Asociación entre la monitoria fetal anteparto y el puntaje de Apgar y gases en sangre de cordón en pacientes que son sometidas a cesárea por sospecha de estado fetal no tranquilizador

Abstract

Introduction: Perinatal asphyxia refers to a deprivation of oxygen long enough to cause neonatal neurologic injury, that happens before, during and after the labor and the delivery. For a long time, findings from the fetal heart tracing along with results from the umbilical arterial cord gas have been used to predict the likelihood that such outcomes occur. However, their sensibility and specificity have been questioned. Methods: Retrospective cohort study that evaluated the association between persistent category II and category III fetal heart rate pattern and perinatal asphyxia signs (evaluated from umbilical arterial cord gas and Apgar score). We estimated the RR and the 95% CI and the odds ratio to develop perinatal asphyxia adjusting by the included covariables. Results: 93 pregnant women were evaluated, 38 in the exposed group and 59 in the unexposed. There were not significant differences among the two groups, except for the onset of labor. The RR was 0.86 (95% CI [0.36, 2.07]). Maternal age (OR=1.22 [1.01, 1.48]), gestational age (OR=0.69 [0.48, 0.99]), gestational hypertensive disorders (OR=34.24 [2.27, 512.77]), and peridural anesthesia (OR=48.30 [2.23, 1044,80]) were significantly associated with the odd of perinatal asphyxia. , la edad gestacional, los trastornos hipertensivos del embarazo, así como el uso de anestesia peridural Conclusions: We could not establish association between persistent category II and category III fetal heart rate pattern and the evaluated neonatal signs. Prospective studies that included higher number of pregnant women are needed to strength the available evidence to support, or not, using the fetal heart rate pattern as a tool as perinatal asphyxia prediction.