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Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study

INTRODUCTION: In the most recent recommendations of the International Federation of Gynecology and Obstetrics (FIGO), a chapter was dedicated to the physiological approach and to the description of fetal mechanisms developed to respond to hypoxia. Our objective was to classify the type of hypoxia in...

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Autores principales: Descourvieres, Léa, Ghesquiere, Louise, Drumez, Elodie, Martin, Claire, Sauvage, Audrey, Subtil, Damien, Houfflin‐Debarge, Véronique, Garabedian, Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812112/
https://www.ncbi.nlm.nih.gov/pubmed/36004701
http://dx.doi.org/10.1111/aogs.14436
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author Descourvieres, Léa
Ghesquiere, Louise
Drumez, Elodie
Martin, Claire
Sauvage, Audrey
Subtil, Damien
Houfflin‐Debarge, Véronique
Garabedian, Charles
author_facet Descourvieres, Léa
Ghesquiere, Louise
Drumez, Elodie
Martin, Claire
Sauvage, Audrey
Subtil, Damien
Houfflin‐Debarge, Véronique
Garabedian, Charles
author_sort Descourvieres, Léa
collection PubMed
description INTRODUCTION: In the most recent recommendations of the International Federation of Gynecology and Obstetrics (FIGO), a chapter was dedicated to the physiological approach and to the description of fetal mechanisms developed to respond to hypoxia. Our objective was to classify the type of hypoxia in the case of metabolic acidemia and to describe the order of appearance of fetal heart rate abnormalities in cases of gradually evolving hypoxia. MATERIAL AND METHODS: 132 neonates born between 2018 and 2020 with acidemia were included. We excluded preterm birth, fetuses with congenital anomaly and twin pregnancies. Intrapartum cardiotocography traces were assigned to one of these four types of labor hypoxia: acute, subacute, gradually evolving and chronic hypoxia. For gradually evolving hypoxia, fetal heart rate abnormalities were described according to the FIGO classification. RESULTS: 36 cardiotocography traces (27.3%) were classified as acute hypoxia, 14 (10.6%) as subacute hypoxia, and 3 (3.2%) as chronic hypoxia; gradually evolving hypoxia occurred in 62 cases (47%). In 77.4% of cases of gradually evolving hypoxia, deceleration was the first anomaly to appear, with loss of variability and bradycardia appearing later. Increased fetal heart rate was observed immediately after late deceleration in 46.8% of cases and was followed by a loss of variability or saltatory rhythm in 37.1% of cases. CONCLUSIONS: In cases of metabolic acidemia at term, the most frequent situation observed was gradually evolving hypoxia, with an initial occurrence of decelerations. The sequence of fetal heart rate modifications was variable.
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spelling pubmed-98121122023-01-05 Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study Descourvieres, Léa Ghesquiere, Louise Drumez, Elodie Martin, Claire Sauvage, Audrey Subtil, Damien Houfflin‐Debarge, Véronique Garabedian, Charles Acta Obstet Gynecol Scand Birth INTRODUCTION: In the most recent recommendations of the International Federation of Gynecology and Obstetrics (FIGO), a chapter was dedicated to the physiological approach and to the description of fetal mechanisms developed to respond to hypoxia. Our objective was to classify the type of hypoxia in the case of metabolic acidemia and to describe the order of appearance of fetal heart rate abnormalities in cases of gradually evolving hypoxia. MATERIAL AND METHODS: 132 neonates born between 2018 and 2020 with acidemia were included. We excluded preterm birth, fetuses with congenital anomaly and twin pregnancies. Intrapartum cardiotocography traces were assigned to one of these four types of labor hypoxia: acute, subacute, gradually evolving and chronic hypoxia. For gradually evolving hypoxia, fetal heart rate abnormalities were described according to the FIGO classification. RESULTS: 36 cardiotocography traces (27.3%) were classified as acute hypoxia, 14 (10.6%) as subacute hypoxia, and 3 (3.2%) as chronic hypoxia; gradually evolving hypoxia occurred in 62 cases (47%). In 77.4% of cases of gradually evolving hypoxia, deceleration was the first anomaly to appear, with loss of variability and bradycardia appearing later. Increased fetal heart rate was observed immediately after late deceleration in 46.8% of cases and was followed by a loss of variability or saltatory rhythm in 37.1% of cases. CONCLUSIONS: In cases of metabolic acidemia at term, the most frequent situation observed was gradually evolving hypoxia, with an initial occurrence of decelerations. The sequence of fetal heart rate modifications was variable. John Wiley and Sons Inc. 2022-08-25 /pmc/articles/PMC9812112/ /pubmed/36004701 http://dx.doi.org/10.1111/aogs.14436 Text en © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Birth
Descourvieres, Léa
Ghesquiere, Louise
Drumez, Elodie
Martin, Claire
Sauvage, Audrey
Subtil, Damien
Houfflin‐Debarge, Véronique
Garabedian, Charles
Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study
title Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study
title_full Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study
title_fullStr Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study
title_full_unstemmed Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study
title_short Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study
title_sort types of intrapartum hypoxia in the newborn at term with metabolic acidemia: a retrospective study
topic Birth
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812112/
https://www.ncbi.nlm.nih.gov/pubmed/36004701
http://dx.doi.org/10.1111/aogs.14436
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