o_1977r8vv9vk1ts2ms0kd8pksa.pdf

370 D. Maulik, R. Figueroa
artery PI and by cardiotocography to detect cordocentesis-derived
fetal blood gas abnormalities. Fetuses
with normal cardiotocography and a normal PI did
not demonstrate hypoxia or acidemia. In contrast,
when both tests were abnormal, two-thirds of the
fetuses had lactic acidosis, low blood oxygen content,
and low pH values. These observations indicate that
the combination of Doppler indices and cardiotocography
is a powerful tool for identifying asphyxia in
the SGA fetus. Use of this approach should improve
management of this condition by identifying the infants
who are not only small but also compromised,
which in turn should promote more timely intervention
and at the same time minimize unnecessary procedures.
More extensive investigations exist regarding the
comparative efficacy of Doppler velocimetry and the
biophysical profile in recognizing fetal asphyxia.
Among these studies the report by Vintzileos and coinvestigators
[24] is the only one that contradicts the
rest of the investigations discussed in this chapter.
They found no association between the Doppler results
and cord arterial and venous pH. Fetal biophysical assessment
was made and the umbilical artery S/D ratio
determined in 62 patients with pregnancy complications
(mostly preeclampsia or SGA) within 3 h of delivery
by cesarean section, which was performed before
the onset of labor. Cord blood gases were measured
on samples collected immediately after delivery of the
baby. The relation between the cord arterial and venous
pH and the biophysical profile score and NST were statistically
significant (p