| Journal: | Revista da Associacao Medica Brasileira |
| Database: | PERIÓDICA |
| System number: | 000308052 |
| ISSN: | 0104-4230 |
| Authors: | Nomura, Roseli Mieko Yamamoto1 Francisco, Rossana Pulcineli Vieira Miyadahira, Seizo Zugaib, Marcelo |
| Institutions: | 1Universidade de Sao Paulo, Faculdade de Medicina, Sao Paulo. Brasil |
| Year: | 2003 |
| Season: | Ene-Mar |
| Volumen: | 49 |
| Number: | 1 |
| Pages: | 79-85 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Experimental |
| English abstract | OBJECTIVES: To study the correlation between cardiotocography parameters and perinatal outcome in pregnancies with absent or reversed end-diastolic velocity (AERDV) in the umbilical arteries. METHODS: One hundred and twenty-seven cases presenting with AREDV followed between 1993 and 2000 were selected for analysis. The last cardiotocographic tracing performed on the day of delivery was reviewed and the following parameters were considered: magnitude of long-term variability, presence or absence of acceleration, late deceleration, variable deceleration, prolonged deceleration, pseudo sinusoidal pattern and the classification in normal, suspected and abnormal tracing. RESULTS: A significant (p<0.05) association was found between abnormal tracing and acidemia at birth (pH inferior to 7.20) with 71.9%, first minute Apgar score inferior to seven (73.4%), newborn intubation at delivery (64.1%), and early neonatal death (20.3%). The absence of acceleration was associated (p<0.05) to acidemia at birth (58.8%), first minute Apgar score inferior to seven (67.7%), newborn intubation at delivery (51%) and neonatal death (29.4%). Low FHR variability (<5bpm) was associated to (p<0.05): acidemia at birth (88.5%), newborn intubation at delivery (69.2%), early neonatal death (34.6%) and neonatal death (42.3%). Late decelerations were significantly (p<0,05) related to acidemia at birth.(78.2%). The severe variable deceleration was associated to (p<0.05): acidemia at birth (79.3%), newborn intubation at delivery (69%) and early neonatal death (17.2%). Prolonged deceleration was associated to (p<0.05) newborn intubation at delivery (70.6%). Pseudo sinusoidal pattern was associated to (p<0.05) early neonatal death (60%). CONCLUSION: The AREDV represents a severe fetal compromise with high risk to neonatal morbidity and mortality, and correlation between cardiotocography abnormalities and adverse perinatal outcome was demonstrated |
| Portuguese abstract | OBJETIVOS: Estudar, em gestações com diástole zero (DZ) ou reversa (DR), dopplervelocimetria das artérias umbilicais os resultados perinatais de acordo com os parâmetros cardiotocográficos. MÉTODOS: Entre 1993 e 2000, foram selecionadas 127 gestantes com DZ ou DR. A classificação adotada para a cardiotocografia foi ativo (normal), hipoativo (suspeito) e inativo (alterado) Os parâmetros analisados foram: variabilidade da FCF, acelerações transitórias, DIP II, DIP umbilical, desaceleração prolongada e padrão pseudo sinusoidal. RESULTADOS: Houve associação (p<0,05) entre o padrão inativo e acidemia no nascimento (pH inferior a 7,20) em 71,9%, Apgar de 1° minuto inferior a sete (73,4%), intubação do RN (64,1%), e óbito neonatal precoce (20,3%). Houve associação (p<0,05) entre a ausência de acelerações transitórias com acidemia no nascimento (58,8%), Apgar de 1° minuto inferior a sete (67,7%), intubação do RN (51%) e total de óbitos no berçário (29,4%). A redução da variabilidade (<5bpm) associou-se a (p<0,05): acidemia no nascimento (88,5%), intubação do RN (69,2%), óbito neonatal precoce (34,6%) e total de óbitos no berçário (42,3%). Constatou-se associação entre a ocorrência de DIP II (p<0,05) e a acidemia no nascimento em 78,2%. O DIP umbilical grave associou-se (p<0,05) com acidemia no nascimento (79,3%), intubação do recém-nascido (69%) e óbito neonatal precoce (17,2%). Houve associação (p<0,05) entre a desaceleração prolongada e intubação do RN (70,6%). O padrão pseudo sinusoidal associou-se ( |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Sistema cardiovascular, Cardiología, Embarazo, Recién nacidos, Diástole, Arterias, Cordón umbilical, Complicaciones médicas, Cardiotocografía |
| Keyword: | Medicine, Cardiovascular system, Diagnosis, Cardiology, Pregnancy, Newborn, Diastole, Arteries, Umbilical cord, Medical complications, Cardiotocography |
| Full text: | Texto completo (Ver HTML) |
