Abnormal fetal heart rate tracing patterns in patients with thick meconium staining of the amniotic fluid: association with perinatal outcomes.
OBJECTIVE
The objective of the study was to evaluate, in labors complicated by thick meconium-stained amniotic fluid, the association between specific fetal heart rate (FHR) patterns and adverse perinatal outcomes.


METHODS
A retrospective cohort study of patients with FHR tracing data (n = 1638) from a previously reported randomized controlled trial of amnioinfusion for the prevention of meconium aspiration syndrome.


RESULTS
The presence of FHR tracing abnormalities was associated with an increased risk of perinatal mortality and/or neonatal morbidity (moderately abnormal: adjusted odds ratio [OR], 1.67; 95% confidence interval [CI], 1.18-2.37; markedly abnormal: adjusted OR, 2.97; 95% CI, 1.88-4.67). Specific abnormalities that were associated with the risk of perinatal mortality and/or neonatal morbidity included prolonged decelerations (OR, 1.22; 95% CI, 1.02-1.48), severe variable decelerations (OR, 1.08; 95% CI, 1.00-1.16), bradycardia (OR, 2.49; 95% CI, 1.02-6.11), and tachycardia (OR, 2.43; 95% CI, 1.49-3.94).


CONCLUSIONS
The presence of abnormal FHR tracing patterns in meconium-stained amniotic fluid patients is associated with an increased risk of adverse perinatal outcomes.
Xu
Hairong
H
Department of Obstetrics and Gynecology, Hôpital Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
Mas-Calvet
Marie
M
Wei
Shu-Qin
SQ
Luo
Zhong-Cheng
ZC
Fraser
William D
WD
D000328:Adult; D000653:Amniotic Fluid; D001919:Bradycardia / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005316:Fetal Distress / Q000401:mortality*; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D008470:Meconium; D009017:Morbidity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013610:Tachycardia / Q000401:mortality; D055815:Young Adult