TY - JOUR
T1 - Prevention of birth asphyxia
T2 - responding appropriately to cardiotocograph (CTG) traces
AU - Chandraharan, Edwin
AU - Arulkumaran, Sabaratnam
PY - 2007/8
Y1 - 2007/8
N2 - Birth asphyxia is a broad term that refers to intrapartum asphyxia sufficient to cause neurological damage in some newborns and, rarely, intrapartum or neonatal death. Cerebral palsy and long-term neurological complications such as learning difficulties and motor impairments may be due to causes other than birth asphyxia. Several intrapartum events may cause asphyxia (i.e. hypoxia and metabolic acidosis) leading to the likelihood of neurological injury. The cardiotocograph (CTG) is a screening tool that is used to assess fetal well-being during labour and to identify the possibility of asphyxia. Abnormality of the CTG, sometimes severe enough to be described as a pathological trace, is commonly termed 'fetal distress', although many fetuses with such traces may not have hypoxia and metabolic acidosis. In current practice, the events are appropriately termed 'pathological CTG trace' or 'acidotic pH' rather than 'fetal distress'. Accurate interpretation of CTG is essential, and it is important to recognize a fetus that shows a pathological CTG in labour that may imply possible hypoxia and birth asphyxia. Considering the wider clinical picture in interpreting the CTG, and taking timely and appropriate action based on the findings, may help prevent birth asphyxia.
AB - Birth asphyxia is a broad term that refers to intrapartum asphyxia sufficient to cause neurological damage in some newborns and, rarely, intrapartum or neonatal death. Cerebral palsy and long-term neurological complications such as learning difficulties and motor impairments may be due to causes other than birth asphyxia. Several intrapartum events may cause asphyxia (i.e. hypoxia and metabolic acidosis) leading to the likelihood of neurological injury. The cardiotocograph (CTG) is a screening tool that is used to assess fetal well-being during labour and to identify the possibility of asphyxia. Abnormality of the CTG, sometimes severe enough to be described as a pathological trace, is commonly termed 'fetal distress', although many fetuses with such traces may not have hypoxia and metabolic acidosis. In current practice, the events are appropriately termed 'pathological CTG trace' or 'acidotic pH' rather than 'fetal distress'. Accurate interpretation of CTG is essential, and it is important to recognize a fetus that shows a pathological CTG in labour that may imply possible hypoxia and birth asphyxia. Considering the wider clinical picture in interpreting the CTG, and taking timely and appropriate action based on the findings, may help prevent birth asphyxia.
KW - acute bradycardia
KW - acute tocolysis
KW - birth asphyxia
KW - cardiotocograph (CTG)
KW - prolonged decelerations
KW - scar dehiscence
UR - http://www.scopus.com/inward/record.url?scp=34547093185&partnerID=8YFLogxK
U2 - 10.1016/j.bpobgyn.2007.02.008
DO - 10.1016/j.bpobgyn.2007.02.008
M3 - Review article
C2 - 17400026
AN - SCOPUS:34547093185
VL - 21
SP - 609
EP - 624
JO - Best Practice and Research: Clinical Obstetrics and Gynaecology
JF - Best Practice and Research: Clinical Obstetrics and Gynaecology
SN - 1521-6934
IS - 4
ER -