Moderate Asph?xia in Intrauterine Growth Restriction of the Fetus - Cardiotocography and Ultrasound Methods of Diagnosis

Elena Pirnareva, Borislav Marinov


Asphyxia remains an important cause for neonatal morbidity and mortality. The tests in themselves cardiotocography (NST), sonography, Doppler studies which are used for antenatal fetus surveillance are aimed at timely diagnosing the signs of the fetus asphyxia. The objective of the current research is to study which modifications in the cardiotocography (NST), arterial and venosus Doppler correlate most strongly with moderate asphyxia pH< 7.20 and base excess (BE) < - 12 mmol/l, regarding pregnancies which are complicated with intrauterine growth restriction of the fetus. At delivery totally 32 are the cases with moderate fetus asphyxia pH < 7.20 and BE < - 12 mmol/l. Loss in reactivity in the non-stress test shows sensitivity 76.9%, specifity 46%, positive predictive value (PPV) 12.8%, negative predictive value (NPV) 95.1%, odds ratio (OR) 2.84, p< 0.051.

The presence of spontaneous decelerations in the cardiotocography shows sensitivity 26.7%, specificity 87.1%, PPV 21.1, NPV 90.2%, odds ratio (OR) 2.45, p< 0.166, the elevated pulsatility index of umbilical artery shows sensitivity 14.3%, specificity 50%, PPV 3.1%, .NPV 83.8%, OR 0.17, p< 0.022, absent end-diastolic velocity of the umbilical artery shows sensitivity 84.6%, specificity 60.3%, PPV 18%, NPV 97.4%, OR 84, p < 0.007, the elevated pulsatility index for veins (PIV) shows sensitivity 7.1%, specificity 52.8%, PPV 1.7% , NPV 83.5% OR 0.09, p < 0.020, reversed a-wave ductus venosus shows sensitivity 75%, specificity 39.4%, PPV 10.5% NPV 94.3% OR 1.9, p< 0.334. Concerning pregnant women with intrauterine growth restriction of the fetus the prognostication of moderate fetus asphyxia at delivery pH < 7.20 and BE< - 12 mmol/l with the highest specificity of antenatal testing is the absent end-diastolic blood velocity of umbilical artery and the reversed a-wave ductus venosus in Doppler studies.


fetus asphyxia at delivery; intrauterine growth restriction of the fetus.

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. Batool, Bhutta Z.Birth Asphyxia in Developing Countries:Current Status and Public Health Implications .Curr Probl Pediatr Adolesc Health Care 2006 ;36:178-188

. J.Bryce , Boschi-Pinto C., Shibuya K. et al.WHO Child Health Epidemiology Reference Group. New WHO estimates of the cases of child deaths. Lancet 2005;365:1147-1152 DOI:10.1016/S0140-6736(05)71877-8

. J. Miler, Turan S., Baschat A.Fetal growth restriction. Semin Perinatol 2008; 32(4):274-280

. G.Mari, Deter R., Hanif F et al. Sequence of cardiovascular changes occurring in severe IUGR fetuses-part II. Ultrasound Obstet Gynecol. 2006;28:390-397

. Low James A. Intra-partum fetal asphyxia: definition, diagnosis, and classification.American Journal of Obstetrics and Gynecology 1997;176:957-959

. O. Turan, Turan S., Berg C. et al. Duration of persistent abnormal ductus venosus flow and its impact on perinatal outcome in fetal growth restriction. Ultrasound Obstet Gynecol 38(3),295-302

. R. Has, Kaleliogli I., Citil I. et al.The perinatal outcome of 48 IUGR fetuses with ARED. Ultrasound Obstet Gynecol. 2006;28:468-476

. S.Visentin, Cavallin F., Zanardo V. Neonatal outcome in intrauterine gowth restricted and small for gestational age fetuses. Ultrasound Obstet Gynecol 2010;36:S1:54

. T.Garite, Clark. R, Thorp A.Intrauterine growth restriction increases morbidity and mortality among premature neonates. Am J Obstet Gynecol. 2004;191:481-487

. W.Hay, Thureen P., Anderson M. Intrauterine growth restriction.Neo Reviews2 2001;129-137

. Z.Alfirevic, Stampalija T., Gyte G. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane.Database.Syst.Rev.2010;20:.CD007529.DOI:10.1002/14651858.CD007529. pub2


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