[ASPHYXIA IN INTRAUTERINE GROWTH RESTRICTION OF THE FETUS- CARDIOTOCOGRAPHY AND ULTRASOUND METHODS OF DIAGNOSIS.]

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Fetal Medicine

Background:

• Fetal asphyxia significantly contributes to neonatal morbidity and mortality.
• Antenatal surveillance using cardiotocography (NST), sonography, and Doppler studies aims to diagnose fetal asphyxia.
• Intrauterine growth restriction (IUGR) complicates pregnancies and increases the risk of fetal distress.

Purpose of the Study:

• To identify cardiotocography (NST) and Doppler flow modifications that correlate strongly with severe fetal asphyxia (pH<7.10, BE≥12 mmol/l).
• To evaluate these correlations specifically in pregnancies complicated by fetal intrauterine growth restriction (IUGR).

Main Methods:

• Analysis of cardiotocography (NST) parameters, including spontaneous decelerations.
• Assessment of arterial and venous Doppler studies, focusing on umbilical artery and ductus venosus blood flow.
• Correlation of antenatal test findings with severe fetal asphyxia markers at delivery (pH<7.10, BE≥12 mmol/l) in IUGR pregnancies.

Main Results:

• Spontaneous decelerations in NST demonstrated high sensitivity (81.3%) and specificity (97.1%) for severe asphyxia.
• Reversed umbilical artery blood velocity showed 58.3% sensitivity and 96.2% specificity.
• Reversed a-wave of the ductus venosus had 51% sensitivity and 94.3% specificity.
• All tested parameters showed statistically significant correlation with severe fetal asphyxia (p<0.001).

Conclusions:

• In pregnancies with fetal IUGR, spontaneous decelerations on NST, reversed umbilical artery blood velocity, and reversed a-wave of the ductus venosus are the most specific antenatal indicators of severe fetal asphyxia at delivery.
• These findings aid in the prognostication and timely management of high-risk pregnancies.