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Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(10):622-631
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Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(10):622-631
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):999-1009
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):999-1009
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):806-817
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):806-817
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):712-718
DOI 10.1590/S0100-72032005001200002
PURPOSE: to verify the fetal heart rate (FHR) patterns of large for gestational age (LGA) fetuses in pregnancies at term complicated by pregestational diabetes. METHODS: fetal surveillance was performed weekly in 64 fetuses of mothers with pregestational diabetes. Inclusion criteria were: diagnosis of pregestational diabetes mellitus, single pregnancy, alive fetus, absence of fetal anomalies, and computerized cardiotocography performed at the 37th week of gestation. Exclusion criteria included: postnatal diagnosis of fetal anomalies and delivery not performed at the local hospital. The FHR patterns were studied with computerized cardiotocography and the parameters were analyzed according to a fetal weight as LGA (birth weight above percentile 90). The cardiotocography parameters included: basal FHR, episodes of high variation, episodes of low variation, and short-term variation. RESULTS: forty-two patients fulfilled the proposed criteria. Ten (23.8%) newborns were LGA. Normal criteria were met in all performed examinations. FHR accelerations (above 15 bpm) were present in 7 (70%) LGA cases and in 29 (90.6%) non-LGA (p=0.135). Accelerations were more frequent in the non-LGA group (1.5±1.3 accelerations/10 min) when compared to LGA group (0.8±0.9 accelerations/10min, p=0.04, Mann-Whitney test). The high variation episodes were detected in all cases. The mean FHR variation in these episodes was different in the LGA group (16.2±2.5 bpm) when compared to the non-LGA group (19.7±4.2 bpm, p=0.02, Mann-Whitney test). CONCLUSION: the FHR patterns of non-LGA (higher frequency of accelerations and higher FHR variation in the high variation episodes) reflect parameters commonly analyzed by traditional cardiotocography of a healthy fetus. This fact appears to confirm the patterns of better oxygen supply to the fetuses less compromised by diabetes in pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):712-718
DOI 10.1590/S0100-72032005001200002
PURPOSE: to verify the fetal heart rate (FHR) patterns of large for gestational age (LGA) fetuses in pregnancies at term complicated by pregestational diabetes. METHODS: fetal surveillance was performed weekly in 64 fetuses of mothers with pregestational diabetes. Inclusion criteria were: diagnosis of pregestational diabetes mellitus, single pregnancy, alive fetus, absence of fetal anomalies, and computerized cardiotocography performed at the 37th week of gestation. Exclusion criteria included: postnatal diagnosis of fetal anomalies and delivery not performed at the local hospital. The FHR patterns were studied with computerized cardiotocography and the parameters were analyzed according to a fetal weight as LGA (birth weight above percentile 90). The cardiotocography parameters included: basal FHR, episodes of high variation, episodes of low variation, and short-term variation. RESULTS: forty-two patients fulfilled the proposed criteria. Ten (23.8%) newborns were LGA. Normal criteria were met in all performed examinations. FHR accelerations (above 15 bpm) were present in 7 (70%) LGA cases and in 29 (90.6%) non-LGA (p=0.135). Accelerations were more frequent in the non-LGA group (1.5±1.3 accelerations/10 min) when compared to LGA group (0.8±0.9 accelerations/10min, p=0.04, Mann-Whitney test). The high variation episodes were detected in all cases. The mean FHR variation in these episodes was different in the LGA group (16.2±2.5 bpm) when compared to the non-LGA group (19.7±4.2 bpm, p=0.02, Mann-Whitney test). CONCLUSION: the FHR patterns of non-LGA (higher frequency of accelerations and higher FHR variation in the high variation episodes) reflect parameters commonly analyzed by traditional cardiotocography of a healthy fetus. This fact appears to confirm the patterns of better oxygen supply to the fetuses less compromised by diabetes in pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):113-120
DOI 10.1590/S0100-72032002000200007
Purpose: to study fetal surveillance examinations in pregnancies complicated by pregestational diabetes mellitus, and to correlate them with large for gestational age (LGA) newborns. Methods: Between March 1999 and June 2001, 46 singleton pregnancies with pregestational diabetes mellitus without fetal anomalies were followed prospectively. From the 28th gestational week on, the following examinations were performed weekly: fetal biophysical profile, amniotic fluid index (AFI), and dopplervelocimetry of umbilical and middle cerebral arteries. The newborns with birthweight above the 90th percentile according to local standard values were characterized as LGA infants. Fisher's exact test and Student's t test were used for statistical analysis. Results: The mean gestational age at delivery was 37.6 weeks and 15 (32.6%) newborns were LGA. LGA fetuses showed significant increase in the AFI mean performed in the 32nd (16.5 cm, p=0.02), 33rd (16.7 cm, p=0.03), 34th (17.0 cm, p=0.02), 35th (17.9 cm, p=0.000), 36th (15.8 cm, p=0.03) and 37th (17.5 cm, p=0.003) weeks. Non-LGA fetuses presented the following mean AFI values: 13.5cm (32nd week), 13.1cm (33th week), 13.4 (34th week), 12.8 (35th week), 12.5 (36th week) and 12.8cm (37th week). AFI values equal to or above 18.0 cm were associated with the occurrence of LGA infants, when detected at the following gestational ages: 34th (60%, p=0.03), 35th (71.4%, p=0.01), 36th (80%, p=0.02) and 37th (66.7%, p=0.04) week. Non-LGA infants presented the following proportion of AFI values equal to or above 18.0 cm: 40.0% (34th week), 28.6% (35th week), 20.0% (36th week), and 33.3% (37th week). Conclusions: abnormal increase in AFI, mainly with values equal to or above 18.0 cm, is related to LGA infants at delivery. The maternal treatment should be adjusted to achieve the best result for maternal-fetal control, according to the AFI values during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):113-120
DOI 10.1590/S0100-72032002000200007
Purpose: to study fetal surveillance examinations in pregnancies complicated by pregestational diabetes mellitus, and to correlate them with large for gestational age (LGA) newborns. Methods: Between March 1999 and June 2001, 46 singleton pregnancies with pregestational diabetes mellitus without fetal anomalies were followed prospectively. From the 28th gestational week on, the following examinations were performed weekly: fetal biophysical profile, amniotic fluid index (AFI), and dopplervelocimetry of umbilical and middle cerebral arteries. The newborns with birthweight above the 90th percentile according to local standard values were characterized as LGA infants. Fisher's exact test and Student's t test were used for statistical analysis. Results: The mean gestational age at delivery was 37.6 weeks and 15 (32.6%) newborns were LGA. LGA fetuses showed significant increase in the AFI mean performed in the 32nd (16.5 cm, p=0.02), 33rd (16.7 cm, p=0.03), 34th (17.0 cm, p=0.02), 35th (17.9 cm, p=0.000), 36th (15.8 cm, p=0.03) and 37th (17.5 cm, p=0.003) weeks. Non-LGA fetuses presented the following mean AFI values: 13.5cm (32nd week), 13.1cm (33th week), 13.4 (34th week), 12.8 (35th week), 12.5 (36th week) and 12.8cm (37th week). AFI values equal to or above 18.0 cm were associated with the occurrence of LGA infants, when detected at the following gestational ages: 34th (60%, p=0.03), 35th (71.4%, p=0.01), 36th (80%, p=0.02) and 37th (66.7%, p=0.04) week. Non-LGA infants presented the following proportion of AFI values equal to or above 18.0 cm: 40.0% (34th week), 28.6% (35th week), 20.0% (36th week), and 33.3% (37th week). Conclusions: abnormal increase in AFI, mainly with values equal to or above 18.0 cm, is related to LGA infants at delivery. The maternal treatment should be adjusted to achieve the best result for maternal-fetal control, according to the AFI values during pregnancy.
