Premium
A comparison of fetal behaviour in breech and cephalic presentations at term
Author(s) -
Kean L. H.,
Suwanrath C.,
Gargari S. S.,
Sahota D. S.,
James D. K.
Publication year - 1999
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1999.tb08150.x
Subject(s) - fetus , medicine , external cephalic version , fetal movement , in utero , breech presentation , pregnancy , fetal heart rate , obstetrics , heart rate , blood pressure , biology , genetics
Objective To evaluate fetal behaviour in breech and cephalic fetuses at term, using a computerised fetal behaviour program. Design An observational study. Setting Pregnancy Assessment Centre, University Hospital, Nottingham. Sample Twenty‐six breech and 58 cephalic fetuses between 36 and 41 weeks. Methods Behaviour (fetal heart rate and activity) was recorded with the use of Doppler ultrasound. The duration of recording was 60 minutes or more in all but four recordings (minimum 49 minutes). Main outcome measures Behavioural criteria studied were 1. the relative percentage time spent in low and high variation fetal heart rate patterns; 2. the duration and recurrence of fetal activity; 3. the number of accelerations in low and high fetal heart rate variation; and 4. the number of fetal behavioural state transitions. Results Breech fetuses differed from the cephalic group in that they were lighter than the cephalic fetuses (median 3105 g vs 3400 g; P < 0.01 ) and were born to older mothers (median maternal age 30 years vs 28 years; P < 0.01 ). No significant differences were found in rates of movement, numbers of accelerations and time exhibiting low and high fetal heart rate variation. However, breech fetuses exhibited significantly more state transitions (median 5.2h vs 3.69h; P = 0.01 ). Conclusions This study shows that breech fetuses are neurologically different from their cephalic counterparts in otherwise healthy pregnancies, and that subtle behavioural differences can be demonstrated in utero using this computerised method.