Efeitos da anemia materna na cardiotocografia computadorizada e perfil biofísico fetal / Effects of maternal anemia on computerized cardiotocography and fetal biophysical profile

OBJETIVOS: avaliar a influência dos níveis de hemoglobina (Hb) materna nos padrões da frequência cardíaca fetal (FCF) e no perfil biofísico fetal (PBF) em gestações a termo. MÉTODOS: gestantes portadoras de anemia (Hb<11,0 g/dL) foram avaliadas prospectivamente, entre a 36ª e a 40ª semana de gestação, no período compreendido entre janeiro de 2008 e março de 2009. O Grupo Controle foi constituído por gestantes de termo, saudáveis, com valores normais de hemoglobina (Hb>11,0 g/dL). Foram excluídos casos com anomalias ou restrição do crescimento fetal. A avaliação da FCF foi realizada pela cardiotocografia computadorizada (Sistema8002-Sonicaid) e análise do traçado com 30 minutos de exame. O PBF foi realizado em todas as pacientes. Foram utilizados os testes t de Student, teste do χ2 e teste exato de Fisher. O nível de significância utilizado foi de 0,05. RESULTADOS: A média da Hb materna no grupo com anemia (n=18) foi de 9,4 g/dL (DP=1,4 g/dL) e no Grupo Controle 12,4 g/dL (DP=1,3 g/dL). Quanto aos parâmetros da cardiotocografia, não foi constatada diferença significativa nas médias entre os grupos com anemia e controle, respectivamente: FCF basal (131,3 bpm versus 133,7 bpm, p=0,5), acelerações da FCF > 10 bpm (7,9 versus. 8,2, p=0,866), acelerações da FCF > 15 bpm (5,2 versus 5,4, p=0,9), episódios de alta variação da FCF (17,1 versus 15,5 min, p=0,5), episódios de baixa variação da FCF (4,4 versus 3,6 min, p=0,6), e variação de curto prazo (10,5 versus 10,9 ms, p=0,5). Em ambos os grupos, todas as pacientes apresentaram PBF normal. CONCLUSÕES: este estudo sugere que a anemia materna leve ou moderada, sem outras comorbidades maternas ou fetais, não se associa a anormalidades nos parâmetros do perfil biofísico fetal e da FCF analisada pela cardiotocografia computadorizada.

PURPOSES: to evaluate the influence of maternal hemoglobin (Hb) levels in the patterns of fetal heart rate (FHR) and in the fetal biophysical profile (FBP) in term gestations. METHODS: pregnant women with anemia (Hb<11.0 g/dL) were prospectively evaluated between the 36th and the 40th week of gestation, from January 2008 to March 2009. The Control Group was composed of term and healthy pregnant women, with normal values of hemoglobin (Hb>11,0 g/dL). Cases of anomalies or fetal growing restrictions were excluded. The FHR evaluation was performed by computerized cardiotocography (8002 System-Sonicaid), and by record analysis during 30 minutes of exam. The FBP was done in all the patients. Student's, χ2 and Fisher's exact tests were used, with 0.05 significance level. RESULTS: The average of maternal Hb in the group with anemia (n=18) was 9.4 g/dL (DP=1.4 g/dL), and in the control group, 12.4g/dL (DP=1.3 g/dL). There has been no significant mean differences between groups concerning the cardiotocography parameters, respectively: basal FHR(131.3 versus 133.7 bpm, p=0.5), FHR accelerations > 10b pm (7.9 versus 8.2, p=0.866), FHR accelerations > 15 bpm (5.2 versus. 5.4, p=0.9), episodes of high variation of the FHR (17.1 versus 15.5 min, p=0,5), episodes of variation of the FHR (4.4 versus 3.6 min, p=06), and short term variation (10.5 versus 10.9 ms, p=0.5). In both groups, all patients presented normal FBP. CONCLUSIONS: this study suggests that light or moderate maternal anemia, without other maternal or fetal comorbidity, is not associated with abnormalities in the parameters of fetal biophysical profile and of the FHR analyzed by computerized cardiotocography.

[Effects of maternal anemia on computerized cardiotocography and fetal biophysical profile]. / Efeitos da anemia materna na cardiotocografia computadorizada e perfil biofísico fetal.

PURPOSES: To evaluate the influence of maternal hemoglobin (Hb) levels in the patterns of fetal heart rate (FHR) and in the fetal biophysical profile (FBP) in term gestations. METHODS: Pregnant women with anemia (Hb<11.0 g/dL) were prospectively evaluated between the 36(th) and the 40(th) week of gestation, from January 2008 to March 2009. The Control Group was composed of term and healthy pregnant women, with normal values of hemoglobin (Hb>11,0 g/dL). Cases of anomalies or fetal growing restrictions were excluded. The FHR evaluation was performed by computerized cardiotocography (8002 System-Sonicaid), and by record analysis during 30 minutes of exam. The FBP was done in all the patients. Student's, chi2 and Fisher's exact tests were used, with 0.05 significance level. RESULTS: The average of maternal Hb in the group with anemia (n=18) was 9.4 g/dL (DP=1.4 g/dL), and in the control group, 12.4 g/dL (DP=1.3 g/dL). There has been no significant mean differences between groups concerning the cardiotocography parameters, respectively: basal FHR(131.3 versus 133.7 bpm, p=0.5), FHR accelerations > 10b pm (7.9 versus 8.2, p=0.866), FHR accelerations > 15 bpm (5.2 versus. 5.4, p=0.9), episodes of high variation of the FHR (17.1 versus 15.5 min, p=0.5), episodes of variation of the FHR (4.4 versus 3.6 min, p=06), and short term variation (10.5 versus 10.9 ms, p=0.5). In both groups, all patients presented normal FBP. CONCLUSIONS: This study suggests that light or moderate maternal anemia, without other maternal or fetal comorbidity, is not associated with abnormalities in the parameters of fetal biophysical profile and of the FHR analyzed by computerized cardiotocography.