Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption
Article first published online: 29 JUL 2012
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 39, Issue 1, pages 61–66, January 2013
How to Cite
Takano, Y., Furukawa, S., Ohashi, M., Michikata, K., Sameshima, H. and Ikenoue, T. (2013), Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption. Journal of Obstetrics and Gynaecology Research, 39: 61–66. doi: 10.1111/j.1447-0756.2012.01945.x
- Issue published online: 7 JAN 2013
- Article first published online: 29 JUL 2012
- Received: September 13 2011.; Accepted: April 14 2012.
- neonatal outcome;
- non-reassuring fetal heart rate;
- placental abruption
Aim: The aim of this study was to determine the correlation between non-reassuring fetal heart rate (NRFHR) patterns and poor neonatal outcome in placental abruption.
Material and Methods: A retrospective study was performed involving 83 placental abruptions with a live fetus at one tertiary and one secondary hospital in Miyazaki prefecture, Japan. We examined the correlation among NRFHR, umbilical arterial blood gas status, and neonatal poor outcomes, including neonatal death (ND) and cerebral palsy (CP).
Results: A total of 83 cases were divided into bradycardia (n = 27), recurrent late deceleration (rLD, n = 29), severe variable deceleration or prolonged deceleration (sVD/PD, n = 8), and other cases (n = 19). In the bradycardia group, the incidence of low umbilical artery (UA) pH (<7.0) was 59% and the average UA pH was 6.96 ± 0.22. Among these cases, 10 showed severe bradycardia (less than 80 b.p.m.) and an average UA pH of 6.85 ± 0.24, and four cases resulted in poor outcome (three CP and one ND). In the rLD group, the incidence of low UA pH (<7.0) was 7% and the average UA pH was 7.24 ± 0.12. In this group, a 40-week-old fetus with umbilical phlebitis had a lower UA pH (6.92) and developed CP. In the sVD/PD group, there were no cases of a low UA pH (<7.0) and the average UA pH was 7.30 ± 0.04. In this group, a 31-week-old boy with a UA pH of 7.36 developed CP (PVL). The remaining 19 cases had no CP.
Conclusion: Poor neonatal outcome of placental abruption is closely related to NRFHR, especially the degree of bradycardia. In the rLD and sVD/PD groups, risk factors, such as prematurity and fetal inflammation, co-existed.