Key result
Severe fetal metabolic acidaemia linked to ~58% more ST-events than normal controls.
Why the study?
Do fetal ECG ST-interval segment changes and CTG abnormalities predict acidaemia at birth in newborns?
Population
Newborns with severe cord artery metabolic acidaemia, moderate metabolic acidaemia, acidaemia…
Comparison
Fetal electrocardiogram ST-interval segment… vs Controls with normal acid-base status at birth
Design
Case-control, Monitoring traces were assessed blinded to outcome
Follow-up
At birth
Authors
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Clinicians should not rely on absent ST-events to exclude acidaemia with abnormal CTG; leaves open the incremental predictive value of combined monitoring.
Case-Control (n=506)
Single-blind
No
Do fetal ECG ST-interval segment changes and CTG abnormalities predict acidaemia at birth in newborns?
Absolute Event Rate: 79% vs 50%
Fetal ECG ST events coinciding with CTG abnormalities precede only a subset of cases with severe or moderate metabolic acidaemia, highlighting the need to intervene for marked CTG abnormalities even without ST events.
Melin et al. (2008) conducted a case-control in Fetal acidaemia at birth (n=506). ST-interval segment changes and CTG abnormalities vs. Controls (cord artery pH >7.20) was evaluated on Occurrence of any ST-event. Any ST-event occurred significantly more often among cases with severe (79%) and moderate (75%) metabolic acidaemia compared to controls (50%), though only two-thirds of severe cases had ST-events coinciding with CTG abnormalities.
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