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Fetal heart monitoring

Kirsten Wisner, Carrie Holschuh
The use of intermittent auscultation (IA) for fetal surveillance during labor decreased with the introduction of electronic fetal monitoring (EFM). The increased use of EFM is associated with an increase in cesarean births. IA is an evidence-based method of fetal surveillance during labor for women with low risk pregnancies and considered one component of comprehensive efforts to reduce the primary cesarean rate and promote vaginal birth. Many clinicians are not familiar with IA practice. This practice monograph includes information on IA techniques; interpretation and documentation; clinical decision-making and interventions; communication; education, staffing, legal issues, and strategies to promote implementation of IA into practice...
December 2018: Nursing for Women's Health
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December 2018: Nursing for Women's Health
Mariatha Yazbek, Julie Jomeen
OBJECTIVE: to explore and describe the use of the partogram in private hospitals in South Africa. DESIGN: an explanatory mixed method design. In-depth interviews were conducted with the midwives and midwife specialists to explicate the significance of the initial quantitative questionnaires. SETTING: a private maternity hospital in Gauteng Province, South Africa. PARTICIPANTS: 11 midwives and 3 advanced midwives working in the labour unit of the private maternity hospital...
November 23, 2018: Midwifery
Piotr Czuczwar
Medical management of ectopic pregnancy with methotrexate, an antimetabolite of folic acid, is an important alternative to surgical treatment, as it ensures a similar outcome whilst being far less invasive. Ultrasound evaluation does not only facilitate an accurate diagnosis, but also helps to select patients most likely to benefit from methotrexate treatment, as opposed to those with a high likelihood of failure of medical management, who are thus eligible for primary surgical treatment. Ultrasound also allows to monitor the outcome of methotrexate therapy...
2018: Journal of Ultrasonography
Marta Campanile, Pietro D'Alessandro, Luigi Della Corte, Gabriele Saccone, Salvatore Tagliaferri, Bruno Arduino, Giuseppina Esposito, Francesca Giovanna Esposito, Antonio Raffone, Maria Gabriella Signorini, Giovanni Magenes, Mariarosaria Di Tommaso, Serena Xodo, Fulvio Zullo, Vincenzo Berghella
OBJECTIVE: To evaluate whether intrapartum cardiotocography with computer analysis decreases the incidence of newborn metabolic acidosis or obstetric intervention when compared with visual analysis through a systematic review with meta-analysis of randomized controlled trials. METHODS: The research was conducted using Medline, Embase, Web of Science, Scopus,, Ovid and Cochrane Library as electronic databases from the inception of each database to May 2018...
November 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
Kristen Nguyen, Elizabeth Bamgbose, Brian P Cox, Sean P Huang, Andrzej Mierzwa, Susie Hutchins, Brand Caso, Martin Culjat, Cynthia Connelly, D Yvette Lacoursiere, Rahul S Singh
Electronic fetal monitoring (EFM) is used widely during labor & delivery, but existing solutions limit patient mobility, are uncomfortable, and do not consistently capture fetal heart rate (FHR) and uterine activity (UA) signals. A wireless EFM system was developed that features wearable US and tocodynamometer devices that conform to the body and do not require cables or belts. Benchtop testing demonstrated that the devices can accurately and consistently measure simulated FHRs and UAs over clinically meaningful ranges and body curvatures...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Haitham M Alangari, Yoshitaka Kimura, Ahsan H Khandoker
Monitoring fetal heart rate in an important aspect in evaluating fetal well being. Maternal-fetal interaction has shown evolution during fetal maturation. In this work, we studied maternal-fetal heart rate synchronization in early and late gestation fetuses. We also evaluated variations in the synchronization due to congenital heart defect (CHD). Maternal-fetal heart rate synchronization for 22 early gestation (Age < 32 weeks), $late gestation (Age >32 weeks) and 7 CHD fetuses (5 of them with gestational age < 32 weeks)...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Janine S Rhoades, Molly J Stout, George A Macones, Alison G Cahill
OBJECTIVE:  To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term. STUDY DESIGN:  Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios...
October 29, 2018: American Journal of Perinatology
Marti D Soffer, Katherine T Chen
BACKGROUND: Regulation of medical applications (apps) has not been rigorous. Concern for inaccurate medical apps with potential health consequences has increased. OBJECTIVE: To identify mobile apps for fetal heart rate monitoring (FHM) and to evaluate their accuracy through a case report. METHODS: A list of FHM apps was found in the Apple iTunes stores using a comprehensive list of search terms. After excluding apps irrelevant to this study, all unique apps were then downloaded and evaluated for necessary purchase of an accessory item, presence of disclaimer regarding medical advice, and accuracy of medical content...
October 24, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Bettina F Cuneo, Sven-Erik Sonesson, Stephanie Levasseur, Anita J Moon-Grady, Anita Krishnan, Mary T Donofrio, Marie-Josee Raboisson, Lisa K Hornberger, Peter Van Eerden, Elena Sinkovskaya, Alfred Abuhamad, Bhawna Arya, Anita Szwast, Helena Gardiner, Katherine Jacobs, Grace Freire, Lisa Howley, Aimee Lam, Alexander M Kaizer, D Woodrow Benson, Edgar Jaeggi
BACKGROUND: Fetal atrioventricular block (AVB) occurs in 2% to 4% of anti-Ro antibody-positive pregnancies and can develop in <24 h. Only rarely has standard fetal heart rate surveillance detected AVB in time for effective treatment. OBJECTIVES: Outcome of anti-Ro pregnancies was surveilled with twice-daily home fetal heart rate and rhythm monitoring (FHRM) and surveillance echocardiography. METHODS: Anti-Ro pregnant women were recruited from 16 international centers in a prospective observational study...
October 16, 2018: Journal of the American College of Cardiology
Benjamin A Kamala, Hege L Ersdal, Ingvild Dalen, Muzdalifat S Abeid, Matilda M Ngarina, Jeffrey M Perlman, Hussein L Kidanto
BACKGROUND: Intrapartum Fetal Heart Rate (FHR) monitoring is crucial for the early detection of abnormal FHR, facilitating timely obstetric interventions and thus the potential reduction of adverse perinatal outcomes. We explored midwifery practices of intrapartum FHR monitoring pre and post implementation of a novel continuous automatic Doppler device (the Moyo). METHODOLOGY: A pre/post observational study among low-risk pregnancies at a tertiary hospital was conducted from March to December 2016...
2018: PloS One
Charlène Bredy, François-Pierre Mongeon, Line Leduc, Annie Dore, Paul Khairy
Atrial septal defect (ASD) is the most common form of congenital heart disease. Left-to-right shunting leads to right ventricular (RV) volume overload with excessive pulmonary blood flow. Complications include exercise intolerance, pulmonary vascular disease, RV dysfunction, paradoxical thromboemboli, and atrial arrhythmias. Women with coexisting severe pulmonary hypertension should be counselled against pregnancy due to high incidence of maternal and fetal morbidity and mortality. In the absence of pulmonary hypertension, pregnancy is generally well tolerated in the setting of an ASD...
September 2018: Journal of Thoracic Disease
Sasha Skinner, Kelly Crossley, Ben Amberg, Aidan Kashyap, Stuart Hooper, Jan A Deprest, Ryan Hodges, Philip DeKoninck
OBJECTIVE: We aim to assess the effect of partial amniotic carbon dioxide insufflation (PACI) at increasing pressures on fetal acid-base, fetal-placental perfusion, and fetal membrane morphology in an ovine model. METHOD: Pregnant ewes and fetuses were instrumented under isoflurane anesthesia at 105 days gestation (term 145 days) to monitor utero-placental blood flow, fetal and maternal blood pressure, heart rate, and blood gas status. One group (n = 6) was exposed to PACI (unheated dry CO2 ), involving 10 mm Hg stepwise increases in insufflation pressure (5 to 25 mm Hg), for 80 minutes followed by 20 minutes of desufflation...
October 4, 2018: Prenatal Diagnosis
Nicole Look, Christopher J Kleck, Evalina L Burger
CASE: Low back pain affects >50% of pregnant women. However, cauda equina syndrome (CES) during pregnancy is rare. Because a delay in treatment increases the risk of irreversible neurologic damage, acute onset is regarded as a surgical emergency. We describe 3 cases of CES in pregnant women at 24, 27, and 30 weeks' gestation, respectively. CONCLUSION: All 3 of the patients underwent surgical decompression in the prone position under general anesthesia with continuous external monitoring of the fetal heart rate...
July 2018: JBJS Case Connector
S Gobillot, J Fontecave-Jallon, V Equy, B Rivet, P Y Gumery, P Hoffmann
BACKGROUND: Continuous fetal monitoring is commonly used during pregnancy and labor to assess fetal wellbeing. The most often used technology is cardiotocography (CTG), but this technique has major drawbacks in clinical use. OBJECTIVES: Our aim is to test a non-invasive multimodal technique of fetal monitoring using phonocardiography (PCG) and electrocardiography (ECG) and to evaluate its feasibility in clinical practice, by comparison with CTG. METHODS: This prospective open label study took place in a French university hospital...
November 2018: Journal of Gynecology Obstetrics and Human Reproduction
Alexandra Crawford, Patrick Anyadi, Louise Stephens, Suzanne L Thomas, Holly Reid, Lucy E Higgins, Lynne K Warrander, Edward D Johnstone, Alexander E P Heazell
INTRODUCTION: Continuous fetal monitoring is used to objectively record the fetal heart rate and fetal activity over an extended period of time; however, its feasibility and acceptability to women is currently unknown. The study addressed the hypothesis that continuous fetal monitoring is feasible and acceptable to pregnant women. MATERIAL AND METHODS: Pregnant participants (n = 22) were monitored using a continuous fetal electrocardiography device, the Monica AN24...
August 22, 2018: Acta Obstetricia et Gynecologica Scandinavica
Hong-Yan Zhan, Feng-Qin Xu, Chuan-Xi Liu, Gang Zhao
BACKGROUND: In recent years, pulmonary artery blood flow acceleration time (AT) has been believed to be applicable in the examination of fetal lung development. OBJECTIVES: This study aims to evaluate the clinical significance of pulmonary artery blood flow AT as a parameter in monitoring of fetal pulmonary artery pressure. MATERIAL AND METHODS: A total of 31 fetuses in midor late-term pregnancy with tricuspid regurgitation were set as the study group (congenital heart disease with a tricuspid regurgitation pressure difference of more than 20 mm Hg was excluded)...
August 21, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Zhidong Zhao, Yang Zhang, Yanjun Deng
Continuous monitoring of the fetal heart rate (FHR) signal has been widely used to allow obstetricians to obtain detailed physiological information about newborns. However, visual interpretation of FHR traces causes inter-observer and intra-observer variability. Therefore, this study proposed a novel computerized analysis software of the FHR signal (CAS-FHR), aimed at providing medical decision support. First, to the best of our knowledge, the software extracted the most comprehensive features (47) from different domains, including morphological, time, and frequency and nonlinear domains...
August 20, 2018: Journal of Clinical Medicine
Paschal F Mdoe, Hege L Ersdal, Estomih Mduma, Robert Moshiro, Ingvild Dalen, Jeffrey M Perlman, Hussein Kidanto
OBJECTIVE: To compare the frequency of abnormal fetal heart rate (FHR) detection between continuous Doppler and intermittent fetoscope monitoring. METHOD: A randomized controlled open-label trial was conducted between February 1, 2016, and January 31, 2017, at Haydom Lutheran hospital, Tanzania. Women in active labor with singleton pregnancies and normal FHR at admission were randomly allocated in a 1:1 ratio to receive either continuous or intermittent FHR monitoring...
August 17, 2018: International Journal of Gynaecology and Obstetrics
Robert Moshiro, Jeffrey M Perlman, Hussein Kidanto, Jan Terje Kvaløy, Paschal Mdoe, Hege L Ersdal
BACKGROUND: Effective positive pressure ventilation (PPV) of non-breathing newborns is crucial in facilitating cardio-respiratory adaptation at birth. Identifying predictors of death in newborns receiving PPV is important in order to facilitate preventative strategies. OBJECTIVE: The objective of this study was to determine the perinatal predictors of death including the quality of PPV administered among admitted newborns. METHODS: An observational study of admitted newborns who received PPV after birth was conducted...
2018: PloS One
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