| Автор | Salafia, Carolyn, M. |
| Автор | Ghidini, Alessandro |
| Автор | Sherer, David, M. |
| Автор | Pezzullo, John, C. |
| Дата выпуска | 1998 |
| dc.description | Objective:To evaluate whether fetal heart rate (FHR) patterns obtained in nonstress testing within 24 hours of delivery in patients with preterm delivery were associated with histologic acute infection, and if so, whether the associations are with maternal as opposed to fetal acute inflammation (acute annionitis versus acute umbilical vasculitis).Methods:The data set included 351 consecutive patients delivering from 22 to 32 weeks' gestation (excluding cases of preeclampsia; nonhypertensive abruption; stillbirth; fetal structural and karyotypic anomalies; Rh isoimmunization and hydrops fetalis; and maternal diabetes and hypertension). Severe variable decelerations were defined as FHR < 70 beats per minute lasting > 60 seconds, and decreased fetal heart variability included both reduced beat-to-beat variability and long-term heart rate cyclicity. Amniotic fluid volume was graded sonographically as part of a fetal biophysical profile. Acute inflammation of amnion (indicative of maternal inflammation) and umbilical cord (fetal inflammation) were scored by a single pathologist blinded to clinical data.Results:Severe FHR variable decelerations were directly related to acute amnionitis (P = .012) and acute umbilical vasculitis (P = .0013). In preterm labor, decreased FHR variability was related to acute amnionitis (P = .005). All observations were independent of amniotic fluid volume or use of tocolytic agents.Conclusions:Severe variable decelerations and decreased FHR variability at < 32 weeks' gestation are related to histologic evidence of acute inflammation. |
| Издатель | Sage Publications |
| Тема | Fetal heart rate |
| Тема | preterm delivery |
| Тема | amnionitis |
| Тема | premature rupture of membranes |
| Тема | preterm labor |
| Название | Abnormalities of the Fetal Heart Rate in Preterm Deliveries Are Associated With Acute Intra-Amniotic Infection |
| Тип | Journal Article |
| DOI | 10.1177/107155769800500405 |
| Print ISSN | 1071-5576 |
| Журнал | Journal of the Society for Gynecologic Investigation |
| Том | 5 |
| Первая страница | 188 |
| Последняя страница | 191 |
| Аффилиация | Salafia, Carolyn, M., Departments of Pathology and Obstetrics and Gynecology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, D.C. Salafiacm@aol.com |
| Аффилиация | Pezzullo, John, C., Departments of Pathology and Obstetrics and Gynecology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, D.C. |
| Выпуск | 4 |
| Библиографическая ссылка | 1. Vintzielos AM, Campbell WC, Rodis JF. Fetal biophysical profile scoring: Current status. Clin Perinatol 1989;16:661-689. |
| Библиографическая ссылка | 2. Salafia CM, Minior VK, Rosenkrantz TS, Pezzullo JC, Cusick W, Vintzileos AM. Maternal, placental and neonatal associations with early germinal matrix/intraventricular hemorrhage in infants born at < 32 weeks gestation. Am J Perinatol 1995;12:427-434. |
| Библиографическая ссылка | 3. Salafia CM, Mangam HE, Weigl CA, Foye GJ, Silberman L. Abnormal fetal heart rate patterns and placental inflammation. Am J Obstet Gynecol 1989;160:140-147. |
| Библиографическая ссылка | 4. Salafia CM, Silberman L. Placental pathology and abnormal fetal heart rate patterns in gestational diabetes. Pediatr Pathol 1989;9:513-520. |
| Библиографическая ссылка | 5. Fleming AD, Salafia CM, Vintzileos AM, et al. The relationships amongst umbilical arterial velocimetry, fetal biophysical profile and placental inflammation in preterm premature rupture of the membranes. Am J Obstet Gynecol 1991;164:38-41. |
| Библиографическая ссылка | 6. Petrie RH. Intrapartum fetal evaluation. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and problem pregnancies. 2nd ed. New York: Churchill Livingstone, 1991. |
| Библиографическая ссылка | 7. Salafia CM, Weigl CA, Silberman L. The prevalence and distribution of acute placental inflammation in uncomplicated term pregnancies. Obstet Gynecol 1989;73:383-383. |
| Библиографическая ссылка | 8. Romero R, Salafia CM, Athanassiadis AP, et al. The relationship between acute inflammatory lesions of the preterm placenta and amniotic fluid microbiology. Am J Obstet Gynecol 1992;166:1382-1388. |
| Библиографическая ссылка | 9. Agresti A. Measures of association for ordinal variables. In: Analysis of ordinal categorical data. New York: John Wiley and Sons, 1984. |
| Библиографическая ссылка | 10. Agresti A. Inference for ordinal measures of association. In: Analysis of ordinal categorical data. New York: John Wiley and Sons, 1984. |
| Библиографическая ссылка | 11. Vintzileos AM, Campbell WA, Nochimson DJ, et al. The fetal biophysical profile in patients with premature rupture of the membranes: An early predictor of infection. Am J Obstet Gynecol 1985;152:510-510. |
| Библиографическая ссылка | 12. Romero R, Ghidini A, Bahado-Singh R. Premature rupture of the membranes.In: Reece EA, Hobbins JC, Mahoney MJ, Petrie RH, eds. Medicine of the fetus and mother. Philadelphia: J.B. Lippincott, 1992:1430-1468. |
| Библиографическая ссылка | 13. Mak KKW, Gude NM, Walters WA, Bourra AL. Effects of vasoactive autacoids on the lumen umbilical fetal placental vasculature. Br J Obstet Gynaecol 1984;91:99-106. |
| Библиографическая ссылка | 14. Nageotte MP, Freeman RK, Garite TJ, Dorchester W. Prophylactic intrapartum amnioinfusion in patients with preterm premature rupture of membranes. Am J Obstet Gynecol 1985;153:557-562. |
| Библиографическая ссылка | 15. Lasker MR, Salafia CM. The placenta and NEC: Identifying infants at risk for NEC. Pediatr Res 1997;41:160A-160A. |
| Библиографическая ссылка | 16. Day D, Ugol JH, French JI, Haverkamp A, Wall RE, McGregor JA. Fetal monitoring in perinatal sepsis. Am J Perinatol 1992;9:28-33. |
