Cerebral palsy and obstetric-neonatological interventions

Młodawski, Jakub; Mlodawska, Marta; Pazera, Grażyna; Michalski, Wojciech; Domański, Tomasz; Dolecka-Ślusarczyk, Magdalena; Głuszek, Stanisław; Rokitaⴕ, Wojciech

doi:10.5603/gp.2019.0124

Cited by 18 publications

(19 citation statements)

References 27 publications

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“…The advantage of the study is that it covers the analysis of umbilical cord blood pH in the majority of newborns (99.7%). From the epidemiological point of view, the predictive value is better than the obtained Apgar score in relation to the neurological development of children in the future 23,24 .…”

Section: Discussionmentioning

confidence: 84%

Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome

Młodawski

Mlodawska

Armanska³

et al. 2021

Sci Rep

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Induction of labour (IOL) is increasingly used in obstetric practice. For patients with unfavourable cervix, we are constantly looking for an optimal, in terms of effectiveness and safety, ripening of cervix protocol. It was retrospective cohort study. We analyzed obstetrical results in 481 patients undergoing IOL in one center using two different vaginal inserts that release prostaglandins at a constant rate for 24 h—misoprostol vaginal insert (MVI) with 200 µg of misoprostol (n = 367) and dinoprostone vaginal insert (DVI) with 10 mg of dinoprostone (n = 114). Full-term, single pregnancy patients with intact fetal membranes and the cervix evaluated in Bishop score ≤ 6 were included in the analysis. In the group of MVI patients, the labour ended with caesarean section more often (OR 2.71 95% CI 1.63–4.47) and more frequent unreassuring cardiotocographic trace indicating the surgical delivery occurred (OR 2.38 95% CI 1.10–5.17). We did not notice any differences in the percentage of vacuum extraction and patients in whom the use of oxytocin was necessary during labour induction. The clinical status of newborns after birth and the pH of cord blood did not differ between groups.The use of MVI 200 μg in patients with an unriped cervix is associated with a greater chance of completing delivery by caesarean section and increased chance of abnormal intrapartum CTG trace compared to the use of DVI 10 mg. These differences do not affect the clinical and biochemical status of the newborn.

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Section: Discussionmentioning

confidence: 84%

Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome

Młodawski

Mlodawska

Armanska³

et al. 2021

Sci Rep

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“…The group of preinduced patients included no children in whom the pH value would be lower than 7.1. The pH cut-off values used in the comparison were selected on the basis of literature data indicating an increasing risk of neonatal morbidity and mortality at the specified values [ 5 , 6 ].…”

Section: Resultsmentioning

confidence: 99%

Is Unfavourable Cervix prior to Labor Induction Risk for Adverse Obstetrical Outcome in Time of Universal Ripening Agents Usage? Single Center Retrospective Observational Study

Młodawski

Mlodawska

Jagoda

et al. 2020

Journal of Pregnancy

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Cervical assessment on the Bishop scale prior to induction of labor (IOL) is one of the strongest prognostic criteria in relation to the success of the procedure. The commonly used preinduction methods are mainly aimed at reducing the percentage of cesarean sections. Our study has analyzed obstetric results of patients who had unripe cervix (Bishop score <7) before IOL and used preinduction (Foley catheter or misoprostol vaginal insert releasing 7 mcg of misoprostol per hour for 24 hours) with obstetric results of patients in whom, due to favourable cervix, only a low-dose infusion of oxytocin was used. We reviewed the medical records of 1010 single pregnancies in whom IOL was performed. We divided the patients into two groups: group A (where preinduction was used) and group B (Bishop score ≥7 points) where preinduction was not used. Patients in group A were more likely to complete the delivery by caesarean section (OR=4.58, 95% CI 3.22-6.51), and more likely to have events that were indications for operative delivery: unreassuring fetal heart rate trace (OR=3.29, 95% CI 2.07-5.23) and arrested labor or failed induction (OR=3.4, 95% CI 2.06-5.62). The groups did not differ in the percentage of vacuum extraction, postpartum haemorrhage, and meconium stained amniotic fluid. In group B, more infants were born with umbilical cord blood pH <7.1 (1.38% vs. 0%), both groups included no deliveries of newborns with Apgar score ≤3 points, the groups did not differ in terms of the percentage of newborns with Apgar score between 4 and 7 at birth (OR=0.66, 95% CI 0.29-1.49). The immature cervix and the need to use labor preinduction is a risk factor for caesarean section. The necessity of preinduction does not impair neonatological results.

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“…Many children born with acidosis may not develop neurological complications in the future. On the other hand, most children with cerebral palsy are born with umbilical cord blood gas analysis within a normal range, as the etiology of this disease is very complex [28].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Apgar score and umbilical cord blood acid-base balance in full-term and late preterm newborns born in medium and severe conditions

et al. 2022

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Objectives: Application of Apgar scores (AS) and umbilical cord blood acid-base analysis is a base for the prediction of future neurological development in children. In clinical practice we often observe huge discrepancy between clinical and biochemical status of newborn.Because many obstetricians consider both assessments as substitute and measure of their proceeding's outcome, we decided to scientifically measure actual correlation between them among newborns born with Apgar less than 8 points. Material and methods:This was an observational retrospective study. The study included 141 newborns born in general medium and severe condition (Apgar < 8 points in first minute of life). Acid-base analysis of umbilical cord vein blood immediately after birth was performed. We correlated gasometer parameters with Apgar scores of newborns. Results:The clinical condition of a newborn at 1, 5, and 10 minutes after birth correlates positively and significantly with pH values (0.25; 0.24; and 0.26; respectively) and bicarbonate levels (0.21; 0.27; 0.28; respectively) in the umbilical cord vein, however correlation was low. Subsequently we qualified newborns to four groups depending on the degree of invasiveness of respiratory support after delivery, and the groups were compared in terms of parameters of acid-based balance. No significant differences were observed between groups in terms of acid-base balance parameters. Conclusions:There is low, but significant correlation between clinical condition of a newborn after birth with most of acid-base parameters from umbilical vein blood. The assessment of the newborn's condition after birth using the Apgar score, (but not acid-base parameters) determines the degree of invasiveness of respiratory support activities for newborns after birth.

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Cerebral palsy and obstetric-neonatological interventions

Cited by 18 publications

References 27 publications

Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome

Misoprostol vs dinoprostone vaginal insert in labour induction: comparison of obstetrical outcome

Is Unfavourable Cervix prior to Labor Induction Risk for Adverse Obstetrical Outcome in Time of Universal Ripening Agents Usage? Single Center Retrospective Observational Study

Relationship between Apgar score and umbilical cord blood acid-base balance in full-term and late preterm newborns born in medium and severe conditions

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