2020
DOI: 10.1016/j.ajog.2020.05.059
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Fetal heart rate pattern in term or near-term cerebral palsy: a nationwide cohort study

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Cited by 21 publications
(21 citation statements)
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References 30 publications
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“…We believe that the research data of Nakao et al 1 are an important contribution, but we suggest that for patients who come into labor, without evidence of existing damage, most CP cases are at least potentially within the control of healthcare providers to maximize the likelihood of good outcomes. What happens after patients arrive and before mothers and babies leave are critical issues amenable to provider influence.…”
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confidence: 91%
“…We believe that the research data of Nakao et al 1 are an important contribution, but we suggest that for patients who come into labor, without evidence of existing damage, most CP cases are at least potentially within the control of healthcare providers to maximize the likelihood of good outcomes. What happens after patients arrive and before mothers and babies leave are critical issues amenable to provider influence.…”
mentioning
confidence: 91%
“…Rapid tocolysis with nitroglycerin could be useful for controlling uterine hypercontraction, which is also included in the FRI. We presumed the 20% R-R class to be because of a prepartum or postpartum etiology, although the etiology was unknown in many cases. 2 Regarding a postnatal etiology, which accounted for 20% of our cerebral palsy cases, almost half the cases were because of neonatal sepsis followed by intracranial hemorrhage, hypoglycemia, and other causes. 2 Infants with cerebral palsy caused by postnatal complications in our data were delivered with a median umbilical arterial pH of 7.32 (interquartile range [IQR], 7.25e7.36), base deficit of 3.4 (IQR, 6.10e2.40), and 1-and 5minute Apgar scores of 9/9 (IQR, 8e9 and 9e10, respectively), followed by the causative events that occurred hours to days after birth (median, 76 hours; IQR, 13.0e306.5).…”
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confidence: 94%
“…We thank Drs Evans and Britt for their Letter to the Editors 1 regarding our original paper in the American Journal of Obstetrics & Gynecology. 2 They expressed concerns about the potential underestimation of the preventability of cerebral palsy. We agree with their opinion that fetal heart rate (FHR) monitoring has limitations from a preventability point of view.…”
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confidence: 99%
“…
American Journal of Obstetrics and Gynecology. 2 They raised concerns about another potential bias in the fetal heart rate (FHR) analysis and its overestimation of the prevention of the development of cerebral palsy (CP).We agree with their opinion that we should follow the American College of Obstetricians and Gynecologists (ACOG) and American Academy of Pediatrics (AAP) recommendations to define acute peripartum or intrapartum events as a cause of neonatal encephalopathy and CP, which require a low Apgar score, fetal umbilical artery acidemia, neuroimaging evidence, multisystem organ failure, and distinct CP types. 3 What we studied is a specific part of the ACOG and AAP recommendation, that is, "[FHR] monitor patterns consistent with an acute peripartum or intrapartum event" in another section, "type and timing of contributing factors that are consistent with an acute peripartum or intrapartum event."
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confidence: 99%