[Possibilities of prenatal diagnosis of umbilical pathology by ultrasonic examination and cardiotocography].
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Changes in fetal scalp transcutaneous PO2 (tcPO2) were compared with those of the fetal heart rate (FHR) in 31 high-risk pregnancies. Fetal tcPO2 at 10 minutes prior to the delivery was quite similar to umbilical arterial PO2. The abnormal FHR pattern evaluated by the FHR score was well correlated with the fetal tcPO2, umbilical arterial PO2, umbilical arterial pH and Apgar score. When there were signs of fetal distress in the FHR pattern, such as late deceleration, severe variable deceleration, or prolonged fetal bradycardia, the tcPO2 was lower than 15mmHg, and there occurred a temporary fall in tcPO2 of more than 5mmHg. It was concluded that proficiency in evaluating FHR tracings might eliminate the necessity of fetal biochemical monitoring, including fetal blood sampling, and also decrease the frequency of cesarean sections for fetal distress.
The effect of warm baths (34-38 degrees C) during pregnancy was studied in 41 patients between 30 and 35 weeks of gestation. The focus of our interest deals with the influence of bathing on the unborn child and physiologic changes in the mother. Continuous CTG monitoring was guaranteed by water-proofed and isolated transducers in connection with telemetry. During the bath, we found a significant increase of registered accelerations due to more frequent fetal body movements. There were no decelerations. A positive effect on the perfusion of the feto-placental unit can be assumed resulting from a significantly higher maternal blood pressure amplitude. Due to an increased diuresis, the average weight loss amounted to 300 g. Subaqua CTG monitoring was used as well in 122 patients who took a bath in the initial period of delivery, 30 of whom after rupture of the membranes. In very few cases (5% and 12% after rupture of the membranes, respectively), we found a slight worsening in the CTG which turned out to be reversible after the bath. There were no pathologic CTG patterns. After bathing, women with early rupture of the membranes showed a significantly lower rate of positive infection parameters than women in a control group who had no bath during the first stage of delivery (13% versus 40%). This fact may be correlated to the duration of delivery which decreased from 17h 10 min to 12th 50 min on average after bathing.
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