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Blood flow in the artery of the umbilical cord during labor
Last reviewed: 19.10.2021
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Modern studies show that cardiotocography does not have significant advantages over conventional fetal auscultation by the obstetric stethoscope. Thus, in 1988, the American Association of Obstetricians and Gynecologists concluded that the periodic auscultation of the fetus in childbirth is "is as effective as electronic monitoring in monitoring high risk patients during labor". Despite this, many obstetric centers monitor in childbirth. There is a poor association of pathological KIT with fetal acidosis, but the chances of acidosis in the fetus are higher with pathological CTG.
Low variability is also poorly correlated with fetal acidosis and the prognosis can be set no more than 5% of the fetuses. When tachycardia or decelerations occur during childbirth, the pH of 7.20 is predicted to rise to 30%. Late decelerations give a prediction of acidosis in the fetus between 30-40%. Late decelerations and the prediction of Apgar score 7 and less are more related to the size of the decleration than the temporal ratios with uterine contractions.
In addition, the use of CTG in labor did not reduce perinatal mortality, but only reduced neonatal damage. Therefore, CTG and CBS of the fetus are necessary in women in labor at high risk for optimal management of labor. For example, in England, less than half of the obstetric centers use CTG and Fetal COC. Only low pH values in the umbilical artery correlate with low Apgar scores, but neither pH nor Apgar can predict neonatal neurological morbidity. Therefore, periodically present hypoxia in childbirth does not give a significant connection with the subsequent neurologic outcome in a newborn child. Continuous monitoring improves the condition of 1 child out of 1,000 who were monitored during labor, but the frequency of caesarean section and obstetric forceps has significantly increased.
Measurement of blood flow in the umbilical artery is even more preferable than CTG in detecting fetal distress in childbirth, as the fetal distress increases the cesarean section by 12 times. The index of pulsation during labor does not change significantly. During fights, it changes only if the fetus has heart beat. The altered index was most often observed with fetal hypotrophy and therefore accurate determination of blood flow in the umbilical artery is essential in predicting fetal hypotrophy, and the absence of a terminal diastolic blood flow in 80% gives hypoxia and in 46% the risk of acidosis development.
When belated delivery pulsation index increase of 20% in the internal carotid artery during a hyperoxygenation mother (60% O 2 inhalation) is a marker of adverse outcome delayed deliveries to the fetus.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]