RESUMO
750 cardiotocographic curves of the last 30 minutes prior to vaginal delivery were assessed retrospectively according to the CTG score after Hammacher et al. (6). The aim of this study was to examine the prognostic value of the CTG score with regard to the foetal acid-base stains. The results obtained showed a distinct interdependence between the CTG score and the risk of foetal acidosis. Correct interpretation of the CTG can be ensured only if all three different CTG parameters are considered. The most frequent and reliable pointers to the existence of foetal acidosis are the occurrence of severe variable or late decelerations which can be detected from an examination of the floating-line pattern.
Assuntos
Coração Fetal/fisiologia , Monitorização Fetal/métodos , Desequilíbrio Ácido-Base/diagnóstico , Feminino , Doenças Fetais/diagnóstico , Frequência Cardíaca , Humanos , Recém-Nascido , Gravidez , RiscoRESUMO
Four patterns of fetal heart frequency with normocardia, two with tachycardia and three with bradycardia are described during the expulsion period. The most frequent patterns are normocardia with decelerations (48%), normocardia with decelerations and final bradycardia (21.1%) and basal bradycardia with decelerations (13.5%). The frequency of acidosis (pH of the umbilical artery less than or equal to 7,200) of these three patterns amounts to 8.3, 24.1 respectively 26.7%. The mean values of pHUA of normocardia with decelerations and final bradycardia, bradycardia, bradycardia with decelerations, tachycardia with decelerations and final bradycardia with prepathologic respectively pathologic Scores (Hammacher's Score, greater than or equal to five points) range from preacidosis to acidosis. Scoring of cardiotocograms seems to be of greater clinical significance than the measurement of deceleration areas.
