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Correlation between total deceleration area in CTG records and cord blood pH in pregnancies with IUGR

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Fetal cardiotocography is the most common method to assess fetal well-being during labor. Nevertheless, its predictive ability for acidemia is limited, both in low-risk and high-risk pregnancies (Nelson et al. in N Engl J Med 334: 613–9, 1996; Rinciples P et al. in Health and Human Development Workshop Report on Electronic Fetal Monitoring : Update on Definitions. no. 2007, 510–515, 2008), especially in high-risk pregnancies, such as those complicated by growth restriction. In this study we aim examine the association between deceleration and acceleration areas and other measure of fetal heart rate in intrapartum fetal monitoring and neonatal arterial cord blood pH in pregnancies complicated by growth restriction.

Materials and methods

A retrospective cohort study of 100 deliveries complicated by growth restriction, delivered during 2018, was conducted. Known major fetal anomalies, non-vertex presentation and elective cesarean deliveries were excluded. Total deceleration and acceleration areas were calculated as the sum of the areas within the deceleration and acceleration, respectively.

Results

In deliveries complicated by growth restriction, cord blood pH is significantly associated with total deceleration area (p = 0.05) and correlates with cumulative duration of the decelerations (Spearman’s rank −0.363, p < 0.05), and total acceleration area (−0.358, p < 0.05). By comparing the cord blood pH in deliveries with a total deceleration area that was above and below the median total deceleration area, we demonstrated a significant difference between the categories.

Conclusions

Cord blood pH significantly correlates with total deceleration area and other fetal monitoring characteristics in neonates with growth restriction. Future studies using real-time, machine-learning based techniques of fetal heart rate monitoring, may provide population specific threshold values that will support bedside clinical decision making and perhaps achieve better outcomes.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Neonatology, Ben-Gurion University of the Negev Faculty of Health Sciences, Sheril and Hain Saban Children Hospital, Soroka Medical Center, Beer-Sheva, Israel

    Neta Geva

  2. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Yael Geva, Adi Yehuda Weintraub & Shimrit Yaniv Salem

  3. Pediatric Division, Rambam Health Care Campus, Haifa, Israel

    Lior Katz

  4. Department of Anesthesiology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Yair Binyamin

  5. Division of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, Jerusalem, Israel

    Reut Rotem

Authors
  1. Neta Geva
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  3. Lior Katz
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Contributions

NG: manuscript writing and editing, data analysis. YG: data analysis, Manuscript editing. LK: data collection, Manuscript editing. YB: manuscript editing. RR: data analysis. AYW: project development, Manuscript editing. SYS: project development, Manuscript editing.

Corresponding author

Correspondence to Neta Geva.

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Conflict of interest

The authors have no relevant financial personal, political, intellectual, or religious or other interests to disclose.

Ethical approval

This study received the approval of the Institutional Review Board (in accordance with the Helsinki declaration) at Soroka University Medical Center. The need for informed consent was waived as participants’ identities were kept strictly anonymous and data was retrospectively collected.

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Geva, N., Geva, Y., Katz, L. et al. Correlation between total deceleration area in CTG records and cord blood pH in pregnancies with IUGR. Arch Gynecol Obstet (2024). https://doi.org/10.1007/s00404-023-07240-0

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