Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses
File(s)
Accepted version
Author(s)
Galli, Letizia
Dall'Asta, Andrea
Whelehan, Virginia
Archer, Abigail
Chandraharan, Edwin
Type
Journal Article
Abstract
Aim
To evaluate the cardiotocography (CTG) features observed in suspected intrapartum chorioamnionitis in term fetuses according to the recently suggested criteria for the pathophysiological interpretation of the fetal heart rate and their correlation with perinatal outcomes.
Methods
Retrospective analysis of nonconsecutive CTG traces. ‘CTG chorioamnionitis’ was diagnosed either based on a persistent rise in the baseline for the given gestation or on a persistent increase in the baseline fetal heart rate during labor >10% without preceding CTG signs of hypoxia and in the absence of maternal pyrexia. Perinatal outcomes were compared among cases with no sign of chorioamnionitis, in those with only CTG features suspicious for chorioamnionitis and in those who developed clinical chorioamnionitis.
Results
Two thousand one hundred and five CTG traces were analyzed. Of these, 356 fulfilled the criteria for “CTG chorioamnionitis”. Higher rates of Apgar <7 at 1 and 5 min (21.6% vs 9.0% and 9.8% vs 2.0%, respectively, P < 0.01 for both) and lower umbilical artery pH (7.14 ± 0.11 vs 7.19 ± 0.11, P < 0.01) and an over fivefold higher rate of neonatal intensive care unit admission (16.6% vs 2.9%, P < 0.01) were noted in the ‘CTG chorioamnionitis’ group. Differences in the incidence of abnormal CTG patterns were noted between cases who eventually had clinical evidence of chorioamnionitis (89/356) and those showing CTG features suspicious for chorioamnionitis in the absence of clinical evidence of chorioamnionitis (267/356).
Conclusion
Intrapartum CTG features of suspected chorioamnionitis are associated with adverse perinatal outcomes.
To evaluate the cardiotocography (CTG) features observed in suspected intrapartum chorioamnionitis in term fetuses according to the recently suggested criteria for the pathophysiological interpretation of the fetal heart rate and their correlation with perinatal outcomes.
Methods
Retrospective analysis of nonconsecutive CTG traces. ‘CTG chorioamnionitis’ was diagnosed either based on a persistent rise in the baseline for the given gestation or on a persistent increase in the baseline fetal heart rate during labor >10% without preceding CTG signs of hypoxia and in the absence of maternal pyrexia. Perinatal outcomes were compared among cases with no sign of chorioamnionitis, in those with only CTG features suspicious for chorioamnionitis and in those who developed clinical chorioamnionitis.
Results
Two thousand one hundred and five CTG traces were analyzed. Of these, 356 fulfilled the criteria for “CTG chorioamnionitis”. Higher rates of Apgar <7 at 1 and 5 min (21.6% vs 9.0% and 9.8% vs 2.0%, respectively, P < 0.01 for both) and lower umbilical artery pH (7.14 ± 0.11 vs 7.19 ± 0.11, P < 0.01) and an over fivefold higher rate of neonatal intensive care unit admission (16.6% vs 2.9%, P < 0.01) were noted in the ‘CTG chorioamnionitis’ group. Differences in the incidence of abnormal CTG patterns were noted between cases who eventually had clinical evidence of chorioamnionitis (89/356) and those showing CTG features suspicious for chorioamnionitis in the absence of clinical evidence of chorioamnionitis (267/356).
Conclusion
Intrapartum CTG features of suspected chorioamnionitis are associated with adverse perinatal outcomes.
Date Issued
2019-10-16
Date Acceptance
2019-09-07
Citation
Journal of Obstetrics and Gynaecology Research, 2019, 45 (12), pp.2343-2350
ISSN
1341-8076
Publisher
Wiley
Start Page
2343
End Page
2350
Journal / Book Title
Journal of Obstetrics and Gynaecology Research
Volume
45
Issue
12
Copyright Statement
© 2019 Japan Society of Obstetrics and Gynecology. This is the accepted version of the following article: Galli, L., Dall'Asta, A., Whelehan, V., Archer, A. and Chandraharan, E. (2019), Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses. J. Obstet. Gynaecol. Res., 45: 2343-2350, which has been published in final form at https://doi.org/10.1111/jog.14133
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000490403900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
cardiotocography pathophysiology
fetal heart monitoring
fetal heart rate
inflammation
intrapartum fever
HEART-RATE PATTERNS
CEREBRAL-PALSY
EPIDURAL ANALGESIA
FETAL
ASSOCIATION
BIRTH
LABOR
MANAGEMENT
INFECTION
PREGNANCY
Publication Status
Published
Date Publish Online
2019-10-16