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Fetal heart rate drugs variability

Kim M J Verdurmen, Alexandra D J Hulsenboom, Judith O E H van Laar, S Guid Oei
INTRODUCTION: Tocolytics may cause changes in fetal heart rate pattern, while fetal heart rate variability is an important marker of fetal wellbeing. We aim to systematically review the literature on how tocolytic drugs affect fetal heart rate variability. MATERIAL AND METHODS: We searched CENTRAL, PubMed, and EMBASE up to June 2016. Studies published in English, using computerized or visual analysis to describe the effect of tocolytics on heart rate variability in human fetuses were included...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Luciana Carvalho Martins, Claudia Maria Vilas Freire, Carolina Andrade Bragança Capuruçu, Maria do Carmo Pereira Nunes, Cezar Alencar de Lima Rezende
BACKGROUND: Heart disease in pregnancy is the leading cause of non- obstetric maternal death. Few Brazilian studies have assessed the impact of heart disease during pregnancy. OBJECTIVE: To determine the risk factors associated with cardiovascular and neonatal complications. METHODS: We evaluated 132 pregnant women with heart disease at a High-Risk Pregnancy outpatient clinic, from January 2005 to July 2010. Variables that could influence the maternal-fetal outcome were selected: age, parity, smoking, etiology and severity of the disease, previous cardiac complications, cyanosis, New York Heart Association (NYHA) functional class > II, left ventricular dysfunction/obstruction, arrhythmia, drug treatment change, time of prenatal care beginning and number of prenatal visits...
April 2016: Arquivos Brasileiros de Cardiologia
Leslie J Matthews, David B McConda, Trapper A J Lalli, Scott D Daffner
Managing orthopedic conditions in pregnant patients leads to challenges that must be carefully considered so that the safety of both the mother and the fetus is maintained. Both perioperative and intraoperative considerations must be made based on physiologic changes during pregnancy, risks of radiation, and recommendations for monitoring. Operative timing, imaging, and medication selection are also factors that may vary based on trimester and clinical scenario. Pregnancy introduces unique parameters that can result in undesirable outcomes for both mother and fetus if not handled appropriately...
October 2015: Orthopedics
Vida Ayatollahi, Safa Faghihi, Shokoufeh Behdad, Najmeh Heiranizadeh, Behnam Baghianimoghadam
Selection of anesthetic drugs for cesarean section requires many considerations. Anesthetic drugs for this purpose must prevent hemodynamic stress due to tracheal intubation, while inducing neonatal complications. This study was conducted to determine the effects of paracetamol given before induction of anesthesia on cardiovascular responses to tracheal intubation and postoperative pain in the mother, and on neonatal Apgar score. This double-blind randomized placebo-controlled trial included 60 women in ASA I, without underlying diseases and fetal distress, who were candidates for elective cesarean section under general anesthesia...
September 2014: Acta Clinica Croatica
Shekoufeh Behdad, Vida Ayatollahi, Hamid Harrazi, Naderali Nazemian, Najmeh Heiranizadeh, Behnam Baghianimoghadam
INTRODUCTION: Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of Remifentanil during cesarean section surgery. METHODS: Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Society of Anesthesia (ASA), who were undergoing general anesthesia for semi-elective cesarean section were randomized into two groups (40 in each group) that received either an intravenous bolus of 0...
April 2013: Colombia Médica: CM
Mariusz Grzesiak, Rehana B Ahmed, Jan Wilczynski
OBJECTIVES: The aims were to evaluate whether any changes in blood flow in fetal inferior vena cava (IVC) are observed during Atosiban tocolysis within the first 48 hours of therapy. METHODS: Detailed Doppler evaluation of blood flow in fetal IVC was performed prior to Atosiban administration and after 24 and 48 hours respectively. Maternal and fetal heart rate was assessed. IVC Doppler indices, such as, S/D (systole/diastole), PVIV (peak velocity index for the vein) and PLI (preload index) were calculated...
2013: Neuro Endocrinology Letters
Mariusz Grzesiak, Rehana B Ahmed, Jan Wilczynski
OBJECTIVES: The aims were to assess the placental and fetal circulation during nifedipine tocolysis within the first 48 hours of therapy. METHODS: Placental and fetal circulation was assessed in Doppler ultrasound examination prior to nifedipine administration and then after 24 and 48 hours. Maternal heart rate and PI in uterine arteries were evaluated as well as FHR, RI and PI of UA and MCA. E/A-wave ratio for A-V valves, MPI and SF were calculated for both ventricles independently...
2013: Neuro Endocrinology Letters
V M Roemer, R Walden
BACKGROUND: Using the naked eye, evaluation of fetal heart-rate (FHR) patterns remains difficult and is not complete. Computer-aided analysis of the FHR offers the opportunity to analyse FHR patterns completely and to detect all changes possibly due to hypoxia and acidosis. It was the goal of this study to make these hypoxic changes of the FHR visible and to compare them directly with normal tracings. METHODS: During a period of 11 years the FHR signals (i. e., R-R intervals of the F-ECG) of 646 fetuses were recorded simultaneously also by a computer...
February 2013: Zeitschrift Für Geburtshilfe und Neonatologie
L B van der Heijden, M A Oudijk, G T R Manten, H ter Heide, L Pistorius, M W Freund
OBJECTIVES: In fetal tachycardia, pharmacological therapy with digoxin, flecainide and sotalol has been reported to be effective. In a recent retrospective multicenter study, sotalol was considered to be less effective than the other drugs in treatment of fetal supraventricular tachycardia (SVT). The aim of this study was to re-evaluate the efficacy and safety of maternally administered sotalol in the treatment of fetal tachycardia. METHODS: This was a retrospective review of the records of 30 consecutive fetuses with tachycardia documented on M-mode echocardiography between January 2004 and December 2010 at Wilhelmina Children's Hospital, a tertiary referral university hospital...
September 2013: Ultrasound in Obstetrics & Gynecology
Morgane Valentin, Guillaume Ducarme, Pierre-François Ceccaldi, Bernard Bougeois, Dominique Luton
OBJECTIVE: To evaluate the effects of epidural analgesia on uterine artery, umbilical, and fetal cerebral Doppler velocities during labor. METHODS: In a prospective study at Beaujon Hospital, Paris, France, between September and December 2010, uterine artery, umbilical, and fetal cerebral Doppler flow velocities were measured in 12 pregnant women during spontaneous labor with epidural analgesia. The data were registered in a period of uterine relaxation before, and 20 and 60 minutes after the first administration of epidural analgesic drugs...
August 2012: International Journal of Gynaecology and Obstetrics
V M Roemer, R Walden
BACKGROUND: Using naked-eye evaluation of foetal heart rate (FHR) patterns remains difficult and is not complete. Computer-aided analysis of the FHR offers the opportunity to analyse the FHR completely and to detect all changes due to hypoxia and acidosis. In order to better understand these changes FHR patterns in non-acidotic foetuses should be studied by first separating FHR into (i) basal FHR (baseline) and (ii) all decelerations. METHODS: The FHR signals (i...
February 2012: Zeitschrift Für Geburtshilfe und Neonatologie
L M Jansson, J A Di Pietro, A Elko, E L Williams, L Milio, M Velez
BACKGROUND: It is suspected that there is a continuum of impairment among prenatally drug-exposed infants, such that opioid and/or poly-drug exposure confers the highest risk for adverse neonatal outcomes than other classes of substances or single substance exposures. Suitable control groups are difficult to identify. This study compared fetal neurobehavioral development and infant outcomes in offspring of three groups of pregnant women in drug treatment. Exposure groups include: Methadone+other illicit substances (MM+Poly) and two groups currently abstinent for poly drug exposures: Methadone only (MM/A) and Non-Methadone (NM/A)...
May 1, 2012: Drug and Alcohol Dependence
Kelly Kenna, Robert De Matteo, Takushi Hanita, Sandra Rees, Foula Sozo, Victoria Stokes, David Walker, Alan Bocking, James Brien, Richard Harding
High levels of ethanol (EtOH) consumption during pregnancy adversely affect fetal development; however, the effects of lower levels of exposure are less clear. Our objectives were to assess the effects of daily EtOH exposure (3.8 USA standard drinks) on fetal-maternal physiological variables and the fetal brain, particularly white matter. Pregnant ewes received daily intravenous infusions of EtOH (0.75 g/kg maternal body wt over 1 h, 8 fetuses) or saline (8 fetuses) from 95 to 133 days of gestational age (DGA; term ∼145 DGA)...
October 2011: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Adrienne Stewart, Roshan Fernando, Sarah McDonald, Rachel Hignett, Tanya Jones, Malachy Columb
BACKGROUND: Hypotension is the most common serious side effect of spinal anesthesia for cesarean delivery. There has been a move recently toward the use of phenylephrine as a vasopressor infusion to improve maternal cardiovascular stability and fetal outcome. Although it seems safe in the elective setting, there have been concerns about its propensity for causing an increase in afterload and a baroreceptor-mediated bradycardia in the mother, with a consequent reduction in maternal cardiac output (CO)...
November 2010: Anesthesia and Analgesia
Leonhard Schäffer, Tilo Burkhardt, Maren Tomaske, Sina Schmidt, Franziska Luzi, Manfred Rauh, Antonio Leone, Ernst Beinder
Beneficial effects of antenatal glucocorticoid treatment in pregnancies at risk for preterm delivery may entail long-term consequences for the establishment of sympathoadrenergic system balance. We analyzed the cardiac autonomic system activity in neonates with a single course of antenatal betamethasone (2 × 12 mg) treatment by calculating heart rate variability (HRV) time-domain parameters from 24 h ECG recordings and short-term frequency-domain parameters during infant active and resting states. In addition, resting and challenged salivary α-amylase levels were measured in 23 betamethasone-exposed neonates and compared with controls...
October 2010: Pediatric Research
Martin G Frasch, Thomas Müller, Mark Szynkaruk, Matthias Schwab
Assessment of baroreceptor reflex sensitivity (BRS) in the ovine fetus provides insight into autonomic cardiovascular regulation. Currently, assessment of BRS relies on vasoactive drugs, but this approach is limited by feasibility issues and by the nonphysiologic nature of the stimulus. Thus we aimed to validate the method of spontaneous BRS assessment against the reference method of using vasoactive drugs in preterm (0.76 gestation, n = 16) and near-term (0.86 gestation, n = 16) chronically instrumented ovine fetuses...
September 2009: Canadian Journal of Physiology and Pharmacology
Martin G Frasch, Thomas Müller, Dirk Hoyer, Christian Weiss, Harald Schubert, Matthias Schwab
Fetal heart rate (FHR) monitoring is commonly used although clinical studies questioned its diagnostic value. Sophisticated FHR variability (fHRV) measures such as fHRV complexity may improve the sensitivity and specificity of FHR monitoring. A more detailed understanding of the physiology underlying fHRV complexity is essential to harness its use for monitoring fetal health. To examine the specific effects of vagal and sympathetic modulations on fHRV complexity, we blocked vagal activity with atropine and sympathetic activity with propranolol in near-term fetal sheep (n = 7, 0...
March 2009: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Lauren M Jansson, Janet A Dipietro, Martha Velez, Andrea Elko, Heather Knauer, Katie T Kivlighan
OBJECTIVE: Daily methadone maintenance is the standard of care for opiate dependency during pregnancy. Previous research has indicated that single-dose maternal methadone administration significantly suppresses fetal neurobehaviours. The purpose of this study was to determine if split-dosing would have less impact on fetal neurobehaviour than single-dose administration. METHODS: Forty methadone-maintained women were evaluated at peak and trough maternal methadone levels on single- and split-dosing schedules...
January 2009: Journal of Maternal-fetal & Neonatal Medicine
Isabella Neri, Francesca Monari, Herbert Valensise, Barbara Vasapollo, Fabio Facchinetti, Annibale Volpe
We compared the effects of ritodrine and atosiban treatments on fetal cardiovascular behavior by computerized nonstress test (c-NST) analysis. Women diagnosed with preterm labor were randomized to receive either atosiban or ritodrine. A c-NST was performed at least 12 hours after the last corticosteroid administration. Differences in fetal cardiovascular behavior were evident when treatment was given before 30 weeks' gestation. Ritodrine induced higher fetal heart rates, lower long-term variation values, and lower low:high-frequency ratios compared with atosiban...
April 2009: American Journal of Perinatology
Ana Conde, Bárbara Figueiredo, Iva Tendais, Ana F Pereira, Elisa Afonso, Raúl Nogueira
BACKGROUND: Recent researches show that psychological development begins much before birth and prenatal influences can explain a significant part of the future variability in infants' behaviour and development. AIMS: The aim of this study was to characterize the fetal development between 20 and 24 weeks of gestation, related to the measures of fetal growth-- iparietal diameter, abdominal circumference, head circumference, femur length and fetal weight-- and fetal activity--fetal heart rate and fetal movements...
January 2008: Acta Médica Portuguesa
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