Intrapartum cardiotocography: Its importance and repercussions
DOI:
https://doi.org/10.33448/rsd-v11i16.37627Keywords:
Cardiotocography; Fetal monitoring; Neonatal death.Abstract
Introduction: Cardiotocography is the graphic record that evaluates fetal well-being, of great importance in questioning legal doctors. Computed cardiotocography came as an advance in order to reduce the subjectivity of tracing interpretation. The external form is most used, as it has non-invasive monitoring that reasonably records the accuracy of heart and fetal beats. The amount of contractions and fetal movements are also analyzed in this modality. Methodology: This is a descriptive qualitative study, defined by an integrative literature review, it is a relevant instrument in the communication of research results, as it provides a synthesis of the knowledge already produced and provides contributions to data production. Discussion: Cardiotocography (CTG) began its activity in the 1960s, seeking to assess fetal heart rate and uterine counteractivity at delivery. Its use was based on the principle of relativity of heartbeats, as it is one of the first changes to be observed in hypoxia situations. This evaluation seeks to assess the vitality of the conceptus during pregnancy and its main indication is to adjust actions that evolve with a higher risk of miscarriage, being more used in the final period of low-risk pregnancy. Conclusion: The cardiotocography tracing should be interpreted and analyzed according to the clinical picture presented by the patient, taking into account the stage of labor. The variations presented in the basal heart rate during labor, especially values of fall and tachycardia, or decelerations lasting longer than 60 seconds should cause greater concern on the part of the health professional.
References
Ayrews-de-Campos, D., Spong, C. Y., Chandrahan, E. & FIGO. (2015). Intrapartum Fetal Monitoring Expert Consensus Panel. FIGO consensus guidelines on intrapartum fetal monitoring: cardiotocography. Int J Gynaecol Obstet. 131(1):25-9.
ACOG. (2005). Committee on Obstetric Practice. Inappropriate use of the terms fetal distress and birth asphyxia, Committee opinion. Number 326. Obstet Gynecol. 106: 1469-70.
Albuquerque, J. C. B. (2010). Reprodutibilidade em Ginecologia e Obstetrícia: Concordância interobservador na avaliação de uma nova classificação do cardiotocograma intraparto. Portugal: Universidade do Porto. 87f. Dissertação (Mestrado em Evidência e Decisão em Saúde) - Universidade do Porto, Portugal, 2010.
Alfirevic, Z., Devane, D., & Gyte, G. M. L. (2008). Cardiotocografia contínua (CTG) como forma de monitorização fetal eletrônica para la evoluación fetal durante el trabajo de parto. La Biblioteca Cochrane Plus. n. 2.
Alfirevic, Z., Devane, D. Gyte, G. M. & Cuthbert, A. (2017). Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev. 2: CD006066 .
Baber, E. L., Lundsberg, L. S., Belanger, K., Pettker, C. M., Funai, E. F., & Illuzzi, J. L. (2011). Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 118: 29-38.
Borgatta L., Shrout P. E., & Divon, M. Y.(1988). Reliability and reproducibility of nonstress test readings. Jornal de Ginecologia e Obstetrícia, v. 159, p. 554-558, 1988.
Pinas A, & Chandraharan E. (2016) Continuous cardiotocography during labour: Analysis, classification and management. Best Pract Res Clin Obstet Gynaecol. 2016;30:33-47
Devane, D., Lalor, J. G., Daly, S., Mcguire, W., Cuthbert, A., & Smith V. (2017).Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. Cochrane Database Syst Rev. 2017;(1):CD005122.
Dildy, G. A. R. D.(2005) Intrapartum assessment of the fetus: historical and evidence-based practice. Obstet Gynecol Clin North Am. 2005;32:255-71
Elimian, A., Figueroa, R., & Tejani, N.(1997) Intrapartum assessment of fetal well-being: A comparison of scalp stimulation with scalp blood pH sampling. Obstet Gynecol. 1997;89:373-6.
Lawn, J. E., Cousens, S., & Zupan, J.(2005) 4 million neonatal deaths: when? where? why? Lancet. 2005;365:891-900.
Lee, C. Y., DI Loreto, P. C., Logrand, B. (1976)et al. Fetal activity acceleration determination for the evaluation of fetal reserve. Obstet Gynecol, 48(1), 19-20, 1976.
Mariani Neto C. (1999).Comparação entre a análise visual e a computadorizada de registros cardiotocográficos anteparto em gestações de alto risco [tese]. Campinas: Universidade de Campinas; 1999.
Zugaib, M., & Behle, I. Fisiopatologia cardiovascular aplicada à monitorização fetal. In: Behle I, Zugaib M, editors. Monitorização Fetal Eletrônica. (1a ed.): Roca; 1981. p.?
Freedman, R. K., Anderson, G., & Dorchester W. A prospective multi-institutional study of antepartum fetal heart rate monitoring. I Risk of perinatal mortality and morbidity according to antepartum fetal heart rate test results. Am J Obstet Gynecol 1982; 143:771-7.
Ascaro, M. S., Calderon, I. M. P., Costa, R. A. A., & .M asta.i.bossolon.g.rudge.m.V.C. (2002) cardiotocografia anteparto e prognóstico perinatal em gestações complicadas pelo diabete: influência do controle metabólico materno. rev. bras. ginecol. obstet. 24 (9) • out 2002 .
Macones, G. A., Hankins, G. D., Spong, C. Y., Hauth, J., & Mooreet, T. (2008)the 2008 national institute of child health and human development workshop report on electronic fetal monitoring: update on definitions interpretation and research guidelines. obstet gynecol. 2008;112(3):661-6.
Mariani Neto, C.(2005) Cardiotocografia Anteparto. In: NEME, B. Obstetrícia Básica. (3ª . ed.): Editora Sarvier, 2005.
Morais, E. D., Spara, P., & Farias, F. M.(1998) Repercussão da monitorização fetal intraparto sobre os índices de operação cesariana. Rev. Bras. Ginecol. Obstet. 20 (2) • Mar 1998.
Mullins, E., Lees, C., & Brocklehurst, P.(2017) Is continuous electronic fetal monitoring useful for all women in labor? BMJ. 2017;359:j5423.
Ribeiro, G. G., & Sousa, P. C. P. (2010)Diretrizes Assistenciais da Cardiotocografia. Maternidade –Escola Assis Chatobriand, Versão eletrônica atualizada em maio de 2010.
Royal College Obstetricinas and Gynaecologists.(2000) The use of electronic fetal monitoring. The use and interpretation of cardiotocography in intrapartum fetal surveillance. Evidence-based Clinical Guideline. Number 8. London: RCOG Press; 2000.
Silveira, S. K., & Júnior, A. T.(2020) Monitorização fetal intraparto. FEMINA 2020;48(1): 59-64.
Souza, A. S. R., & Amorim, M. M. R.(2008) Avaliação da vitalidade fetal intraparto. Acta Med Port. 2008;21:229-40.
Tutera, G., & Newman, R. L.(1975) Fetal monitoring: Its effect on the perinatal mortality and cesarean section rates and its complications. Am J Obstet Gynecol 1975; 122:750-754.
Vintzileos, A. M., & Smulian, J. C.(2016) Decelerations, tachycardia, and decreased variability: have we overlooked the significance of longitudinal fetal heart rate changes for detecting intrapartum fetal hypoxia? Am J Obstet Gynecol. 201.6;215(3):261-4.
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