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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. 2004;26(3):254-254
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):254-254
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(3):137-143
DOI 10.1590/S0100-72032001000300002
Purpose: to study, in high risk pregnancies with cerebral redistribution of blood flow, the fetal surveillance and perinatal outcome, according to umbilical artery dopplervelocimetry. Methods: a total of 717 high-risk pregnancies attended at the Fetal Surveillance Unit were included. The last examination performed until 72 h prior to delivery was taken into account. Multiple gestations and fetal anomalies were excluded. The redistribution of blood flow was diagnosed if the pulsatility index of middle cerebral artery was below the 5th percentile for gestational age. The umbilical artery dopplervelocimetry was abnormal when A/B ratio was more than the 95th p. Results: in the group with normal umbilical artery dopplervelocimetry (560 cases -- 78.1%), significant correlation was found only between redistribution of blood flow and suspected or abnormal cardiotocography (17.1%). In the group with abnormal umbilical artery dopplervelocimetry (157 cases -- 21.9%) we found significant correlation between redistribution of blood flow (105 cases -- 66.9%) and cardiotocography abnormalities (57.2%), abnormal 1st(43.8%) and 5th (12.4%) minute Apgar scores. In these cases, the mean values of gestational age at delivery (34.4 ± 3.6 weeks), birth weight (1,810.5 ± 769.3 g), and pH at birth (7.20 ± 0.1) were significantly lower. Conclusion: The redistribution of fetal blood flow characterized by means of middle cerebral artery dopplervelocimetry is related to perinatal results when some level of placental insufficiency occurs, and does not present association to perinatal outcome when pregnancy shows normal fetal-placental blood flow.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(3):137-143
DOI 10.1590/S0100-72032001000300002
Purpose: to study, in high risk pregnancies with cerebral redistribution of blood flow, the fetal surveillance and perinatal outcome, according to umbilical artery dopplervelocimetry. Methods: a total of 717 high-risk pregnancies attended at the Fetal Surveillance Unit were included. The last examination performed until 72 h prior to delivery was taken into account. Multiple gestations and fetal anomalies were excluded. The redistribution of blood flow was diagnosed if the pulsatility index of middle cerebral artery was below the 5th percentile for gestational age. The umbilical artery dopplervelocimetry was abnormal when A/B ratio was more than the 95th p. Results: in the group with normal umbilical artery dopplervelocimetry (560 cases -- 78.1%), significant correlation was found only between redistribution of blood flow and suspected or abnormal cardiotocography (17.1%). In the group with abnormal umbilical artery dopplervelocimetry (157 cases -- 21.9%) we found significant correlation between redistribution of blood flow (105 cases -- 66.9%) and cardiotocography abnormalities (57.2%), abnormal 1st(43.8%) and 5th (12.4%) minute Apgar scores. In these cases, the mean values of gestational age at delivery (34.4 ± 3.6 weeks), birth weight (1,810.5 ± 769.3 g), and pH at birth (7.20 ± 0.1) were significantly lower. Conclusion: The redistribution of fetal blood flow characterized by means of middle cerebral artery dopplervelocimetry is related to perinatal results when some level of placental insufficiency occurs, and does not present association to perinatal outcome when pregnancy shows normal fetal-placental blood flow.