[Diagnostic efficacy of biophysical tests and cerebral-umbilical index when assessing fetal oxygenation].
BACKGROUND
Perinatal morbidity and mortality are the ultimate indicators of antenatal care today, whose responsible task is to assess the respiratory function of the placenta, fetal growth and placental maturation in order to provide conditions for the delivery of a living and viable newborn. The diagnostic procedures of antenatal care tested within this study were the biophysical tests of cardiotocography and the fetal biophysical profile, along with the colour doppler evaluation of the cerebral-umbilical ratio. The objective of this study was to determine the most effective diagnostic procedure when assessing fetal oxygenation.


METHODS
The prospective study included 119 pregnant women. They all underwent cardiotocography, biophysical profile and colour doppler evaluation of the cerebral-umbilical ratio. The babies' umbilical artery blood pH was determined in the first minute upon birth, along with the Apgar score.


RESULTS
The results were processed statistically and the most effective diagnostic procedure for the evaluation of fetal oxygenation was selected, after which the rates of perinatal morbidity and mortality were calculated. The findings revealed that cardiotocography was the most sensitive antepartal predictor of fetal acidosis, while the fetal biophysical profile proved the most specific. The rates of perinatal morbidity and of perinatal mortality were 24.37% and 1.68%, respectively.


CONCLUSIONS
The findings analysis revealed a high statistical significance of both biophysical tests and the cerebral-umbilical ratio evaluation as predictors of the fetal distress syndrome. The analysis of the cerebral-umbilical ratio and biophysical tests showed that the cerebral-umbilical ratio evaluation not only was more sensitive as a parameter compared to biophysical tests but it was also more specific than cardiotocography. Cardiotocography is the most sensitive antepartal predictor of fetal acidosis, followed by the cerebral-umbilical ratio, and the biophysical profile as the least sensitive. The biophysical profile proved to be the most specific, followed by the cerebral-umbilical ratio, and cardiotocography as the least specific.
Klinicki centar Banja Luka, Banja Luka Klinika za ginekologiju i akuserstvo. brankagin@yahoo.com
Branka Cancarević
BC
Dajić
Rade
R
Vilendecić
D000138:Acidosis / Q000175:diagnosis; D001034:Apgar Score; D015148:Cardiotocography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005311:Fetal Hypoxia / Q000175:diagnosis*; D005333:Fetus / Q000098:blood supply* / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000502:physiology
D010100:Oxygen