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Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses.

Galli, L; Dall'Asta, A; Whelehan, V; Archer, A; Chandraharan, E (2019) Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses. J Obstet Gynaecol Res, 45 (12). pp. 2343-2350. ISSN 1447-0756 https://doi.org/10.1111/jog.14133
SGUL Authors: Chandraharan, Edwin

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Abstract

AIM: To evaluate the cardiotocography (CTG) features observed in suspected intrapartum chorioamnionitis in term fetuses according to the recently suggested criteria for the pathophysiological interpretation of the fetal heart rate and their correlation with perinatal outcomes. METHODS: Retrospective analysis of nonconsecutive CTG traces. 'CTG chorioamnionitis' was diagnosed either based on a persistent rise in the baseline for the given gestation or on a persistent increase in the baseline fetal heart rate during labor >10% without preceding CTG signs of hypoxia and in the absence of maternal pyrexia. Perinatal outcomes were compared among cases with no sign of chorioamnionitis, in those with only CTG features suspicious for chorioamnionitis and in those who developed clinical chorioamnionitis. RESULTS: Two thousand one hundred and five CTG traces were analyzed. Of these, 356 fulfilled the criteria for "CTG chorioamnionitis". Higher rates of Apgar <7 at 1 and 5 min (21.6% vs 9.0% and 9.8% vs 2.0%, respectively, P < 0.01 for both) and lower umbilical artery pH (7.14 ± 0.11 vs 7.19 ± 0.11, P < 0.01) and an over fivefold higher rate of neonatal intensive care unit admission (16.6% vs 2.9%, P < 0.01) were noted in the 'CTG chorioamnionitis' group. Differences in the incidence of abnormal CTG patterns were noted between cases who eventually had clinical evidence of chorioamnionitis (89/356) and those showing CTG features suspicious for chorioamnionitis in the absence of clinical evidence of chorioamnionitis (267/356). CONCLUSION: Intrapartum CTG features of suspected chorioamnionitis are associated with adverse perinatal outcomes.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Galli, L., Dall'Asta, A., Whelehan, V., Archer, A. and Chandraharan, E. (2019), Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses. J. Obstet. Gynaecol. Res., 45: 2343-2350, which has been published in final form at https://doi.org/10.1111/jog.14133. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Keywords: cardiotocography pathophysiology, fetal heart monitoring, fetal heart rate, inflammation, intrapartum fever, Cardiotocography, Chorioamnionitis, Female, Heart Rate, Fetal, Humans, Pregnancy, Retrospective Studies, Humans, Chorioamnionitis, Cardiotocography, Retrospective Studies, Pregnancy, Heart Rate, Fetal, Female, cardiotocography pathophysiology, fetal heart monitoring, fetal heart rate, inflammation, intrapartum fever, cardiotocography pathophysiology, fetal heart monitoring, fetal heart rate, inflammation, intrapartum fever, Cardiotocography, Chorioamnionitis, Female, Heart Rate, Fetal, Humans, Pregnancy, Retrospective Studies, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Journal or Publication Title: J Obstet Gynaecol Res
ISSN: 1447-0756
Language: eng
Dates:
DateEvent
December 2019Published
16 October 2019Published Online
7 September 2019Accepted
Publisher License: Publisher's own licence
PubMed ID: 31621146
Web of Science ID: WOS:000490403900001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/112541
Publisher's version: https://doi.org/10.1111/jog.14133

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