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Opportunite de l'amnioscopie de routine dans le depistage de la souffrance foetale. [Place of routine amnioscopy in the screening of fetal distress (author's transl)]
Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
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In order to assess the benefits of routine amnioscopy in the screening of fetal distress, the CTG score, the pH of umbilical artery and the Apgar score were determined and compared in two groups of patients: one group had meconium stained amniotic fluid (MSAF), the other (control) had clear amniotic fluid. Although the prepathological and pathological CTG scores were more frequent in the MSAF group, the values of the umbilical artery pH had the same distribution in the two groups. The percentage of acidotic fetuses in the MSAF group is very low (2.9 p. 100) and practically the same as in the control group (2.5 p. 100). The Apgar score distribution at one and five minutes is also the same in the two groups. The distribution of CTG scores in acidotic fetuses is the same in the two groups, but the pre-acidotic fetuses born with meconial fluid have more often a pre-pathological or pathological CTG score. Fetuses with normal or suspect CTG-score and nevertheless acidotic or pre-acidotic pH values at birth are equally present whether the liquid is stained or not. Amnioscopy is therefore of no help even in this situation. In conclusion, the discovery of a MSAF is the manifestation of fetal hypoxia in only 2.9 p. 100 of cases: the detection of this condition is better achieved by CTG recordings than by routine amnioscopy.
Amniotic Fluid/analysis Apgar Score Cesarean Section Female Fetal Distress/*diagnosis *Fetoscopy Humans Hydrogen-Ion Concentration Infant, Newborn Meconium/analysis Pregnancy
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