Intrapartum fetal heart rate patterns and perinatal outcome in chorioamnionitis at or beyond 34 weeks of gestation.
Intrapartum fetal heart rate patterns and perinatal outcome in chorioamnionitis at or beyond 34 weeks of gestation.
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妊娠 34 周或以上的绒毛膜羊膜炎的产时胎心率模式和围产期结局。
DOI：
10.1111/jog.14641
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Sameshima H.
中科院分区：
文献类型：
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作者：
Muraoka J;Kodama Y;Goto T;Yamashita R;Doi K;Kaneko M;Sameshima H.
AimTo调查产时胎儿心率（FHR）模式在绒毛膜炎的妇女在或超过34周的妊娠与新生儿的结局，并比较临床和亚临床绒毛膜炎methodsA回顾性问卷调查分娩在2015年期间进行了由日本妇产科学会围产期委员会从2016年至2018年。共纳入498例妊娠≥34周时分娩的合并绒毛膜炎的单胎分娩，无重大先天性畸形。根据Lencki标准将受试者分为临床和亚临床绒毛膜炎组。围产期结局不良定义为死亡或脑损伤。结果妊娠≥34周绒毛膜炎发生率为0.59%（522/87827），其中妊娠34周的绒毛膜炎发生率为0.59%（522/87827），妊娠34周的绒毛膜炎发生率为0.59%（522/87827）。临床和亚临床绒毛膜炎分别包括240和258例。异常胎心率模式（晚期减速或基线变异性降低）与围产期预后不良显著相关。合并晚期减速和变异性降低显示阳性预测值低（12.8%）和阴性预测值高（99.5%），并且仅与临床绒毛膜炎的长期不良结局显著相关（比值比：29.4，p < 0.01）。临床和亚临床绒毛膜炎groups.ConclusionsCombined晚减速和变异性降低可以预测临床绒毛膜炎围产儿预后不良。临床和亚临床绒毛膜炎母亲所生婴儿的围产期结局较差。
AimTo investigate intrapartum fetal heart rate (FHR) patterns in women with chorioamnionitis at or beyond 34 weeks of gestation in relation to neonatal outcome and to compare clinical and subclinical chorioamnionitis.MethodsA retrospective questionnaire survey on deliveries during 2015 was conducted by the Perinatology Committee of the Japan Society of Obstetrics and Gynecology from 2016 to 2018. A total of 498 singleton births complicated by chorioamnionitis delivered at ≥34 weeks of gestation without major congenital malformations were included. The subjects were divided into clinical and subclinical chorioamnionitis groups based on Lencki's criteria. Poor perinatal outcome was defined as death or brain damage. We analyzed clinical features, FHR patterns in the last 2 h before delivery, gestational age, birthweight, Apgar score, umbilical arterial blood gas analysis, and infant's outcome.ResultsIncidence of chorioamnionitis at ≥34 weeks of gestation was 0.59% (522/87827). Clinical and subclinical chorioamnionitis comprised 240 and 258 cases, respectively. Abnormal FHR patterns (late deceleration or decreased baseline variability) were significantly associated with poor perinatal outcome. Combined late deceleration and decreased variability showed low positive predictive value (12.8%) and high negative predictive value (99.5%), and was significantly associated with long‐term poor outcome in clinical chorioamnionitis only (odds ratio: 29.4,p< 0.01). Poor perinatal outcome showed no significant difference between the clinical and subclinical chorioamnionitis groups.ConclusionsCombined late deceleration and decreased variability could predict poor perinatal outcome in clinical chorioamnionitis. Poor perinatal outcome occurred in infants born to mothers with clinical and subclinical chorioamnionitis.