Research on the Relationship between the Fetal Heart Rate Tracing Patterns in Active Phase and Last Hour be-fore Delivery and the Neonatal Prognosis
- VernacularTitle:活跃期和分娩前胎心监护图形与新生儿预后关系的研究
- Author:
Qiao WENG
1
;
Zhiqun WANG
;
Yimin DAI
Author Information
1. 南京大学医学院附属鼓楼医院妇产科
- Keywords:
Fetal heart rate tracing;
Three-tier classification system;
Atypical decelerations;
Neonatal prognosis
- From:
Chinese Journal of Clinical Medicine
2014;(6):707-710
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the fetal heart rate tracing patterns in active phase and last hour before delivery,and to ex-plore the indicative role of fetal heart rate tracing patterns in different labor stages in neonatal prognosis.Methods:A total of 181 full-term vaginal delivery primiparas from February 2014 to may 2014 in Nanjing Drum Tower Hospital Affiliated to Nan-jing University Medical School.The fetal heart rate tracing patterns in the active phase and those in the last hour before deliver-y were recorded and compared with each other.Indicative significance of uncertain fetal heart rate tracing patterns duration in the last hour before delivery and long second stage of labor on neonatal prognosis was analyzed with ROC curve.Results:1.No category III fetal heart rate pattern was found in the 181 cases.The proportion of Category I fetal heart rate patterns was lower in the last hour before delivery than that in the active stage while the proportion of category II fetal heart patterns was on the contrary(P <0.05).The proportion of atypical decelerations in the last hour before delivery was significantly higher than that in the active stage(P <0.05).2.In active stage,no significant difference in any category offetal heart patten was found between the favorable prognosis group and the poor prognosis group(P >0.05).3.In the last hour before delivery,duration of category II in the poor prognosis group was longer than that in the favorable prognosis while the duration of category I was on the con-trary(P <0.05).The proportions of slow returns and non-moderate variability were higher in the poor prognosis group(P <0.05).4.The area under the ROC of the relationship between category II duration in the last hour before delivery and neonatal prognosis was 0.646 (95%CI 0.544-0.748).Conclusions:All types of atypical decelerations in fetal heart rate tracing patterns were prone to appear during the last hour before delivery.Different standards may be required to interpret fetal heart rate trac-ing patterns in the active stage and in the last hour before delivery.Category II duration in the last hour before delivery had cer-tain significance in predicting neonatal prognosis,especially the appearance of slow returns and non-moderate variability,while the duration of the second stage of labor had no relationship with neonatal prognosis.
