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АВАВАКдлАмА дла длама АсАядлАмА АВА АсдлАя & MАядлдлАмАК TА 3, T 4, АВ 313-319, 2004 fi 1: Амapple apple fi Авfi fi АУapple) Ав fiав, - Ав apple - Ав applefi - applefi apple Ав АУ apple apple apple (Elimian et al, 2003) АК Ав applefi Ав АУ apple appleав, Авfi АУАв fi АУ fi АУapple apple - Ав apple apple appleау apple appleав (Levene et al, 1985) АК - apple fi Ав-, fi Ав (Mortimer and Dickinson, 1993) АК - Ав apple fi fi applefi - applefi apple apple fi applefi АУ АУ apple apple- Ав Ав (Smith et al, 2000) АК apple Ав Ав Ав - apple - Ав АУ fi Авfi apple- - apple Ав А»70, fi Ав Авfi apple- apple fi- 71 1000 Ав А»90 fi 18 1000 АУ Ав (Thornberg et al, 1995) 19 1000 Ая (Smith et al, 2000) АК Ав Ав Ав, АУ Ав applefi АУ- fiapple appleав applefi -, Ав appleав apple- АУ- (Nelson and Leviton, 1991; Yudkin et al, 1994) appleавfi, fi apple applefi Ав apple Авfi Авfi apple Ав apple Ав- (Pellantova et al, 2000) fi, apple applefi АУ applefi apple АУ (Pellantova et al, 2000) O Ellison et al (1991) АУАв fi 135 applefi АУ 2362 apple- Ав apple apple fi appleав Ав apple Ав Ав Ав apple- fi apple А Yudkin et al (1994) apple fi 6 applefi 7 appleapple apple - apple Ав Ав- Ая АУ Spender et al (1997), fiapple АУАв fi 91 appleapple apple 50% appleapple apple apple Ав- (appleав АУ - fi) 1 89% appleapple apple apple Ав- е«1 apple АУ Ас, Ав, apple АУ, applefi 53-100%, Авfi applefi 46-100% 317
АК Ав Ав fi apple applefi 10 АУ 37% (Rosen and Dickinson, 1993) apple apple apple apple apple Ав applefi 2/3 appleав apple apple- apple Phelan and Ahn (1994) applefi Ав- (apple apple - Ав - ), Ав applefiapple 1/3 apple Ав- АУ (appleау - fi, Ав, appleав - Ав ) Ав apple, Ав АУАв Ав Ав АУ applefi АУ apple- Ав apple- fi АУ (Smith et al, 2000; Sameshima et al, 2004) The cardiotocography during labor The benefit Ая Vitoratos 2nd Department of Obstetrics and Gynaecology, Univercity of Athens, Athens, Greece Correspondence: N A Vitoratos 76, Vas Sofias str 11528 Athens, Greece Tel: 210 7286204, Fax: 210 7484820 -mail: nikolasvitoratos@yahoogr Summary The continuous electronic fetal heart monitoring is a common method for fetal assessment during labor Normal cardiotocographic patterns are associated with good perinatal outcome On the contrary, the appearance of pathological or suspicious patterns are associated with the birth of newborns with low Apgar Score, low ph level and elevated Decf concentrations Reduced or absence of fetal heart variability, a finding observed only with the cardiotocographic investigation, indicates fetal distress Furthermore, the appearance of fetal heart rate decelerations (lates or variables) predicts the presence of fetal acidosis in the most of the cases Catastrophic events effecting fetus during labor such as anemia or infection give characteristic cardiotocographic patterns Finally, the fetal assessment during labor by cardiotocography has contributed to the decreased incidence of neonatal encephalopathy at term Key words: cardiotography, labor, fetal distress, neonatal encephalopathy American College of Obstetricians and Gynecologists (1975) Technical Bulletin Bellver, J, Perales, A, Maiques, V and Serra, V (2004) Can antepartum computerized cardiotocography predict the evolution of intrapartum acid-base status in normal fetuses? Acta Obstet Gynecol Scand 83,267-271 Boehm, FH (1999) Intrapartum fetal heart rate monitoring Obstet Gynecol Clin North Am 26,623-629 Boog, G (2001) Acute fetal distress Eur J Obstet Gynecol Reprod Biol 30,715-718 Carles, G, Tobal, N, Marret, H and Arbeille, P (2003) Acute reversible placental dysfunction and abnormal fetal heart rate at delivery Eur J Obstet Gynecol Report Biol 110,136-142 Chuang, J, Chou, CT, Cheng, WC et al (2004) Spontaneous fetal heart rate deceleration: an ominous sign for fetal outcome Arch Gynecol Obstet 269,254-258 Cremer, M (1906) Mе nch Med Wochenschr 53,811 Elimian, A, Lawlor, P, Pigueroa, R et al (2003) Intrapartum assessment of fetal well-being: any role for a fetal admission test? J Matern Fetal Neonatal Med 13,408-413 Ellison, P H, Foster, M, Sheridan-Pereira, M, and Mac- Donald, D (1991) Electronic fetal heart monitoring, auscultation and neonatal outcome Am J Obstet Gynecol 164,1281-1289 FIGO 1987 News Guidelines for the use of fetal monitoring Int J Gynecol Obstet 25,159-167 Gonik, B and Bobrowski, R (1996) Medical complications in Labor Blackwell science, Detroit Michigan, p 112-118 Hadar, A, Sheiner, E, Hallak, M et al (2001) Abnormal fetal heart rate tracing patterns during the first stage of labor: effect on perinatal outcome Obstet Gynecol 185:863-868 Holmes, P, Oppenheimer, LW, Gravelle, A et al (2001) The effect of variable heart rate decelerations on intraventicular haemorrhage and other perinatal outcomes in preterm infants J Matern Fetal Med 10,264-268 Hon, EH (1958) The electronic evaluation of the fetal heart rate Am J Obstet Gynecol 75,1215-1222 Hon, EH (1963) Instrumentation of fetal heart rate and electrocardiography II A vaginal electrode Am J Ob- 318
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