engleski

Fetal Doppler Hypoxic index for the prediction of abnormal fetal heart rate at delivery in chronic fetal distress

Objective: To design a Doppler Hypoxic index (HI) which takes into account both the duration and the intensity of etal flow redistribution (i.e. hypoxia) for predicting the occurence of abnormal fetal heart rate (FHR) at delivery. Method: Sixty-six pregnancies with hypertension and/or growth reterdation (IUGR) were investigated (age: 23+/- 5 years, primigravidas: 30%, CS 59%, hospitalisation: 10+/- 8 days ; IUGR (<10 c) 82% ; intensive care 23% fetal death 1). Umbilical (URI) and cerebral (CRI) Doppler resistance indices and the C/U ratio (CRI/URI) were measured every 2 days from the admission to delivery. HI was calculated by summing the daily % of C/u reduction (in % from the normal cut-off limit of 1.1) over the period of observation (or mean C/U reduction in % from 1.1 x number of days of observation). Doppler C/U and HI were compared with fetal hear rate (FHR) traces and perinatal data. Results: HI>160% was associated with abnormal FHR in 80% of the cases (PPV = 87%, NPV = 88%). HI> than 160% predicted the occurence of abnormal FHR 8+/-6 days before they happened. Conclusion: A combination of intensity and duration of the fetal flow redistribution (i.e. hypoxia) evaluated by Doppler is correlated with the occurence of abnormal fetal heart rate.

fetus; heart rate; hypoxia; Doppler; cerebral artery; umbilical artery

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