Abstract
Subjective pattern classification will be changed to numeric and
objective #hypoxia index, which prevents cerebral palsy, and objective
deceleration area. which predicts neonatal acidemia, particularly in
#computrized fetal monitoring. A 50 minutes repeated late decelerations (LD) was followed by highly
depressed Apgar 3 neonate, while 3 connected LD cases developed normal
vigorus Apgar 9 neonate despite of reports on its ominous outcome [1]. The author found that LD is ominous by its frequent repetition , but not
by its particular deceleration shape, and created a novel "hypoxia
index", which was the sum of duration (min) of all fetal heart rate
deceleraions (transient #bradycardia) divided by the lowest #fetal heart rate (bpm), and multiplied by 100, in fetal heat rate monitoring, where
the deceleration pattern classification into early, late and variable
decelerations have been used since 1968 by Hon to diagnose fetal
distress in fetal monitoring [1]. The author calculaed novel hypoxia
index in fetal heart rat curve recorded in the labor, where the author
found that the index was 25 or more in all of 6 cases who were diagnosed
as infantile cerebral palsy, while the index was 24 or less in all of
16 cases of no cerebral palsy, namely, cerebral palsy is prevented, if
hypoxia index is kept below 24 during delivery [2]. In addition, cerebral palsy is able to be treated in very early stage
in the neonates whose fetal hypoxia index was 25 or more. Furthermore,
an LD is treated by its disappearing after changing maternal supine
posture to lateral one in LD case [3], because the LD developed by the
loss of placental blood flow due to the compression of pelvic artery by
contracted uterus. The lateral posture is recommended to reject LD.
Cahill et al reported high deceleration area predicted low umbilical
cord blood pH (acidemia), of which presence diagnosed fetal hypoxia [4],
while the acidemia and low neonatal Apgar score were predicted by high
FHR score even in the 1st stage of birth, which was created by the
author [5].
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