Intrapartum zigzag pattern of fetal heart rate is an early sign of fetal hypoxia: A large obstetric retrospective cohort study

• DOI: 10.1111/aogs.14007
• Publication Date: 2020-09-27T12:19:57Z
• Authors: Mikko Tarvonen; Petteri Hovi; Susanna Sainio; Piia Vuorela; Sture Andersson; Kari Teramo
• Keywords: Umbilical artery; Apgar score; Cardiotocography

Abstract Introduction The aim of the present study was to identify possible associations fetal heart rate (FHR) patterns during last 2 hours labor with asphyxia expressed by umbilical artery acidemia at birth and neonatal complications in a large obstetric cohort. Material methods Cardiotocographic recordings from 4988 singleton term childbirths over 1 year were evaluated retrospectively blinded pregnancy outcomes university teaching hospital Helsinki, Finland. Umbilical pH, base excess pO , low Apgar scores 5 minutes, need for intubation resuscitation, early hypoglycemia, encephalopathy used as outcome variables. According severity birth, cohort divided into three groups: no (Group 1), moderate 2) severe 3). Results Of deliveries, ZigZag pattern (FHR baseline amplitude changes >25 bpm duration 2‐30 minutes) occurred 11.7%, late decelerations 41.0%, bradycardia episodes 52.9%, reduced variability 36.7%, tachycardia 13.9% uterine tachysystole 4.6%. No case saltatory (baseline >30 observed. presence or decelerations, both, associated cord blood (odds ratio [OR] 3.3, 95% confidence interval [CI] 2.3‐4.7) 3) (OR CI 2.4‐4.9). In contrast, significant existed between other FHR complications. preceded 88.7% cases. A normal 90.4% cases, whereas after episodes, observed only 0.9%. Conclusions are significantly precedes fact that majority cases suggests is an sign hypoxia, which emphasizes its clinical importance.