Obstetrics & Gynecology Email Alerts
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 1989;74:715-721
© 1989 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by STEER, P J
Right arrow Articles by BEARD, R W
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by STEER, P J
Right arrow Articles by BEARD, R W

Interrelationships Among Abnormal Cardiotocograms in Labor, Meconium Staining of the Amniotic Fluid, Arterial Cord Blood pH, and Apgar Scores

P J STEER, MD, MRCOG, F. EIGBE, MB, MRCOG, T J LISSAUER, MB, MRCP. and R W BEARD, MD, FRCOG.

From the Departments of Obstetrics and Gynecology and Pediatrics, St. Mary's Hospital Medical School, London, United Kingdom

Abstract

A prospective study of the relationships among fetal heart rate pattern, meconium staining of the amniotic fluid, umbilical cord artery pH, and Apgar score was carried out in 1219 consecutive births. Interpretable cardiotocogram patterns and cord arterial pH and blood gas analysis were obtained in 698 cases. The sensitivity of an abnormal cardiotocogram at any time for acidosis (more than 1 SD below the mean, pH less than 7.17) was 80%, and for severe acidosis (more than 2 SDs below the mean, pH less than 7.085) was 83%. However, the predictive value was low, and 32% of fetuses had an abnormal cardiotocogram but no acidosis. If only cardiotocogram abnormality in the first stage of labor was considered, sensitivity was still 47% for acidosis and 67% for severe acidosis, and the false-positive rate was reduced to only 14%. We attempted to improve the prediction of acidosis by including meconium staining of the amniotic fluid, but 65% of the variation in umbilical cord artery pH and 72 and 86% of the variation in 1- and 5-minUte Apgar scores, respectively, remained unexplained. In light of these poor correlations, the current practice of considering cardiotocogram abnormality, meconium staining of the amniotic fluid, acidosis, and low Apgar scores as indicating one single disorder, "fetal distress," is not valid




This article has been cited by other articles:


Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
J C Becher, J E Bell, J W Keeling, N McIntosh, and B Wyatt
The Scottish perinatal neuropathology study: clinicopathological correlation in early neonatal deaths
Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2004; 89(5): F399 - F407.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
B. A. Yoder, E. A. Kirsch, W. H. Barth Jr, and M. C. Gordon
Changing Obstetric Practices Associated With Decreasing Incidence of Meconium Aspiration Syndrome
Obstet. Gynecol., May 1, 2002; 99(5): 731 - 739.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
S. DOLLBERG, S. LIVNY, N. MORDECHEYEV, and F. B. MIMOUNI
Nucleated Red Blood Cells in Meconium Aspiration Syndrome
Obstet. Gynecol., April 1, 2001; 97(4): 593 - 596.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
K Mahomed, R Nyoni, T Mulambo, J Kasule, and E Jacobus
Randomised controlled trial of intrapartum fetal heart rate monitoring
BMJ, February 19, 1994; 308(6927): 497 - 500.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1989 by the American College of Obstetricians and Gynecologists.