Abstract：
UNASSIGNED: To determine cardiotocographic patterns in newborns with metabolic acidosis, based on clinical signs of neurological alteration (NA) and the need for hypothermic treatment.
UNASSIGNED: All term newborns with metabolic acidosis in a single center from 2016 to 2020 were included in the study. Three segments of intrapartum CTG (cardiotocography) were considered (first 30 min of active labor, 90 to 30 min before birth, and last 30 min before delivery) and a longitudinal analysis of CTG pattern was performed according to the 2015 FIGO classification.
UNASSIGNED: Three hundred and twenty-four neonates with metabolic acidosis diagnosed at birth were divided into three groups: the first group included all neonates with any clinical sign of neurological alteration, requiring hypothermia according to the recommendation of the Italian Society of Neonatology (group TNA-Treated neurological Alteration, n = 17), the second encompassed neonates with any clinical sign of neurological alteration not requiring hypothermia (group NTNA-Not Treated neurological Alteration, n = 83), and the third enclosed all neonates without any sign of clinical neurological involvement (group NoNA-No neurological Alteration, n = 224). The most frequent alterations of CTG in TNA group were late decelerations, reduced variability, bradycardia, and tachysystole. Unexpectedly, from the longitudinal analysis of the CTG, 49% of all cases with metabolic acidosis never showed a pathological CTG with normal trace at the beginning of labor followed by normal or suspicious trace in the final part of labor, the same as in TNA and NTNA groups (10 and 39%, respectively).
UNASSIGNED: CTG has limited specificity in identifying cases of acidosis at birth, even in babies who will develop NA.
UNASSIGNED: All term newborns with metabolic acidosis in a single center from 2016 to 2020 were included in the study. Three segments of intrapartum CTG (cardiotocography) were considered (first 30 min of active labor, 90 to 30 min before birth, and last 30 min before delivery) and a longitudinal analysis of CTG pattern was performed according to the 2015 FIGO classification.
UNASSIGNED: Three hundred and twenty-four neonates with metabolic acidosis diagnosed at birth were divided into three groups: the first group included all neonates with any clinical sign of neurological alteration, requiring hypothermia according to the recommendation of the Italian Society of Neonatology (group TNA-Treated neurological Alteration, n = 17), the second encompassed neonates with any clinical sign of neurological alteration not requiring hypothermia (group NTNA-Not Treated neurological Alteration, n = 83), and the third enclosed all neonates without any sign of clinical neurological involvement (group NoNA-No neurological Alteration, n = 224). The most frequent alterations of CTG in TNA group were late decelerations, reduced variability, bradycardia, and tachysystole. Unexpectedly, from the longitudinal analysis of the CTG, 49% of all cases with metabolic acidosis never showed a pathological CTG with normal trace at the beginning of labor followed by normal or suspicious trace in the final part of labor, the same as in TNA and NTNA groups (10 and 39%, respectively).
UNASSIGNED: CTG has limited specificity in identifying cases of acidosis at birth, even in babies who will develop NA.
摘要：
■为了确定患有代谢性酸中毒的新生儿的心电图模式，基于神经系统改变（NA）的临床体征和低温治疗的需要。
■从2016年到2020年，在单个中心中出现代谢性酸中毒的所有足月新生儿均被纳入研究。考虑了产时CTG（心电图）的三个部分（积极分娩的前30分钟，出生前90至30分钟，并在交付前持续30分钟），并根据2015年FIGO分类对CTG模式进行纵向分析。
■将出生时诊断为代谢性酸中毒的三百二十四例新生儿分为三组：第一组包括所有具有神经系统改变临床体征的新生儿，根据意大利新生儿学会的建议需要体温过低（TNA治疗的神经系统改变，n=17),第二个包括具有不需要低温的神经系统改变的任何临床体征的新生儿（NTNA-未治疗的神经系统改变，n=83),第三个包括所有没有任何临床神经系统受累迹象的新生儿（NoNA-无神经系统改变，n=224）。TNA组中最常见的CTG改变是晚期减速，减少变异性，心动过缓,和心动过速收缩.出乎意料的是,从CTG的纵向分析来看，在所有代谢性酸中毒病例中，有49％在分娩开始时从未出现病理性CTG，其痕迹正常，然后在分娩的最后部分出现正常或可疑痕迹。与TNA和NTNA组相同(10%和39%，分别)。
■CTG在识别出生时的酸中毒病例方面具有有限的特异性，即使在婴儿谁会发展NA。
■从2016年到2020年，在单个中心中出现代谢性酸中毒的所有足月新生儿均被纳入研究。考虑了产时CTG（心电图）的三个部分（积极分娩的前30分钟，出生前90至30分钟，并在交付前持续30分钟），并根据2015年FIGO分类对CTG模式进行纵向分析。
■将出生时诊断为代谢性酸中毒的三百二十四例新生儿分为三组：第一组包括所有具有神经系统改变临床体征的新生儿，根据意大利新生儿学会的建议需要体温过低（TNA治疗的神经系统改变，n=17),第二个包括具有不需要低温的神经系统改变的任何临床体征的新生儿（NTNA-未治疗的神经系统改变，n=83),第三个包括所有没有任何临床神经系统受累迹象的新生儿（NoNA-无神经系统改变，n=224）。TNA组中最常见的CTG改变是晚期减速，减少变异性，心动过缓,和心动过速收缩.出乎意料的是,从CTG的纵向分析来看，在所有代谢性酸中毒病例中，有49％在分娩开始时从未出现病理性CTG，其痕迹正常，然后在分娩的最后部分出现正常或可疑痕迹。与TNA和NTNA组相同(10%和39%，分别)。
■CTG在识别出生时的酸中毒病例方面具有有限的特异性，即使在婴儿谁会发展NA。
