The utility of fetal heart rate deceleration's descending slope in searching for a non-National Institute of Child Health and Human Development parameter for the detection of fetal acidosis
© 2024 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics..
OBJECTIVE: To identify new parameters predicting fetal acidemia.
METHODS: A retrospective case-control study in a cohort of deliveries from a tertiary referral hospital-based cohort deliveries in Zaragoza, Spain between 2018 and 2021 was performed. To predict fetal acidemia, the NICHD categorizations and non-NICHD parameters were analyzed in the electronic fetal monitoring (EFM). Those included total reperfusion time, total deceleration area and the slope of the descending limb of the fetal heart rate of the last deceleration curve. The accuracy of the parameters was evaluated using the specificity for (80%, 85%, 90%, 95%) sensitivity and the area under the receiver operating characteristic curve (AUC).
RESULTS: A total of 10 362 deliveries were reviewed, with 224 cases and 278 controls included in the study. The NICHD categorizations showed reasonable discriminatory ability (AUC = 0.727). The non-NICHD parameters measured during the 30-min fetal monitoring, total deceleration area (AUC = 0.807, 95% CI: 0.770, 0.845) and total reperfusion time (AUC = 0.750, 95% CI: 0.707, 0.792), exhibited higher discriminatory ability. The slope of the descending limb of the fetal heart rate of the last deceleration curve had the best AUC value (0.853, 95% CI: 0.816, 0.889). The combination of total deceleration area or total reperfusion time with the slope demonstrated high discriminatory ability (AUC = 0.908, 95% CI: 0.882, 0.933; specificities of 71.6% and 72.7% for a sensitivity of 90%).
CONCLUSIONS: The slope of the descending limb of the fetal heart rate of the last deceleration curve is the strongest predictor of fetal acidosis, but its combination with the total reperfusion time shows better clinical utility.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics - (2024) vom: 05. März |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Castán Larraz, Berta [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acidemia |
|---|
| Anmerkungen: |
Date Revised 05.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1002/ijgo.15454 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369311043 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369311043 | ||
| 003 | DE-627 | ||
| 005 | 20240305233230.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240305s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/ijgo.15454 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1317.xml |
| 035 | |a (DE-627)NLM369311043 | ||
| 035 | |a (NLM)38441244 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Castán Larraz, Berta |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The utility of fetal heart rate deceleration's descending slope in searching for a non-National Institute of Child Health and Human Development parameter for the detection of fetal acidosis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 05.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. | ||
| 520 | |a OBJECTIVE: To identify new parameters predicting fetal acidemia | ||
| 520 | |a METHODS: A retrospective case-control study in a cohort of deliveries from a tertiary referral hospital-based cohort deliveries in Zaragoza, Spain between 2018 and 2021 was performed. To predict fetal acidemia, the NICHD categorizations and non-NICHD parameters were analyzed in the electronic fetal monitoring (EFM). Those included total reperfusion time, total deceleration area and the slope of the descending limb of the fetal heart rate of the last deceleration curve. The accuracy of the parameters was evaluated using the specificity for (80%, 85%, 90%, 95%) sensitivity and the area under the receiver operating characteristic curve (AUC) | ||
| 520 | |a RESULTS: A total of 10 362 deliveries were reviewed, with 224 cases and 278 controls included in the study. The NICHD categorizations showed reasonable discriminatory ability (AUC = 0.727). The non-NICHD parameters measured during the 30-min fetal monitoring, total deceleration area (AUC = 0.807, 95% CI: 0.770, 0.845) and total reperfusion time (AUC = 0.750, 95% CI: 0.707, 0.792), exhibited higher discriminatory ability. The slope of the descending limb of the fetal heart rate of the last deceleration curve had the best AUC value (0.853, 95% CI: 0.816, 0.889). The combination of total deceleration area or total reperfusion time with the slope demonstrated high discriminatory ability (AUC = 0.908, 95% CI: 0.882, 0.933; specificities of 71.6% and 72.7% for a sensitivity of 90%) | ||
| 520 | |a CONCLUSIONS: The slope of the descending limb of the fetal heart rate of the last deceleration curve is the strongest predictor of fetal acidosis, but its combination with the total reperfusion time shows better clinical utility | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acidemia | |
| 650 | 4 | |a cardiotocography | |
| 650 | 4 | |a deceleration | |
| 650 | 4 | |a fetal heart rate | |
| 650 | 4 | |a reperfusion | |
| 650 | 4 | |a slope | |
| 700 | 1 | |a Esteban, Luis Mariano |e verfasserin |4 aut | |
| 700 | 1 | |a Castán Mateo, Sergio |e verfasserin |4 aut | |
| 700 | 1 | |a Chóliz Ezquerro, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Calvo Torres, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Esteban-Escaño, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez Solanilla, Belén |e verfasserin |4 aut | |
| 700 | 1 | |a Cisneros Gimeno, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Savirón-Cornudella, Ricardo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics |d 1973 |g (2024) vom: 05. März |w (DE-627)NLM000003336 |x 1879-3479 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:05 |g month:03 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/ijgo.15454 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 05 |c 03 | ||