Accuracy of intrapartum cardiotocography in identifying fetal acidemia by umbilical cord blood analysis in low-risk pregnancies.

Abstract

Objective: The aim of this study was to evaluate the accuracy of intrapartum cardiotocography in identifying fetal acidemia by umbilical cord blood analysis in low-risk pregnancies.

Methods: This is a retrospective cohort study of low-risk singleton pregnancies in labor after performing intrapartum cardiotocography categories I, II, and III. The presence of fetal acidemia at birth was identified by analyzing the pH of umbilical cord arterial blood (pH<7.1).

Results: No significant effect of the cardiotocography category on the arterial (p=0.543) and venous (p=0.770) pH of umbilical cord blood was observed. No significant association was observed between the cardiotocography category and the presence of fetal acidemia (p=0.706), 1-min Apgar score <7 (p=0.260), hospitalization in the neonatal intensive care unit (p=0.605), newborn death within the first 48 h, need for neonatal resuscitation (p=0.637), and adverse perinatal outcomes (p=0.373). Sensitivities of 62, 31, and 6.0%; positive predictive values of 11.0, 16.0, and 10.0%; and negative predictive values of 85, 89.0, and 87.0% were observed for cardiotocography categories I, II, and III, respectively.

Conclusion: The three categories of intrapartum cardiotocography presented low sensitivities and high negative predictive values to identify fetal acidemia at birth in low-risk pregnancies.