"Cardiotocografia computadorizada em gestantes com diabetes mellitus: efeitos da glicemia capilar materna na freqüência cardíaca fetal" / Computerized cardiotocography in pregnants affected by diabetes mellitus: effects of maternal capillary glycemia in the fetal heart rate

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

The effects of maternal glycemia over the of fetal heart rate (FHR) regulation appoint a controversial subject in the literature, mainly in pregnancies affected by diabetes mellitus. The objective of this research was to investigate the influence of maternal glycemia in the FHR indices analysed by computerized cardiotocography. Methods: Thirty nine patients with pre-gestational diabetes mellitus were examined prospectively in the Obstetrics Department of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- Brazil in a period of time between July of 2003 and February of 2005. The patients included had pre-gestational diabetes diagnosis, single pregnancy, gestational age between 36 and 40 weeks and absent of fetal malformations. Each patient were evaluated by computerized cardiotocography during 60 minutes, with analysis of these follow FHR parameters: basal FHR, time necessary to reach normality criteria, fetal movements rate, contraction peaks, accelerations and decelerations, episodes of high and low FHR variation, short-term FHR variation. The capillary glycemia were colleted immediately before the cardiotocography be performed, 30 and 60 minutes after the beginning of the exam. The glicemic mean level was used for analysis with the cardiotocografics results, with the cut values of 100 mg/dL and 120mg/dL. Results: From 39 patients studied, 25 (64,1%) presented glicemic mean ≥ to 100 mg/dL and 19 (48,7%) ≥ to 120 mg/dL. 1) The mean of FHR showed significant elevation in the groups with the glicemic mean ≥ to 100 mg/dL and to 120mg/dl (p<0,05); 2) There was significant positive correlation (p<0,05 and r=0,57) between the FHR and the mean glicemic; 3) There was significant negative correlation (p<0,05) between the number of transitory accelerations ≥ than 10bpm (r=-0,32) and ≥ than 15 bpm (r=-0,44) and the mean glicemic; 4) The short-term FHR variation presented significant association (p<0,05) with the mean glicemic ≥ 120mg/dL; 5) There was significant negative correlation (p<0,05) between short-term FHR variation (r=-0,47) and the mean glicemic. The others indices evaluated by computerized cardiotocography didn’t exhibit significant difference with the mean glicemic. Conclusions: The maternal glicemic levels during computerized cardiotocography seem to have influence over these analised FHR parameters.

ASSUNTO(S)

cardiotocografia fetal heart rate glicemia blood glucose pregnancy in dibetics cardiotocography freqüência cardíaca fetal gravidez em diabéticas

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