Yıl: 2005 Cilt: 36 Sayı: 1 Sayfa Aralığı: 1 - 5 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies

Öz:
Amaç: Gebelerde fetal asidozu belirlemek için fetal kalp hızının klinik doğruluğunu değerlendirmek. Gereç ve yöntem: Doğum eylemindeki 38-40 gebelik haftaları arasındaki 55 gebe kardio-tokogram ile monitorize edildi ve doğumda umbilikal kordon gaz analizleri çalışıldı. Umbilikal kordon kan gazlan sonuçlarını ve neonatal bebeklerin durumlarını bilmeyen bir araştırmacı, fetal kalp atım traselerini değerlendirdi. Variabilite kaybı (amplitüd < 5 atım), variabilya da geç deselerasyon anormal kalp atım paterni olarak değerlendirildi. Umbilikal arter PH < 7.1,1. ve 5. dakika Apgar skorları < 7 ve umbilikal arter baz açığı > -14 değerleri fetal asidoz olarak değerlendirildi. Fetal kalp atım paternleri, umbilikal kan gazı, baz açığı ve Apgar skorları fetal asidozun prediksiyonu için çalışıldı. İstatistiksel değerlendirmede Ki-kare (Fisher's exact) test kullanıldı. P < 0.05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Anormal, fetal kalp traselerinin düşük Apgar skorun düşüklüğünü belirlemedeki sensitivite, spesifisite, pozitif ve negatif prediktif değerleri 1. dakika için sırasıyla, % 100, % 90.2, % 44.4, % 100 ve 5. dakika için % 100, % 88.9, % 14.3 ve %100 bulundu. Anormal fetal kalp hızı paterninin umbilikal aıterpH'smm < 7.1 olmasını belirlemedeki sensitivite, spesifisite, pozitif ve negatif prediktif değerleri sırasıyla % 88.8, % 97.8,'% 88.9 ve % 97.8 bulundu. Anormal fetal kalp hızı paternlerinin umbilikal arter baz açığını belirlemedeki sensitivite, spesifisite, pozitif ve negatif prediktif değerleri sırasıyla, % 75.0, % 93.6, % 66.7 ve % 95.6 bulundu. Sontiç: Fetal kalp hızı monutörizasyonu fetal asideminin saptanmasında faydalı olsa bile, anormal trase varlığında operatif doğum oranlarında artışa . neden olmaktadır. Bu nedenle, obstetrisyen anormal trase yarlığında yüksek yalancı pozitiflik nedeniyle gereksiz sezaryen doğumlardan kaçınmalıdır.
Anahtar Kelime: Fetal kan Kardiyotokografi Apgar skoru Asidoz Gebelik Kalp hızı, fetal

Konular: Cerrahi

Gebelerde anormal kardiotokogram, arterial kord kanı pH'sı, baz açığı ve düşük apgar skorları arasındaki ilişki

Öz:
Objective: Our purpose was to evaluate the clinical validity of electronic heart rate monitoring in pregnancies and to predict fetal acidosis. Materials and Methods: Fifty-five women between 38 and 40 weeks''gestational age who had electronic fetal monitoring were recruited prospectively and umbilical artery cord gas analysis was performed at delivery. One investigator, blinded to the cord blood gases outcome and using the standard guidelines for fetal heart rate monitoring reviewed all tracings with decreased variability (amplitude < 5 beats). Variable or late decelerations were considered as abnormal fetal heart rate patterns. The occurrences of an umbilical arterial pH of < 7.1, 1- and 5-minute Apgar scores of < 7 and an umbilical artery base deficit of>-14 mmol/L were interpreted as fetal acidosis. Results: The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of abnormal tracings for predicting low Apgar scores were 100 %, 90.2 %, 44.4 %, and 100 °/o for 1-minute, and 100 %, 88.9 %, 14.3 %, and 100 %, for 5-minute, respectively. The sensitivity, specificity, PPV and NPV of abnormal tracings for predicting umbilical arterial pH of 7.1 were 88.8 %, 97.8 %, 88.9 %, and 97.8 %, respectively. The sensitivity, specificity, PPV and NPV of abnormal tracings for predicting base deficit were 75.0 %, 93.6 %, 66.7 %, and 95.6 %, respectively. Conclusion: Intrapartum fetal heart rate monitoring is useful to detect fetal acidemia, nevertheless, the operative delivery rate is higher among patients with abnormal fetal heart rate patterns. The obstetrician should therefore, be aware of the high false positivity rate of abnormal tracings in order to avoid unnecessary cesarean delivery.
Anahtar Kelime: Acidosis Pregnancy Heart Rate, Fetal Fetal Blood Cardiotocography Apgar Score

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Özdemir İ, YAVUZ T, YAVUZ Ö, DEMİRCİ F, SOMUNKIRAN A (2005). Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. , 1 - 5.
Chicago Özdemir İsmail,YAVUZ Taner,YAVUZ Özlem,DEMİRCİ Furat,SOMUNKIRAN Aslı Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. (2005): 1 - 5.
MLA Özdemir İsmail,YAVUZ Taner,YAVUZ Özlem,DEMİRCİ Furat,SOMUNKIRAN Aslı Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. , 2005, ss.1 - 5.
AMA Özdemir İ,YAVUZ T,YAVUZ Ö,DEMİRCİ F,SOMUNKIRAN A Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. . 2005; 1 - 5.
Vancouver Özdemir İ,YAVUZ T,YAVUZ Ö,DEMİRCİ F,SOMUNKIRAN A Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. . 2005; 1 - 5.
IEEE Özdemir İ,YAVUZ T,YAVUZ Ö,DEMİRCİ F,SOMUNKIRAN A "Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies." , ss.1 - 5, 2005.
ISNAD Özdemir, İsmail vd. "Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies". (2005), 1-5.
APA Özdemir İ, YAVUZ T, YAVUZ Ö, DEMİRCİ F, SOMUNKIRAN A (2005). Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. Zeynep Kamil Tıp Bülteni, 36(1), 1 - 5.
Chicago Özdemir İsmail,YAVUZ Taner,YAVUZ Özlem,DEMİRCİ Furat,SOMUNKIRAN Aslı Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. Zeynep Kamil Tıp Bülteni 36, no.1 (2005): 1 - 5.
MLA Özdemir İsmail,YAVUZ Taner,YAVUZ Özlem,DEMİRCİ Furat,SOMUNKIRAN Aslı Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. Zeynep Kamil Tıp Bülteni, vol.36, no.1, 2005, ss.1 - 5.
AMA Özdemir İ,YAVUZ T,YAVUZ Ö,DEMİRCİ F,SOMUNKIRAN A Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. Zeynep Kamil Tıp Bülteni. 2005; 36(1): 1 - 5.
Vancouver Özdemir İ,YAVUZ T,YAVUZ Ö,DEMİRCİ F,SOMUNKIRAN A Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies. Zeynep Kamil Tıp Bülteni. 2005; 36(1): 1 - 5.
IEEE Özdemir İ,YAVUZ T,YAVUZ Ö,DEMİRCİ F,SOMUNKIRAN A "Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies." Zeynep Kamil Tıp Bülteni, 36, ss.1 - 5, 2005.
ISNAD Özdemir, İsmail vd. "Interrelations among abnormal cardiotocograms in labor, arterial cord blood pH, base deficit and apgar scores in pregnancies". Zeynep Kamil Tıp Bülteni 36/1 (2005), 1-5.