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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
J T Parer, Austin Ugwumadu
No abstract text is available yet for this article.
April 5, 2016: 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 computer analysis of cardiotocographic signals and ST events, which has been adapted to the 2015 International Federation of Gynecology and Obstetrics (FIGO) guidelines for intrapartum fetal 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.
March 3, 2016: 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)...
February 16, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Malene M Andersen, Dorthe L A Thisted, Isis Amer-Wåhlin, Lone Krebs
OBJECTIVE: To compare cardiotocographic abnormalities recorded during labour in women with prior caesarean delivery (CD) and complete uterine rupture with those recorded in controls with prior CD without uterine rupture. STUDY DESIGN: Women with complete uterine rupture during labour between 1997 and 2008 were identified in the Danish Medical Birth Registry (n = 181). Cases were validated by review of medical records and 53 cases with prior CD, trial of labour, available cardiotocogram (CTG) and complete uterine rupture were included and compared with 43 controls with prior CD, trial of labour and available CTG...
2016: PloS One
Barbara S Kisilevsky, C Ann Brown
PURPOSE: To determine the reliability at term of: (1) two methods of measuring fetal heart rate (HR), electrocardiographic (ECG, the 'gold standard') and cardiotocographic (CTG) and (2) two ECG methods of measuring maternal HR variability over relatively brief periods of time (s-min). METHODS: During 20 min of rest (N=39) and during 2 min of auditory stimulation (mother's recorded voice, n=19), fetal HR data were collected using an ECG (Monica AN24) and a Hewlett-Packard Model 1351A CTG...
February 2016: Infant Behavior & Development
Peter Brocklehurst
BACKGROUND: Continuous electronic fetal heart rate monitoring in labour is widely used but its potential for improving fetal and neonatal outcomes has not been realised. The most likely reason is the difficulty of interpreting the fetal heart rate trace correctly during labour. Computerised interpretation of the fetal heart rate and intelligent decision-support has the potential to deliver this improvement in care. This trial will test whether the addition of decision support software to aid the interpretation of the cardiotocogram (CTG) during labour will reduce the number of 'poor neonatal outcomes' in those women judged to require continuous electronic fetal heart rate monitoring...
2016: BMC Pregnancy and Childbirth
Maria Laura Annunziata, Salvatore Tagliaferri, Francesca Giovanna Esposito, Natascia Giuliano, Flavia Mereghini, Andrea Di Lieto, Marta Campanile
AIM: To analyze computerized cardiotocographic (cCTG) parameters (baseline fetal heart rate, baseline FHR; short term variability, STV; approximate entropy, ApEn; low frequency, LF; movement frequency, MF; high frequency, HF) in physiological pregnancy in order to correlate them with the stages of labor. This could provide more information for understanding the mechanisms of nervous system control of FHR during labor progression. METHODS: A total of 534 pregnant women were monitored on cCTG from the 37th week before the onset of spontaneous labor and during the first and the second stage of labor...
March 2016: Journal of Obstetrics and Gynaecology Research
Salvatore Tagliaferri, Andrea Fanelli, Giuseppina Esposito, Francesca Giovanna Esposito, Giovanni Magenes, Maria Gabriella Signorini, Marta Campanile, Pasquale Martinelli
OBJECTIVE: This study used a new method called Acceleration (or Deceleration) Phase-Rectified Slope, APRS (or DPRS) to analyze computerized Cardiotocographic (cCTG) traces in intrauterine growth restriction (IUGR), in order to calculate acceleration- and deceleration-related fluctuations of the fetal heart rate, and to enhance the prediction of neonatal outcome. METHOD: Cardiotocograms from a population of 59 healthy and 61 IUGR fetuses from the 30th gestation week matched for gestational age were included...
2015: Computational and Mathematical Methods in Medicine
A Ugwumadu, P Steer, B Parer, B Carbone, C Vayssiere, G Maso, S Arulkumaran
No abstract text is available yet for this article.
May 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Alfredo Illanes, Michel Haritopoulos
The main objective of this work is to perform an autoregressive model (AR)-based power spectral analysis of the fetal heart rate (FHR) signal for the extraction of significant features for fetal welfare assessment. A group of features is directly computed from the AR-based spectrum while another group is computed from the poles representation. The presented method is applied to real cardiotocographic (CTG) signals and for different frequency bands, and the obtained results are very promising as they exhibit direct correlations between the extracted features and the fetal welfare in terms of umbilical pH...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Robyn M Maude, Joan P Skinner, Maralyn J Foureur
BACKGROUND: Fetal monitoring guidelines recommend intermittent auscultation for the monitoring of fetal wellbeing during labour for low-risk women. However, these guidelines are not being translated into practice and low-risk women birthing in institutional maternity units are increasingly exposed to continuous cardiotocographic monitoring, both on admission to hospital and during labour. When continuous fetal monitoring becomes routinised, midwives and obstetricians lose practical skills around intermittent auscultation...
June 2016: Women and Birth: Journal of the Australian College of Midwives
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