Correlation of cardiotocographic parameters witt the risk of neonatal hypoxic ischemic encephalopathy
Objective. To determine cardiotocographic (CTG) criteria for the risk of hypoxic ischemic encephalopathy (HIE) varying in severity. Subjects and methods. The prospective case-control study included 180 female patients and their newborn infants. After the birth of a baby, the CTG curves were interpreted by a specialist. Results. A pathological CTG curve was predominant in the study patient group (66.7% vs. 16%; p < 0.0001); a suspicious CTG curve was prevalent in the control group (48.6% vs. 16.7%; p < 0.001). A detailed analysis of CTG data showed the higher frequency of late decelerations in the study group (p <0.001); the presence of variable decelerations did not lead to the emergence of HIE. Bradycardia below 100 beats increased the risk of HIE (p < 0.001). Tachysystole was diagnosed significantly more often in the study patient group (44.4% vs. 12.5%, p < 0.001). No relationship was found between the type of a CTG curve and the grade of neonatal HIE. There were 10 (4–14.25), 7 (1.75–25.25), and 45 (38–52) decelerations in grades 1, 2, and 3 HIE, respectively (p = 0.02). The duration of a CTG curve with decelerations was 36.1 (20.4), 40.8 (24.9), and 59.0 (32.5) min, respectively (p = 0.05). The severity of HIE increased with a larger number of late decelerations (p = 0.03). Conclusion. This paper shows the relationship between the CTG curve parameters and the risk of neonatal HIE. The risk factors for the development of HIE are a pathological type of CTG; a decrease in basal heart rate and variability; late decelerations; bradycardia, and tachysystole. The clinical manifestations of neonatal encephalopathy with a normal or suspicious type of CTG in childbirth may suggest that there are causes of HIE, which are unassociated with intranatal fetal hypoxia.Prikhodko A.M., Romanov A.Yu., Evgrafova A.V., Baev O.R.
Keywords
hypoxic ischemic encephalopathy
cardiotocography
fetal hypoxia
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Received 07.11.2019
Accepted 29.11.2019
About the Authors
Andrey M. Prikhodko, PhD, physician of the maternity department, assistant of the Department Obstetrics and Gynecology, Researcher of the Innovative Technologies Department of Obstetrics Institute, National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare of Russian Federation.Tel. +7 (495) 438-30-47. E-mail: a_prikhodko@oparina4.ru 117997, Russia, Moscow, Ac. Oparina str. 4.
Andrey Yu. Romanov, postgraduate student, specialist of R&D Department, National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry
of Healthcare of Russian Federation. Tel. +7 (903) 158-94-00. E-mail: romanov1553@yandex.ru 117997, Russia, Moscow, Ac. Oparina str. 4.
Alexandra V. Evgrafova, postgraduate student of National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare of Russian Federation. Tel. +7 (495) 438-30-47. E-mail: a_evgrafova@oparina4.ru 117997, Russia, Moscow, Ac. Oparina str. 4.
Oleg R. Baev, MD, Head of maternity department, National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare of the Russian Federation, professor of the Department of Obstetrics, Gynecology, Perinatology, and Reproductology of I.N. Sechenov First Moscow State Medical University of Ministry
of Healthcare of Russian Federation 117997, Russia, Moscow, Ac. Oparina str. 4.
For citation: Prikhodko A.M., Romanov A.Yu., Evgrafova A.V., Baev O.R. Correlation of cardiotocographic parameters witt the risk of neonatal hypoxic ischemic encephalopathy.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; 3: 80-5. (In Russian).
https://dx.doi.org/10.18565/aig.2020.3.80-85
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