INTRAPARTAL CARDIOTOCOGRAPHY IN PREDICTION OF WELL-BEING OF SMALL-FOR-GESTATIONAL-AGE NEWBORNS

An attempt to predict neonatal well-being in vaginal delivery was made in groups of 103 term small for gestational age (SGA) and 103 term adequate for gestational age (AGA) newborns, by assessing cardiotocography scores immediately before birth. For assessment, modified Fischer scores (from 0 to 10, normal greater-than-or-equal-to 8) and subjective visual scores (from 0 to 6, normal greater-than-or-equal-to 5) were used. Modified Fischer scores had a sensitivity of 25% in detecting acidosis (umbilical artery pH < 7.20) in SGA cases; and of 50%, in AGA cases. Visual scores had a sensitivity of 75 and of 50%, respectively. Specificities in these groups were 64 and 65%, and 56 and 60%, respectively. The positive predictive values in all groups were below 10%. It is concluded that intrapartal cardiotocographic scoring is neither very sensitive nor specific in the prediction of neonatal condition in term vaginal SGA and AGA deliveries.