Archives of Gynecology and Obstetrics

, Volume 277, Issue 3, pp 249–253

Fetal heart rate pattern reflecting the severity of placental abruption

  • Rie Usui
  • Shigeki Matsubara
  • Akihide Ohkuchi
  • Tomoyuki Kuwata
  • Takashi Watanabe
  • Akio Izumi
  • Mitsuaki Suzuki
Original Article

Abstract

Objective

To identify fetal heart rate (FHR) patterns reflecting the severity of placental abruption, and to determine the incidence of normal FHR pattern in cases of placental abruption.

Materials and methods

We analyzed FHR tracings from 40 pregnant Japanese women with placental abruption. We analyzed which FHR patterns appeared more frequently in cases of low 5-min Apgar score, low cord arterial pH, and large separation.

Results

Eight out of 40 cases showed a normal FHR pattern, while 32 cases did not show a normal FHR pattern. Undetectable variability and bradycardia appeared more frequently in cases with 5-min Apgar < 7, with cord blood pH < 7.1, and with larger placental separation than in cases without these features. The normal FHR pattern was associated with 5-min Apgar ≥ 7, cord blood pH ≥ 7.1, and separation of <25%.

Conclusion

Fetal heart rate pattern reflected the severity of placental abruption. Undetectable variability and bradycardia occurred significantly more frequently in cases of severe placental abruption, and thus may reflect the severity of placental abruption.

Keywords

Acidosis Fetal heart rate pattern Placental abruption 

References

  1. 1.
    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD (2005) Obstetrical hemorrhage. In: Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC III, Wenstrom KD (eds) Williams obstetrics, 22nd edn. McGraw-Hill, New York, pp 809–854Google Scholar
  2. 2.
    Oyelese Y, Ananth CV (2006) Placental abruption. Obstet Gynecol 108:1005–1016PubMedCrossRefGoogle Scholar
  3. 3.
    Heinonen PK, Kajan M, Saarikoski S (1986) Cardiotocographic findings in abruptio placentae. Eur J Obstet Gynecol Reprod Biol 23:75–78PubMedCrossRefGoogle Scholar
  4. 4.
    Benirschke K, Kaufmann P, Baergen RN (2006) Abruptio placentae In: Benirschke K, Kaufmann P, Baergen RN (eds) Pathology of the human placenta, 5th edn. Springer, New York, pp 615–625Google Scholar
  5. 5.
    ACOG Practice Bulletin Number 70, December 2005 (2005) Intrapartum fetal heart rate monitoring. Obstet Gynecol 106:1453–1461Google Scholar
  6. 6.
    National Institute of Child Health and Human Development Research Planning Workshop (1997) Electronic fetal heart rate monitoring: research guidelines for interpretation. Am J Obstet Gynecol 177:1385–1390CrossRefGoogle Scholar
  7. 7.
    Freeman RK (2002) Problems with intrapartum fetal heart rate monitoring interpretation and patient management. Obstet Gynecol 100:813–826PubMedCrossRefGoogle Scholar
  8. 8.
    Kubli FW, Hon EH, Khazin AF, Takemura H (1969) Observations on heart rate and pH in the human fetus during labor. Am J Obstet Gynecol 104:1190–1206PubMedGoogle Scholar
  9. 9.
    Low JA, Victory R, Derrick EJ (1999) Predictive value of electronic fetal monitoring for intrapartum fetal asphyxia with metabolic acidosis. Obstet Gynecol 93:285–291PubMedCrossRefGoogle Scholar
  10. 10.
    Gilstrap III LC, Hauth JC, Toussaint S (1984) Second stage fetal heart rate abnormalities and neonatal acidosis. Obstet Gynecol 63:209–213PubMedGoogle Scholar
  11. 11.
    Williams KP, Galerneau F (2003) Intrapartum fetal heart rate in the prediction of neonatal acidemia. Am J Obstet Gynecol 188:820–823PubMedCrossRefGoogle Scholar
  12. 12.
    Kayani SI, Walkinshaw SA, Preston C (2003) Pregnancy outcome in severe placental abruption. BJOG 110:679–683PubMedCrossRefGoogle Scholar
  13. 13.
    Glantz C, Purnell L (2002) Clinical utility of sonography in the diagnosis and treatment of placental abruption. J Ultrasound Med 21:837–840PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Rie Usui
    • 1
  • Shigeki Matsubara
    • 1
  • Akihide Ohkuchi
    • 1
  • Tomoyuki Kuwata
    • 1
  • Takashi Watanabe
    • 1
  • Akio Izumi
    • 1
  • Mitsuaki Suzuki
    • 1
  1. 1.Department of Obstetrics and GynecologyJichi Medical UniversityShimotsukeJapan

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