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Fetal heart monitoring

Uwe Schneider, Franziska Bode, Alexander Schmidt, Samuel Nowack, Anja Rudolph, Eva-Maria Dölker, Peter Schlattmann, Theresa Götz, Dirk Hoyer
[This corrects the article DOI: 10.1371/journal.pone.0200799.].
2018: PloS One
Gerard Cummins, Jessica Kremer, Anne Bernassau, Andrew Brown, Helen L Bridle, Holger Schulze, Till T Bachmann, Michael Crichton, Fiona C Denison, Marc P Y Desmulliez
This article reviews existing clinical practices and sensor research undertaken to monitor fetal well-being during labour. Current clinical practices that include fetal heart rate monitoring and fetal scalp blood sampling are shown to be either inadequate or time-consuming. Monitoring of lactate in blood is identified as a potential alternative for intrapartum fetal monitoring due to its ability to distinguish between different types of acidosis. A literature review from a medical and technical perspective is presented to identify the current advancements in the field of lactate sensors for this application...
August 13, 2018: Sensors
Tal Weissbach, Ishai Heusler, Michal Ovadia, Liron David, Yair Daykan, Faye Schreiber, Tal Biron-Shental
OBJECTIVE: To correlate the duration of Category II cardiotocograms (CTG) with adverse neonatal outcomes associated with perinatal asphyxia and determine the duration before fetal compromise. STUDY DESIGN: This retrospective, observational study used electronic medical record data from a cohort of 271 patients, delivered by C-section due to non-reassuring fetal heart rate, at a tertiary medical center, from 2015 through 2017. Duration of Category II CTG, variability, tachycardia and deceleration frequency were analyzed and correlated to immediate postnatal outcomes...
July 30, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Jane Warland, Jillian Dorrian, Allan J Kember, Craig Phillips, Ali Borazjani, Janna L Morrison, Louise M O'Brien
STUDY OBJECTIVES: To test whether a customized positional therapy device, PrenaBelt, would reduce time spent sleeping supine and evaluate any change in maternal or fetal parameters, in a group of healthy pregnant women in the third trimester of pregnancy. METHODS: Participants underwent an in-home, overnight sleep study during late pregnancy (32-38 weeks). Participants were observed over 2 nights: 1 night when the PrenaBelt was not worn (nonintervention or control) and 1 night when it was (intervention)...
August 6, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Toshiyuki Uchida, Naohiro Kanayama, Kenta Kawai, Mari Mukai, Kazunao Suzuki, Hiroaki Itoh, Masatsugu Niwayama
AIM: Although several studies reported the measurement of fetal oxygen saturation using fetal pulse oximetry (FPO) for evaluation of the fetal intrapartum condition, a systematic review of the seven randomized controlled trials (RCTs) provided no evidence to support FPO for intrapartum fetal monitoring. In the present review, we re-evaluate an overview for the use of FPO and seven RCTs of FPO. METHODS: We reviewed numerous previous reports on FPO and seven RCTs of intrapartum FPO...
August 6, 2018: Journal of Obstetrics and Gynaecology Research
Samantha Low, Carmen Kiper, Aimee Armstrong, Clifford L Cua
A pregnant female presented at 37 weeks of gestation in labor. The fetus was noted to be tachycardic on fetal monitor. Postnatally, the male neonate was still noted to be tachycardic with heart rates in the low 200 bpm range. EKG was consistent with tachycardia, but rhythm diagnosis was not definitively made. Echocardiogram with M-mode analysis clearly demonstrated 2:1 atrial to ventricular contraction pattern consistent with atrial flutter. The neonate was subsequently transferred to a tertiary pediatric hospital where the diagnosis of atrial flutter was confirmed...
August 6, 2018: Echocardiography
Bobby Brar, David Jackson, Manita Nat, Pooja Patil, Brian Iriye, Petar Planinic
OBJECTIVE: Daily opioid dependence for maternal pain management, methadone maintenance, or buprenorphine/naloxone therapy is an increasing trend in modern obstetrics. Opioids may produce depressive effects on fetal neurobehavioral status and thus on fetal heart rate patterns. Our primary objective was to describe the current methods utilized in antenatal monitoring of the daily opioid exposed fetus; and to describe interventions based upon monitoring which precipitated a recommendation for delivery...
August 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Marya Plotkin, Dunstan Bishanga, Hussein Kidanto, Mary Carol Jennings, Jim Ricca, Amasha Mwanamsangu, Gaudiosa Tibaijuka, Ruth Lemwayi, Benny Ngereza, Mary Drake, Jeremie Zougrana, Neena Khadka, James A Litch, Barbara Rawlins
BACKGROUND: Globally, an estimated 2.7 million babies die in the neonatal period annually, and of these, about 0.7 million die from intrapartum-related events. In Tanzania 51,000 newborn deaths and 43,000 stillbirths occur every year. Approximately two-thirds of these deaths could be potentially prevented with improvements in intrapartum and neonatal care. Routine measurement of fetal intrapartum deaths and newborn deaths that occur in health facilities can help to evaluate efforts to improve the quality of intrapartum care to save lives...
2018: PloS One
Faezeh Marzbanrad, Lisa Stroux, Gari D Clifford
One-dimensional Doppler ultrasound (1D-DUS) provides a low-cost and simple method for acquiring a rich signal for use in cardiovascular screening. However,
 despite the use of 1D-DUS in cardiotocography (CTG) for decades, there are still challenges that limit the effectiveness of its users in reducing fetal and neonatal morbidities and mortalities. This is partly due to the noisy, transient, complex and non-stationary nature of the 1D-DUS signals. Current challenges also include lack of efficient signal quality metrics, insufficient signal processing techniques for extraction of fetal heart rate and other vital parameters with adequate temporal resolution, and lack of appropriate clinical decision support for CTG and Doppler interpretation...
July 20, 2018: Physiological Measurement
Benjamin A Kamala, Hussen L Kidanto, Peter J Wangwe, Ingvild Dalen, Estomih R Mduma, Jeffrey M Perlman, Hege L Ersdal
Background: Fetal stethoscopes are mainly used for intermittent monitoring of fetal heart rate (FHR) during labor in low-income countries, where perinatal mortality is still high. Handheld Dopplers are rarely available and are dependent on batteries or electricity. The objective was to compare the Pinard stethoscope versus a new wind-up handheld Doppler in the detection of abnormal FHR. Materials and methods: We conducted a randomized controlled study at Muhimbili National Hospital, Tanzania, from April 2013 to September 2015...
2018: International Journal of Women's Health
Yin Liu, Matthew J Bock, June-Anne Gold
A 24-year-old woman with a history of idiopathic dilated cardiomyopathy status post heart transplant gave birth to a healthy term female infant. At 5 months of age, the infant was diagnosed with severe left ventricular dysfunction with an ejection fraction of 18% and moderate non-compaction of the left ventricle. She received a heart transplant at 7 months of age. Familial dilated cardiomyopathy was diagnosed. Genetic testing revealed a likely pathogenic variant in the TPM1 gene. Fetal cardiac screening is critical for offspring of heart transplant recipients, especially when the reason for transplant was cardiomyopathy...
July 19, 2018: Cardiology in the Young
Uwe Schneider, Franziska Bode, Alexander Schmidt, Samuel Nowack, Anja Rudolph, Eva-Maria Doelcker, Peter Schlattmann, Theresa Götz, Dirk Hoyer
BACKGROUND: Fetal heart rate variability (fHRV) of normal-to-normal (NN) beat intervals provides high-temporal resolution access to assess the functioning of the autonomic nervous system (ANS). AIM: To determine critical periods of fetal autonomic maturation. The developmental pace is hypothesized to change with gestational age (GA). STUDY DESIGN: Prospective longitudinal observational study. SUBJECTS: 60 healthy singleton fetuses were followed up by fetal magnetocardiographic heart rate monitoring 4-11 times (median 6) during the second half of gestation...
2018: PloS One
Habiba Kapaya, Emma R Dimelow, Dilly Anumba
OBJECTIVE: To determine the acceptability, to women, of wearing a portable fetal electrocardiogram recording device at different stages of pregnancy and to gain insight into their experience of its use for long-periods of monitoring of small-for-gestational fetuses in the home environment. METHODS: A qualitative study using both a questionnaire and focus group involving women with singleton pregnancy >24 weeks gestation, no evidence of fetal malformation and an estimated fetal weight below 10th gestational centile on ultrasound scan...
January 2018: Women's Health
E Fotiadou, J O E H van Laar, S G Oei, R Vullings
Extraction of a clean fetal electrocardiogram (ECG) from non-invasive abdominal recordings is one of the biggest challenges in fetal monitoring. An ECG allows for the interpretation of the electrical heart activity beyond the heart rate and heart rate variability. However, the low signal quality of the fetal ECG hinders the morphological analysis of its waveform in clinical practice. The time-sequenced adaptive filter has been proposed for performing optimal time-varying filtering of non-stationary signals having a recurring statistical character...
June 25, 2018: Medical & Biological Engineering & Computing
Encarnación Castillo, Diego P Morales, Antonio García, Luis Parrilla, Víctor U Ruiz, José A Álvarez-Bermejo
Non-invasive fetal electrocardiography (ECG) is based on the acquisition of signals from abdominal surface electrodes. The composite abdominal signal consists of the maternal electrocardiogram along with the fetal electrocardiogram and other electrical interferences. These recordings allow for the acquisition of valuable and reliable information that helps ensure fetal well-being during pregnancy. This paper introduces a procedure for fetal heart rate extraction from a single-channel abdominal ECG signal. The procedure is composed of three main stages: a method based on wavelet for signal denoising, a new clustering-based methodology for detecting fetal QRS complexes, and a final stage to correct false positives and false negatives...
2018: PloS One
Natthicha Chainarong, Chusana Petpichetchian
OBJECTIVES: The cerebroplacental ratio (CPR) Doppler has been proposed as an instrument for predicting adverse perinatal outcomes particularly during antepartum period. Abnormal CPR is associated with non-reassuring fetal status requiring operative delivery, low Apgar score and neonatal complications. The aim of this study was to assess the role of CPR Doppler in the labor triage suite, so as to identify fetuses at risk for non-reassuring status as well as other adverse perinatal outcomes...
June 11, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Radek Martinek, Radana Kahankova, Janusz Jezewski, Rene Jaros, Jitka Mohylova, Marcel Fajkus, Jan Nedoma, Petr Janku, Homer Nazeran
Non-adaptive signal processing methods have been successfully applied to extract fetal electrocardiograms (fECGs) from maternal abdominal electrocardiograms (aECGs); and initial tests to evaluate the efficacy of these methods have been carried out by using synthetic data. Nevertheless, performance evaluation of such methods using real data is a much more challenging task and has neither been fully undertaken nor reported in the literature. Therefore, in this investigation, we aimed to compare the effectiveness of two popular non-adaptive methods (the ICA and PCA) to explore the non-invasive (NI) extraction (separation) of fECGs, also known as NI-fECGs from aECGs...
2018: Frontiers in Physiology
Zafer Cömert, Adnan Fatih Kocamaz, Velappan Subha
Cardiotocography (CTG) is applied routinely for fetal monitoring during the perinatal period to decrease the rates of neonatal mortality and morbidity as well as unnecessary interventions. The analysis of CTG traces has become an indispensable part of present clinical practices; however, it also has serious drawbacks, such as poor specificity and variability in its interpretation. The automated CTG analysis is seen as the most promising way to overcome these disadvantages. In this study, a novel prognostic model is proposed for predicting fetal hypoxia from CTG traces based on an innovative approach called image-based time-frequency (IBTF) analysis comprised of a combination of short time Fourier transform (STFT) and gray level co-occurrence matrix (GLCM)...
June 6, 2018: Computers in Biology and Medicine
Spencer G Kuper, Victoria C Jauk, David M George, Rodney K Edwards, Jeff M Szychowski, Sara E Mazzoni, Michelle J Wang, Pamela Files, Alan T Tita, Akila Subramaniam, Lorie M Harper
OBJECTIVE: To assess whether outpatient cervical ripening with a transcervical Foley catheter in parous women undergoing elective induction of labor shortens the total duration of time from admission to the labor ward until delivery. METHODS: We performed an open-label randomized controlled trial at a single academic center in parous women at 39 weeks of gestation or greater with a cervix 3 cm or less dilated, or, if 2-3 cm dilated, less than 80% effaced and reassuring fetal heart rate monitoring (defined as moderate variability with a normal baseline and absence of decelerations)...
July 2018: Obstetrics and Gynecology
Ning Tian, Weiyuan Zhang
This study aimed to identify cardiotocography patterns that discriminate fetal acidemia newborns by comprehensively evaluating the parameters obtained from Holter monitoring during delivery. Between June 1, 2015, and August 1, 2016, a prospective observational study of 85 patients was conducted using fetal Holter monitoring at the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China. Umbilical cord blood was sampled immediately after delivery and fetal acidemia was defined as umbilical cord arterial blood pH < 7...
2018: BioMed Research International
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