnormal antepartum CTG pattern with a high Doppler flow velocity. (2) An abnormal Doppler flow velocity is connected with the delivery of newborns in a bad condition. (3) Low gestational age increases the risk of newborns in bad condition independent of results antepartum CTG and Doppler flow velocity.
Bilar
Marek
M
Klinika Medycyny Matczyno-Ptodowej Katedry Połoznictwa i Ginekologii PAM w Szczecinie. marcobil@sci.pam.szcze.cin.pl
Płonka
Tomasz
T
Engel-Pietrzak
Karina
K
Ronin-Walknowska
Elzbieta
E
D001034:Apgar Score; D001783:Blood Flow Velocity; D015148:Cardiotocography; D002585:Cesarean Section; D005260:Female; D005333:Fetus / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*