000132471 001__ 132471 000132471 005__ 20240822135944.0 000132471 0247_ $$2doi$$a10.1002/ijgo.15454 000132471 0248_ $$2sideral$$a137611 000132471 037__ $$aART-2024-137611 000132471 041__ $$aeng 000132471 100__ $$aCastan Larraz, Berta 000132471 245__ $$aThe utility of fetal heart rate deceleration's descending slope in searching for a non-National Institute of Child Health and Human Development parameter for the detection of fetal acidosis 000132471 260__ $$c2024 000132471 5060_ $$aAccess copy available to the general public$$fUnrestricted 000132471 5203_ $$aAbstractObjectiveTo identify new parameters predicting fetal acidemia.MethodsA retrospective case–control study in a cohort of deliveries from a tertiary referral hospital‐based cohort deliveries in Zaragoza, Spain between 2018 and 2021 was performed. To predict fetal acidemia, the NICHD categorizations and non‐NICHD parameters were analyzed in the electronic fetal monitoring (EFM). Those included total reperfusion time, total deceleration area and the slope of the descending limb of the fetal heart rate of the last deceleration curve. The accuracy of the parameters was evaluated using the specificity for (80%, 85%, 90%, 95%) sensitivity and the area under the receiver operating characteristic curve (AUC).ResultsA total of 10 362 deliveries were reviewed, with 224 cases and 278 controls included in the study. The NICHD categorizations showed reasonable discriminatory ability (AUC = 0.727). The non‐NICHD parameters measured during the 30‐min fetal monitoring, total deceleration area (AUC = 0.807, 95% CI: 0.770, 0.845) and total reperfusion time (AUC = 0.750, 95% CI: 0.707, 0.792), exhibited higher discriminatory ability. The slope of the descending limb of the fetal heart rate of the last deceleration curve had the best AUC value (0.853, 95% CI: 0.816, 0.889). The combination of total deceleration area or total reperfusion time with the slope demonstrated high discriminatory ability (AUC = 0.908, 95% CI: 0.882, 0.933; specificities of 71.6% and 72.7% for a sensitivity of 90%).ConclusionsThe slope of the descending limb of the fetal heart rate of the last deceleration curve is the strongest predictor of fetal acidosis, but its combination with the total reperfusion time shows better clinical utility. 000132471 536__ $$9info:eu-repo/grantAgreement/ES/DGA/T69-23R 000132471 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/ 000132471 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000132471 700__ $$0(orcid)0000-0002-3007-302X$$aEsteban, Luis Mariano 000132471 700__ $$0(orcid)0000-0002-9048-121X$$aCastán Mateo, Sergio$$uUniversidad de Zaragoza 000132471 700__ $$aChóliz Ezquerro, Marta 000132471 700__ $$aCalvo Torres, Javier 000132471 700__ $$0(orcid)0000-0001-7995-6969$$aEsteban-Escaño, Javier 000132471 700__ $$aRodríguez Solanilla, Belén$$uUniversidad de Zaragoza 000132471 700__ $$0(orcid)0000-0002-5494-343X$$aCisneros Gimeno, Ana$$uUniversidad de Zaragoza 000132471 700__ $$aSavirón-Cornudella, Ricardo 000132471 7102_ $$11003$$2027$$aUniversidad de Zaragoza$$bDpto. Anatom.Histolog.Humanas$$cArea Anatom.Embriol.Humana 000132471 7102_ $$11013$$2645$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Obstetricia y Ginecología 000132471 773__ $$g166, 2 (2024), 859-870$$pInt. j. gynaecol. obstet.$$tInternational Journal of Gynecology and Obstetrics$$x0020-7292 000132471 8564_ $$s2811198$$uhttps://zaguan.unizar.es/record/132471/files/texto_completo.pdf$$yVersión publicada 000132471 8564_ $$s2462856$$uhttps://zaguan.unizar.es/record/132471/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000132471 909CO $$ooai:zaguan.unizar.es:132471$$particulos$$pdriver 000132471 951__ $$a2024-08-22-13:58:15 000132471 980__ $$aARTICLE