132471 20260217205508.0 doi 10.1002/ijgo.15454 sideral 137611 ART-2024-137611 eng Castan Larraz, Berta The 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 2024 Access copy available to the general public Unrestricted AbstractObjectiveTo 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. info:eu-repo/grantAgreement/ES/DGA/T69-23R info:eu-repo/semantics/openAccess by-nc-nd https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es 2.6 2024 OBSTETRICS & GYNECOLOGY 35 / 141 = 0.248 2024 Q1 T1 0.892 2024 Obstetrics and Gynecology 2024 Q1 Medicine (miscellaneous) 2024 Q2 4.7 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Esteban, Luis Mariano (orcid)0000-0002-3007-302X Castán Mateo, Sergio Universidad de Zaragoza (orcid)0000-0002-9048-121X Chóliz Ezquerro, Marta Calvo Torres, Javier Esteban-Escaño, Javier (orcid)0000-0001-7995-6969 Rodríguez Solanilla, Belén Universidad de Zaragoza Cisneros Gimeno, Ana Universidad de Zaragoza (orcid)0000-0002-5494-343X Savirón-Cornudella, Ricardo 1003 027 Universidad de Zaragoza Dpto. Anatom.Histolog.Humanas Area Anatom.Embriol.Humana 1013 645 Universidad de Zaragoza Dpto. Cirugía Área Obstetricia y Ginecología 166, 2 (2024), 859-870 Int. j. gynaecol. obstet. International Journal of Gynecology and Obstetrics 0020-7292 2811198 http://zaguan.unizar.es/record/132471/files/texto_completo.pdf Versión publicada 2462856 http://zaguan.unizar.es/record/132471/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:132471 articulos driver 2026-02-17-20:24:02 ARTICLE