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Fetal heart monitoring

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 145d) to monitor utero-placental blood flow, fetal and maternal blood pressure, heart rate and blood gas status. One group (n=6) were exposed to PACI (unheated dry CO2 ), involving 5mmHg stepwise increases in insufflation pressure (5 to 25mmHg), for 80min followed by 20min 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...
August 23, 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
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...
October 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 15, 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...
September 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 nonstationary 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...
August 14, 2018: Physiological Measurement
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