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[The role of cardiotocographic study in older primiparae]
Insights
Cardiotocographic examination (ECTE) is crucial for identifying fetal risk in elderly primiparas (EP). Specific ECTE findings like lacking fetal reactivity and low FHF scores signal fetal distress in EP, guiding obstetric management.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Perinatal Care
Background:
- Elderly primiparas (EP), defined as women aged 35 years or older having their first child, face increased pregnancy risks.
- Cardiotocographic examination (ECTE) is a key tool for monitoring fetal well-being during pregnancy.
Purpose of the Study:
- To evaluate the significance of cardiotocographic examination (ECTE) in determining fetal risk specifically in elderly primiparas (EP).
- To correlate non-stress test (NST) findings with newborn status and perinatal outcomes in EP.
Main Methods:
- Investigated 207 primiparas, including 73 EP (≥35 years).
- Assessed fetal reactivity and fetal heart frequency (FHF) variability during NST.
- Employed semiquantitative FHF evaluation and FHF scoring to enhance NST quality.
Main Results:
- Lack of fetal reactivity, FHF variability of 5 beats per minute, an FHF score of ≤6, and a non-reactive NST curve were indicative of fetal distress primarily in EP.
- These cardiotocographic criteria were more prevalent in EP with co-existing or worsening pregnancy diseases.
- The identified criteria are crucial for guiding obstetric management in EP.
Conclusions:
- Cardiotocographic examination (ECTE) is essential and compulsory for all elderly primiparas (EP).
- Specific NST findings serve as critical indicators of fetal distress in the EP group.
- ECTE results should play a leading role in clinical decision-making for managing pregnancies in elderly primiparas.
Abstract:
The authors aimed to study the significance of cardiotocographic examination (ECTE) for determination of fetal risk in elderly primiparas (EP). Data on NST, one the one hand, and the state of the newborn and perinatal outcome on the other, were, compared for its realization. 207 primiparas were investigated, 73, of whom were EP (35 years). The fetal reactivity and variability of fetal heart frequency (FHF) were evaluated during the performed NST. Semiquantitative evaluation of FHF was also made, in order to improve the quality of NST. FHF score was examined as well. The following inferences were made as a result of the examination: 1. Lacking reactivity of the fetus, variability 5 min beats per min, FHF score--6 points and even curve of NST as a signal for fetal distress were found mainly in EP. 2. These cardiotocographic criteria were encountered in EP with accompanying and worsening the pregnancy diseases and should pray a leading role in determining obstetric management. 3. The performance of ECTE is compulsory in EP.