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Mortality rates in low-birth-weight infants born after a positive contraction stress test
Insights
This study on contraction stress tests (CSTs) found higher perinatal mortality in smaller infants. Prompt delivery is crucial for positive CST results when neonatal survival is possible.
Area of Science:
- Perinatology
- Obstetrics
- Neonatalogy
Background:
- Perinatal mortality remains a significant concern in high-risk pregnancies.
- Contraction stress tests (CSTs) are utilized to assess fetal well-being in specific obstetric scenarios.
Purpose of the Study:
- To investigate perinatal mortality rates in relation to positive contraction stress test (CST) results.
- To identify the primary indications for CST in a cohort of high-risk pregnancies.
- To analyze the impact of infant birth weight on perinatal outcomes following positive CSTs.
Main Methods:
- Retrospective analysis of 46 patients with positive CST results.
- Focus on infants born weighing between 500 and 1500 grams.
- Evaluation of indications for CST, including severe pre-eclampsia and intra-uterine growth retardation.
Main Results:
- Perinatal mortality rates were inversely correlated with birth weight: 76.9% (500-1000g), 38.5% (1001-1250g), and 25% (1251-1500g).
- Conservative management for fetal immaturity resulted in a low survival rate (1/7).
- Immediate caesarean section in infants <1000g led to a high incidence of fatal hyaline membrane disease.
Conclusions:
- Positive CST results signify a substantial risk of intra-uterine death.
- Prompt delivery is indicated for fetuses with a viable chance of neonatal survival.
- Management decisions must balance the risks of intra-uterine death against the challenges of extreme prematurity.
Abstract:
Perinatal mortality rates and the indications for contraction stress tests (CSTs) were studied in 46 patients with positive test results and who gave birth to infants weighing between 500 and 1 500 g. Severe pre-eclampsia and intra-uterine growth retardation were the indications for the CST in the large majority of patients. The perinatal mortality rate for infants weighing between 500 and 1 000 g was 76.9%, for infants between 1 001 and 1 250 g 38.5%, and only 25% when the infants weighed 1 251 - 1 500 g. After conservative treatment because of fetal immaturity only 1 of 7 infants was born alive, but after immediate delivery by caesarean section there was a high rate of fatal hyaline membrane disease in infants weighing less than 1 000 g. The real danger of intra-uterine death in the presence of a positive CST result indicates prompt delivery when the fetus has a reasonable chance of survival in the neonatal period.
