Fetal vitality Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 1999;21(1):7-12
DOI 10.1590/S0100-72031999000100002
Purpose: to evaluate the accuracy of Doppler velocimetry in the diagnosis of fetal well-being. Methods: a total of 130 pregnant women assisted at the Ultrasound Unit of the Center for Integral Assistance of Women's Health, UNICAMP, between the 28th and 42nd gestational weeks was analyzed. The correlation between fetal umbilical and middle cerebral arteries, abdominal aorta, and the adverse perinatal results was established. The pregnant women selected for this study were submitted electively to cesarean sections, at the utmost four hours after the color Doppler examination. We considered as adverse perinatal results: Apgar score lower than seven at the 5th minute, neonatal intensive care unit hospitalization, intrauterine growth retardation, acute fetal distress, perinatal mortality, hypoglycemia, polycythemia, necrotizing enterocolitis, and cerebral hemorrhage. The indexes for the umbilical and middle cerebral arteries and the abdominal aorta were related, in each case, to the adverse perinatal results. Results: the systole/diastole umbilical artery ratio presented a higher sensitivity than the pulsatile and tolerance indexes. The Doppler study of the umbilical artery presented greater sensitivity than the middle cerebral artery and the abdominal aorta in detecting adverse perinatal results. Conclusion: the Doppler velocimetry of the umbilical and middle cerebral arteries presented good diagnostic capacity in evaluating fetal well-being, and a significant association with the adverse perinatal results.
Summary
Rev Bras Ginecol Obstet. 1999;21(1):7-12
DOI 10.1590/S0100-72031999000100002
Purpose: to evaluate the accuracy of Doppler velocimetry in the diagnosis of fetal well-being. Methods: a total of 130 pregnant women assisted at the Ultrasound Unit of the Center for Integral Assistance of Women's Health, UNICAMP, between the 28th and 42nd gestational weeks was analyzed. The correlation between fetal umbilical and middle cerebral arteries, abdominal aorta, and the adverse perinatal results was established. The pregnant women selected for this study were submitted electively to cesarean sections, at the utmost four hours after the color Doppler examination. We considered as adverse perinatal results: Apgar score lower than seven at the 5th minute, neonatal intensive care unit hospitalization, intrauterine growth retardation, acute fetal distress, perinatal mortality, hypoglycemia, polycythemia, necrotizing enterocolitis, and cerebral hemorrhage. The indexes for the umbilical and middle cerebral arteries and the abdominal aorta were related, in each case, to the adverse perinatal results. Results: the systole/diastole umbilical artery ratio presented a higher sensitivity than the pulsatile and tolerance indexes. The Doppler study of the umbilical artery presented greater sensitivity than the middle cerebral artery and the abdominal aorta in detecting adverse perinatal results. Conclusion: the Doppler velocimetry of the umbilical and middle cerebral arteries presented good diagnostic capacity in evaluating fetal well-being, and a significant association with the adverse perinatal results.
Summary
Rev Bras Ginecol Obstet. 2000;22(4):201-208
DOI 10.1590/S0100-72032000000400003
Purpose: to evaluate the modifications due to premature rupture of the membranes of variables of the fetal biophysical profile, comparing them to the ones found in pregnant women with intact membranes. In the group with premature rupture of the membranes, the association of biophysical variables with the Apgar score at the first and fifth minutes and with the occurrence or not of clinical chorioamnionitis and neonatal infection was analyzed. Patients and Methods: in a prospective study, 112 fetal biophysical profiles were established in 60 pregnant women with premature rupture of the membranes at a period between the 28th and the 40th week of pregnancy, and only the last fetal biophysical profile was analyzed and compared to other 60 fetal biophysical profiles of pregnant women with gestational ages identical to the group of study and with intact membranes. Results: statistical analysis of the results revealed that the premature rupture of the membranes diminished the reactivity, not interfering with the body movements of the fetus. It also diminished the frequency of the respiratory movements of the fetus, not determining modifications of the fetal tonus, and considerably decreasing the amniotic fluid index. In terms of prediction of chorioamnionitis and neonatal infection, the fetal biophysical profile did not show any significant statistic validity; however, when the biophysical variables were present, the correlation with the absence of chorioamnionitis and neonatal infection was clearly shown. The result of the last fetal biophysical profile was strongly associated with the Apgar score at the 5th minute. Conclusion: the fetal biophysical profile should be used routinely in pregnant women with premature rupture of the membranes with the purpose of evaluating fetal vitality, and in order to detect those fetuses at a higher risk of infection, specially those with gestational ages of less than 34 weeks. Regarding those fetuses it is best to use a conservative approach.
Summary
Rev Bras Ginecol Obstet. 2000;22(4):201-208
DOI 10.1590/S0100-72032000000400003
Purpose: to evaluate the modifications due to premature rupture of the membranes of variables of the fetal biophysical profile, comparing them to the ones found in pregnant women with intact membranes. In the group with premature rupture of the membranes, the association of biophysical variables with the Apgar score at the first and fifth minutes and with the occurrence or not of clinical chorioamnionitis and neonatal infection was analyzed. Patients and Methods: in a prospective study, 112 fetal biophysical profiles were established in 60 pregnant women with premature rupture of the membranes at a period between the 28th and the 40th week of pregnancy, and only the last fetal biophysical profile was analyzed and compared to other 60 fetal biophysical profiles of pregnant women with gestational ages identical to the group of study and with intact membranes. Results: statistical analysis of the results revealed that the premature rupture of the membranes diminished the reactivity, not interfering with the body movements of the fetus. It also diminished the frequency of the respiratory movements of the fetus, not determining modifications of the fetal tonus, and considerably decreasing the amniotic fluid index. In terms of prediction of chorioamnionitis and neonatal infection, the fetal biophysical profile did not show any significant statistic validity; however, when the biophysical variables were present, the correlation with the absence of chorioamnionitis and neonatal infection was clearly shown. The result of the last fetal biophysical profile was strongly associated with the Apgar score at the 5th minute. Conclusion: the fetal biophysical profile should be used routinely in pregnant women with premature rupture of the membranes with the purpose of evaluating fetal vitality, and in order to detect those fetuses at a higher risk of infection, specially those with gestational ages of less than 34 weeks. Regarding those fetuses it is best to use a conservative approach.