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Helen Perry, Costa Healy, Diana Wellesley, Nigel J Hall, Melanie Drewett, David M Burge, David T Howe
AIM: To investigate whether an antenatal surveillance protocol including ultrasound and cardiotocograph monitoring reduces intrauterine death (IUD) in cases of gastroschisis. Secondary outcomes included neonatal death rate, mode of delivery and rate of intervention before planned time of delivery. METHODS: This was a retrospective observational study of all women with antenatally diagnosed gastroschisis who were managed according to the surveillance program between 2002 and 2015 in a tertiary fetal medicine and pediatric surgical center covering the Wessex region of England...
February 6, 2017: Journal of Obstetrics and Gynaecology Research
Célia Amorim-Costa, Diogo Ayres de Campos, João Bernardes
AIM: The aim of this study was to assess how cardiotocographic (CTG) parameters differ between small-for-gestational-age (SGA) and normal fetuses at different gestational ages. METHODS: This was a retrospective cross-sectional study using the first antepartum tracing of singleton pregnancies with no malformations. Fetuses with birthweight ≥10th percentile for gestational age and other normal pregnancy outcome criteria (term birth, normal umbilical artery pH and Apgar scores, no intensive care unit admission) were compared with fetuses with birthweight <10th and <3rd percentiles for gestational age (SGA < p10 and SGA < p3, a subgroup of the latter)...
February 6, 2017: Journal of Obstetrics and Gynaecology Research
A G Van Wassenaer-Leemhuis, N Marlow, C Lees, H Wolf
OBJECTIVE: To study the relationship between neonatal morbidity (NNM) and two-year neurodevelopmental impairment (NDI) in surviving children after early fetal growth restriction (FGR). DESIGN: Secondary analysis of a European randomised trial (TRUFFLE) of delivery for very preterm fetuses dependent on venous Doppler or cardiotocographic criteria. SETTING: Tertiary perinatal centres, participants in TRUFFLE. POPULATION: 402 surviving children after early FGR...
February 3, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
Declan Devane, Joan G Lalor, Sean Daly, William McGuire, Anna Cuthbert, Valerie Smith
BACKGROUND: The admission cardiotocograph (CTG) is a commonly used screening test consisting of a short (usually 20 minutes) recording of the fetal heart rate (FHR) and uterine activity performed on the mother's admission to the labour ward. This is an update of a review published in 2012. OBJECTIVES: To compare the effects of admission cardiotocography with intermittent auscultation of the FHR on maternal and infant outcomes for pregnant women without risk factors on their admission to the labour ward...
January 26, 2017: Cochrane Database of Systematic Reviews
Salvatore Tagliaferri, Francesca Giovanna Esposito, Rosa Fagioli, Marco Di Cresce, Lucia Sacchi, Maria Gabriella Signorini, Marta Campanile, Pasquale Martinelli, Giovanni Magenes
AIM: We aimed to analyze computerized cardiotocographic (cCTG) parameters (including fetal heart rate baseline, short-term variability, Delta, long-term irregularity [LTI], interval index [II], low frequency [LF], movement frequency [MF], high frequency [HF], and approximate entropy [ApEn]) in physiological term pregnancies in order to correlate them with ethnic differences. The clinical meaning of numerical parameters may explain physiological or paraphysiological phenomena that occur in fetuses of different ethnic origins...
December 17, 2016: Journal of Obstetrics and Gynaecology Research
Peter R Stone, Wendy Burgess, Jordan P R McIntyre, Alistair J Gunn, Christopher A Lear, Laura Bennet, Edwin A Mitchell, John M D Thompson
KEY POINTS: Fetal behavioural state in healthy late gestation pregnancy is affected by maternal position. Fetal state 1F is more likely to occur in maternal supine or right lateral positions. Fetal state 4F is less likely to occur when the woman lies supine or semi-recumbent. Fetal state change is more likely when the woman is supine or semi-recumbent. Fetal heart rate variability is affected by maternal position with variability reduced in supine and semi-recumbent positions. ABSTRACT: Fetal behavioural states (FBS) are measures of fetal wellbeing...
November 21, 2016: Journal of Physiology
Gerard H A Visser, C M Bilardo, J B Derks, E Ferrazzi, N Fratelli, T Frusca, W Ganzevoort, C Lees, R Napolitano, T Todros, H Wolf, K Hecher, N Marlow, B Arabin, C Brezinka, A Diemert, J J Duvekot, P Martinelli, E Ostermayer, A T Papageorghiou, D Schlembach, Ktm Schneider, B Thilaganathan, A Valcamonico
OBJECTIVE: In the TRUFFLE study on outcome of early fetal growth restriction women were allocated to three timing of delivery plans according to antenatal monitoring strategies based on reduced computerized cardiotocographic heart rate short term variation (c-CTG STV) , early Ductus Venosus (DV p95) or late DV (DV noA) changes. However, many infants were per protocol delivered because of 'safety net' criteria, or for maternal indications, or 'other fetal indications' or after 32 weeks of gestation when the protocol was not applied anymore...
November 11, 2016: Ultrasound in Obstetrics & Gynecology
Grażyna Gebuza, Agnieszka Dombrowska, Marzena Kaźmierczak, Małgorzata Gierszewska, Estera Mieczkowska
OBJECTIVE: The assessment of cardiac parameters of the fetus in cardiotocographic record of pregnant women listening to Classical music. STUDY DESIGN: 60 NST records with no musical stimulation and 30 NST records during a 15-minute auditive stimulation with Wolfgang Amadeus Mozart's "Turkish March" as well as 30 NST records during Johann Strauss's "Tritsch-Tratsch Polka" were performed for the study. The average stage of the responders' pregnancy was the 36rd week, the lowest - the 27th week, the highest - 41st...
November 6, 2016: Journal of Maternal-fetal & Neonatal Medicine
Mariana Rei, Sara Tavares, Pedro Pinto, Ana P Machado, Sofia Monteiro, Antónia Costa, Cristina Costa-Santos, João Bernardes, Diogo Ayres-De-Campos
BACKGROUND: Visual analysis of cardiotocographic (CTG) tracings has been shown to be prone to poor intra- and interobserver agreement when several interpretation guidelines are used, and this may have an important impact on the technology's performance. OBJECTIVES: The aim of this study was to evaluate agreement in CTG interpretation using the new 2015 FIGO guidelines on intrapartum fetal monitoring. STUDY DESIGN: A pre-existing database of intrapartum CTG tracings was used to sequentially select 151 cases acquired with a fetal electrode, with duration exceeding 60minutes, and signal loss less than 15%...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Pl Bozhinov, S Bojinova
PURPOSE: To determine the frequency and the course of hypertensive disorders in pregnant women with epilepsy (PWWE). MATERIALS AND METHODS: The survey is prospective and covers 206 PWWE during the period 1997-2012 year, monitored and treated in Risk Pregnancy Clinic of University Hospital - Pleven. All the patients (PWWE) are with clinically established etiology and prescription of epilepsy, type of seizures and their frequency. EEG records, ultrasound of fetus and cardiotocograph monitoring were conducted...
2016: Akusherstvo i Ginekologii︠a︡
Célia Amorim-Costa, A Rita Gaio, Diogo Ayres-de-Campos, João Bernardes
OBJECTIVE: To compare longitudinal trends of cardiotocographic (CTG) parameters between small-for-gestational-age (SGA) and normal fetuses, from 24 to 41 weeks of pregnancy. METHODS: A prospective cohort study was carried out in singleton pregnancies without fetal malformations. At least one CTG was performed in each of the following intervals: 24-26 weeks+6 days, 27-29 weeks+6 days, 30-32 weeks+6 days, 33-35 weeks+6 days, 36-38 weeks+6 days and ≥39 weeks. Tracings were analyzed using the Omniview-SisPorto® 3...
July 30, 2016: Journal of Perinatal Medicine
A Měchurová, P Velebil, L Hruban, P Janků
UNLABELLED: Monitoring of fetal heart rate is one of the basic components of obstetrical care, in which the cardiotocography remains the gold standard and screening method in early diagnosis of fetal hypoxia, even after introduction of other selective methods of intrauterine monitoring of fetal well-being. The review article is divided into several parts: pathophysiology of fetal oxygenation, fetal heart rate and changes of fetal hemodynamics, and rules for fetal heart rate auscultation...
April 2016: Ceská Gynekologie
Emma R Allanson, Kate Grobicki, Robert C Pattinson, Jan E Dickinson
BACKGROUND: Of the 5.54 million stillbirths and neonatal deaths occurring globally each year, a significant amount of these occur in the setting of inadequate intrapartum care. The introduction of universal umbilical artery lactate (UA) measurements in this setting may improve outcomes by providing an objective measurement of quality of care and stimulating case reflection, audit, and practice change. It is important that consideration is given to the barriers and facilitators to implementing this tool outside of a research setting...
2016: BMC Pregnancy and Childbirth
Tullio Ghi, Giovanni Morganelli, Federica Bellussi, Paola Rucci, Francesca Giorgetta, Nicola Rizzo, Tiziana Frusca, Gianluigi Pilu
BACKGROUND: The RCOG classification system of CTG trace is widely used for the analysis of the fetal heart rate during the first and second stage of labor. Other authors proposed specific classification systems for the second stage traces. OBJECTIVE: To evaluate the accuracy of RCOG and Piquard cardiotocographic patterns classification systems in predicting fetal acidemia in the second stage of labor. STUDY DESIGN: This was a nested retrospective case-control study including fetuses delivered with metabolic acidemia in the second stage of labor and a matched group of non-acidemic fetuses as controls...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Célia Amorim-Costa, Cristina Costa-Santos, Diogo Ayres-de-Campos, João Bernardes
INTRODUCTION: The longitudinal cardiotocographic (CTG) changes throughout pregnancy in normal fetuses have never been fully described. We aimed at characterizing the evolution of CTG parameters in healthy fetuses, from 24 to 41 weeks of gestation. MATERIAL AND METHODS: A prospective cohort study was conducted in singleton fetuses without structural abnormalities on second-trimester ultrasound. At least one CTG was performed in each of the following intervals: 24-26 weeks(+6d) , 27-29 weeks(+6d) , 30-32 weeks(+6d) , 33-35 weeks(+6d) , 36-38 weeks(+6d) and ≥39 weeks; tracings were analyzed by the OMNIVIEW-SISPORTO 3...
October 2016: Acta Obstetricia et Gynecologica Scandinavica
G Virdis, A Gulotta, C Cherchi, G Spanedda, M G Olzai, G Ambrosini, S Dessole, G Capobianco
Fetal umbilical intra-abdominal vein varix (FIUV) is a rare congenital malformation characterized by focal dilatation of the umbilical vein. The authors report a case of pregnant woman at 32 weeks of gestation with a fetus affected by dilatation of an intra-abdominal portion of the umbilical vein. They performed continuous ultrasound and cardiotocographic monitoring, from admission to the delivery. They describe the case and perform a review of the literature.
2016: Clinical and Experimental Obstetrics & Gynecology
Julian T Parer, Austin Ugwumadu
There is much inconsistency in management recommendations for cardiotocograms by international organizations. Impediments to achieving consensus include disagreement on the spectrum of risk of fetal acidemia, different fetal heart rate pattern display due to differing chart paper speed, and the necessity for ancillary testing in confirming fetal acidemia.
February 2017: Journal of Maternal-fetal & Neonatal Medicine
Diogo Ayres-de-Campos, Mariana Rei, Inês Nunes, Paulo Sousa, João Bernardes
SisPorto 4.0 is the most recent version of a program for the computer analysis of cardiotocographic (CTG) signals and ST events, which has been adapted to the 2015 International Federation of Gynaecology and Obstetrics (FIGO) guidelines for intrapartum foetal monitoring. This paper provides a detailed description of the analysis performed by the system, including the signal-processing algorithms involved in identification of basic CTG features and the resulting real-time alerts.
January 2017: Journal of Maternal-fetal & Neonatal Medicine
Célia Amorim-Costa, Joana Cruz, Diogo Ayres-de-Campos, João Bernardes
OBJECTIVE: To establish reference values for cardiotocographic (CTG) parameters from 24 to 41 weeks of gestation in normal pregnancies. STUDY DESIGN: Retrospective cross-sectional study, using the first antepartum tracing of singleton fetuses with normal pregnancy outcomes (term birth, normal birthweight, normal umbilical artery pH and Apgar scores, no intensive care unit admission). Cases were consecutively selected from a hospital electronic patient record, and analyzed using the OmniviewSisPorto 3...
April 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
P Reif, S Schott, C Boyon, J Richter, G Kavšek, K N Timoh, J Haas, P Pateisky, A Griesbacher, U Lang, D Ayres-de-Campos
OBJECTIVE: To investigate whether knowledge of fetal outcome influences retrospective interpretation of cardiotocographic tracings and subsequent management recommendations. DESIGN: Prospective online study. SETTING: Seven university hospitals in five European countries. POPULATION: Forty-two intrapartum tracings from women with singleton pregnancies and uneventful antepartum courses. METHODS: Using an online questionnaire, 123 healthcare professionals interpreted 42 tracings without any knowledge of fetal outcome and provided management recommendations according to the National Institute of Clinical Excellence guidelines (intrapartum care)...
2016: BJOG: An International Journal of Obstetrics and Gynaecology
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