000078794 001__ 78794 000078794 005__ 20190709135546.0 000078794 0247_ $$2doi$$a10.1080/14767058.2016.1256993 000078794 0248_ $$2sideral$$a104853 000078794 037__ $$aART-2017-104853 000078794 041__ $$aeng 000078794 100__ $$aMartí Gamboa, S. 000078794 245__ $$aDeceleration area and fetal acidemia 000078794 260__ $$c2017 000078794 5060_ $$aAccess copy available to the general public$$fUnrestricted 000078794 5203_ $$aAims: To compare the predictive ability for neonatal acidemia of individual components of intrapartum cardiotocography (CTG) described by National Institute of Child Health and Human Development (NICHD) system and deceleration area. Design: Case-control study. Setting: Spanish tertiary obstetrical hospital. Population: CTG patterns of 102 acidemic fetus (umbilical arterial cord gas pH =7.10, base deficit (BD>48) and 102 nonacidemic controls (umbilical arterial cord gas pH>7.10). Methods: Two reviewers blind to clinical and outcome data analyzed the last thirty minutes before delivery of 204 fetal heart rate (FHR) tracings, extracting those features defined by NICHD and certain measures of FHR decelerations, including deceleration area, not considered by this system. Outcome measures: The primary outcome was the predictive ability of NICHD features and non-NICHD deceleration measures for fetal acidemia. The secondary outcome was the impact of deceleration area in the last 30 min of labor on gasometry components (pH, BD and lactate). Results: Minimal variability (area under the curve (AUC) 0.74), total number of late (AUC: 0.75) and prolonged decelerations (0.77) were the three NICHD features with the greatest predictive ability for fetal acidemia in the last thirty minutes of labor. Total deceleration area demonstrated the highest discrimination power (AUC: 0.83) of all the analyzed elements. For each cm2 the area increases in the last 30 min of labor, pH decreases 0.08 units, BD increases 0.272 mEq/L and lactate 0.183 mEq/L. Conclusions: Total deceleration area showed the greatest predictive ability for fetal acidemia and its measure could help to estimate intrapartum fetal acid-base status. 000078794 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000078794 590__ $$a1.493$$b2017 000078794 591__ $$aOBSTETRICS & GYNECOLOGY$$b62 / 81 = 0.765$$c2017$$dQ4$$eT3 000078794 592__ $$a0.714$$b2017 000078794 593__ $$aPediatrics, Perinatology and Child Health$$c2017$$dQ2 000078794 593__ $$aObstetrics and Gynecology$$c2017$$dQ2 000078794 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion 000078794 700__ $$aLapresta Moros, M. 000078794 700__ $$aPascual Mancho, J. 000078794 700__ $$aLapresta Moros, C. 000078794 700__ $$0(orcid)0000-0002-9048-121X$$aCastán Mateo, S.$$uUniversidad de Zaragoza 000078794 7102_ $$11004$$2645$$aUniversidad de Zaragoza$$bDpto. Cirugía,Ginecol.Obstetr.$$cÁrea Obstetricia y Ginecología 000078794 773__ $$g30, 21 (2017), 2578-2584$$pJ. matern.-fetal neonatal med.$$tJournal of Maternal-Fetal & Neonatal Medicine$$x1476-7058 000078794 8564_ $$s589874$$uhttps://zaguan.unizar.es/record/78794/files/texto_completo.pdf$$yPostprint 000078794 8564_ $$s17581$$uhttps://zaguan.unizar.es/record/78794/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint 000078794 909CO $$ooai:zaguan.unizar.es:78794$$particulos$$pdriver 000078794 951__ $$a2019-07-09-12:09:25 000078794 980__ $$aARTICLE