title: [Evaluation of the CNGOF foetal heart rate classification].
abstract: BACKGROUND
  The 2007 CNGOF guidelines for good practice on "Methods of foetal surveillance during labour" proposed a consensual definition of intra-partum foetal heart rate (FHR) patterns. In order to facilitate its application, Carbon et al. published in 2013 a simplified table of the classification with 5 types of tracing.
  
  
  OBJECTIVE
  To evaluate the diagnosis value of this FHR classification to determine the risk of foetal acidosis.
  
  
  METHODS
  Retrospective single-centre study including 252 single pregnancies beyond 34 weeks of gestation with a record of at least 60minutes before delivery. The primary endpoint was a pH at birth < 7.20.
  
  
  RESULTS
  When pH was < 7.20, type 3 tracing was significantly more frequent during the first stage of labour while types 4 and 5 were more frequently found during active second stage. A pH<7.20 was significantly associated with more instrumental extractions, emergency caesarean section, Apgar score < 7 and neonatal respiratory distress. The areas under the curve were 0.63 for the analysis during the first stage of labour, 0.69 for second stage, and 0.68 when the two stages were combined.
  
  
  CONCLUSIONS
  Our study found that the CNGOF classification improved the FHR interpretation but its diagnosis value to predict acidosis remained limited.
authors.affiliation: Pôle femme mère nouveau-né, clinique d'obstétrique, maternité Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Cheurfa
authors.affiliation: EA4489, environnement périnatal et santé, faculté de médecine, université Lille 2, CIC-IT, CHRU de Lille, 59037 Lille cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Butruille
authors.affiliation: EA4489, environnement périnatal et santé, faculté de médecine, université Lille 2, CIC-IT, CHRU de Lille, 59037 Lille cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: De Joonckhere
authors.affiliation: Maternité, centre hospitalier Princesse Grace, avenue Pasteur, 98000 Monaco.
authors.forename: B
authors.initials: B
authors.lastname: Carbonne
authors.affiliation: Pôle femme mère nouveau-né, clinique d'obstétrique, maternité Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA4489, environnement périnatal et santé, faculté de médecine, université Lille 2, CIC-IT, CHRU de Lille, 59037 Lille cedex, France. Electronic address: philippe.deruelle@univ-lille2.fr.
authors.forename: P
authors.initials: P
authors.lastname: Deruelle
mesh_terms: D000138:Acidosis / Q000175:diagnosis*; D000328:Adult; D001034:Apgar Score; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000592:standards*; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies
keywords: Acid-base balance; Classification; Foetal heart rate tracing; Labour; Tracés du rythme cardiaque fœtal; Travail; Équilibre acido-basique