Johns Hopkins University2014-12-03 4:22 PM

Diagnostic Accuracy of Fetal Heart Rate Monitoring in the Identification of Neonatal Encephalopathy

ABSTRACT


OBJECTIVE : To estimate the diagnostic accuracy of electronic fetal heart rate abnormalities in the identification of neonates with encephalopathy treated with whole-body hypothermia .


METHODS : Between January 1 , 2007, and July 1 , 2013 , there were 39 neonates born at two hospitals within our system treated with whole-body hypothermia within 6 hours of birth . Neurologically normal control neonates were matched to each case by gestational age and mode of delivery in a two-to-one fashion . The last hour of electronic fetal heart rate monitoring before delivery was evaluated by three obstetricians blinded to outcome .


RESULTS : The differences in tracing category were not significantly different (neonates in the case group 10.3% I , 76.9% II , 12.8% III ; neonates in the control group 9.0% I , 89.7% II , 1.3% III ; P=.18) . 


Bivariate analysis showed neonates in the case group had significantly increased late decelerations , total deceleration area 30 (debt 30) and 60 minutes (debt 60) before delivery and were more likely to be nonreactive . Multivariable logistic regression showed neonates in the case group had a significant decrease in early decelerations (P=.03) and a significant increase in debt 30 (.01) and debt 60 (P=.005) . 


The area under the receiver operating characteristic curve , sensitivity , and specificity were 0.72, 23.1% , and 94.9% for early decelerations; 0.66, 33.3%, and 87.2% for debt 30 , and 0.68, 35.9% , and 89.7% for debt 60, respectively .


CONCLUSION : Abnormalities during the last hour of fetal heart rate monitoring before delivery are poorly predictive of neonatal hypoxic–ischemic encephalopathy qualifying for whole-body hypothermia treatment within 6 hours of birth .


LEVEL OF EVIEDENCE: II


Full Article:

http://journals.lww.com/greenjournal/Abstract/2014/09000/Diagnostic_Accuracy_of_Fetal_Heart_Rate_Monitoring.5.aspx

KEYWORDS

SHARE & LIKE

COMMENTS

ABOUT THE AUTHOR

Johns Hopkins University

0 Following 0 Fans 0 Projects 13 Articles

SIMILAR ARTICLES

AbstractBackgroundBeing able to investigate the relationship between underage drinkers' preferences for particular brands and their exposure to adverti

Read More

ABSTRACTImportance Diabetic macular edema (DME) is a leading cause of vision loss in persons with diabetes mellitus. Although there are national estim

Read More

AbstractSpecies of Clostridium bacteria are notable for their ability to lyse tumor cells growing in hypoxic environments . We show that an attenuated

Read More

AbstractLubrication is key for the efficient function of devices and tissues with moving surfaces , such as articulating joints, ocular surfaces and th

Read More

ABSTRACTImportance Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Be

Read More

AbstractStem cell therapy has shown promise in treating a variety of pathologies including skin wounds, but practical applications remain elusive. Here

Read More

BackgroundSocial anxiety disorder—a chronic and naturally unremitting disease that causes substantial impairment—can be treated with pharmacological ,

Read More

AbstractOsteogenesis during bone modeling and remodeling is coupled with angiogenesis . A recent study showed that a specific vessel subtype, strongly

Read More

ABSTRACTOBJECTIVE : To estimate the diagnostic accuracy of electronic fetal heart rate abnormalities in the identification of neonates with encephalopa

Read More

BackgroundSupply-side reductions to the calories in chain restaurants are a possible benefit of upcoming menu labeling requirements .PurposeTo describe

Read More