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Fetal heart rate trace drugs

T N Chethanananda, M R Shashank, N Madhu, J Achyutha, Karna Venkata Siva Kumar
BACKGROUND AND AIMS: This study aims to compare the minimum effective concentration of local anesthetic (LA) bupivacaine and ropivacaine with highly lipid soluble opioids fentanyl for providing optimal labor epidural analgesia. SETTINGS AND DESIGN: The objective of this study was to evaluate the efficacy of racemic bupivacaine 0.0625% and 0.1% of ropivacaine both mixed with 2 μg/ml of fentanyl for epidural labor analgesia in parturients with spontaneous labor and normal fetal heart rate tracing...
July 2017: Anesthesia, Essays and Researches
Kathryn J Sharma, Maria Rodriguez, Sarah J Kilpatrick, Naomi Greene, Paola Aghajanian
OBJECTIVE: To determine whether the incidence of hypotension or adverse fetal heart tracing (FHT) category change differed following antepartum administration of intravenous (IV) labetalol versus hydralazine. METHODS: Blood pressure and FHT categories were assessed one hour before and after medication administration. Hypotension was defined as ≥30% reduction in baseline systolic blood pressure (SBP) or SBP <90 mmHg. Changes in mean arterial pressure (MAP) were also compared...
2016: Hypertension in Pregnancy
Gabriele Tonni, Maria Paola Bonasoni, Claudio De Felice, Andrea Rossi, Silvia Tonni
BACKGROUND: Spontaneous hematoma of the umbilical cord is a rare, unpreventable, and dramatic event mainly due to a disruption of the vascular wall, often resulting in adverse perinatal outcome. CASE: We describe a case of a term fetus with acute hemorrhage in the cord occurred intrapartum during spontaneous vaginal delivery. No iatrogenic factors were involved because no drugs, obstetric instruments, or procedures were applied. Umbilical hematoma probably developed in a time frame of 90 seconds, when the electronic fetal monitoring tracing detected a loss of fetal heart rate...
December 2015: American Journal of Forensic Medicine and Pathology
Kelly T Harkey, Michael B Casale, Alexandros A Pantelopoulos, Mark A Zurcher
INTRODUCTION: The Sense4Baby system is a novel, wireless, noninvasive maternal and fetal monitor that locally transmits cardiotocography data and uploads it for a clinician. This device can help address health care disparities in high-risk pregnant women in underserved and remote areas by capturing and relaying data in a more cost-effective manner. The clinical use of the recording and interpretation capability of the Sense4Baby system device was compared with a U.S. Food and Drug Administration-approved predicate cardiotocograph (Philips system)...
May 2014: Obstetrics and Gynecology
Gloria T Too, James B Hill
Hypertension affects 10% of pregnancies, many with underlying chronic hypertension, and approximately 1-2% will undergo a hypertensive crisis at some point during their lives. Hypertensive crisis includes hypertensive urgency and emergency; the American College of Obstetricians and Gynecologists describes a hypertensive emergency in pregnancy as persistent (lasting 15 min or more), acute-onset, severe hypertension, defined as systolic BP greater than 160 mmHg or diastolic BP >110 mmHg in the setting of pre-eclampsia or eclampsia...
August 2013: Seminars in Perinatology
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
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
Aruna Nigam, Monika Madan, Manju Puri, Swati Agarwal, Shubha Sagar Trivedi
We undertook this study in order to compare the efficacy of 25 microg versus 50 microg of intravaginal misoprostol for cervical ripening and labour induction at term. The study population consisted of 120 women with term singleton pregnancies in vertex presentation booked for caesarean section. They had a Bishop scoring of <6 and a reactive fetal heart rate tracing. They were randomized into two groups, A and B, to receive 25 microg and 50 microg of vaginal misoprostol, respectively, 4 hourly with a maximum of five doses until the patient had three contractions in 10 minutes...
January 2010: Tropical Doctor
Cynthia A Wong, Robert J McCarthy, John T Sullivan, Barbara M Scavone, Susan E Gerber, Edward A Yaghmour
OBJECTIVE: To determine whether early initiation of neuraxial analgesia (anesthetic[s] placed around the nerves of the central nervous system) compared with systemic opioid analgesia, followed later in labor by epidural analgesia, increases the rate of cesarean delivery in nulliparas undergoing induction of labor. METHODS: Nulliparas undergoing induction of labor who requested analgesia when cervical dilation was less than 4 cm participated in the study. Patients were randomized to neuraxial (early) or systemic opioid (late) analgesia at the first analgesia request...
May 2009: Obstetrics and Gynecology
Gal Dubnov-Raz, David N Juurlink, Rami Fogelman, Paul Merlob, Shinya Ito, Gideon Koren, Yaron Finkelstein
OBJECTIVES: Prolongation of the QT interval is a risk factor for sudden death. Selective serotonin-reuptake inhibitor antidepressants can prolong the QT interval and are widely used by pregnant women. Whether antenatal exposure to selective serotonin-reuptake inhibitor causes QT prolongation in offspring is unknown. The aim of this study was to determine the effect of maternal use of selective serotonin-reuptake inhibitor antidepressants during pregnancy on the QTc interval of the offspring...
September 2008: Pediatrics
William Andres Ramirez-Cacho, Stephanie Flores, Ron M Schrader, Jaymi McKay, William F Rayburn
OBJECTIVE: Treatment of maternal opioid dependence with methadone is associated with a delay in fetal heart rate (FHR) accelerations in nonstress tests. The objective of this investigation was to determine the effect of methadone maintenance therapy on intrapartum FHR patterns. METHODS: This retrospective cohort study compared intrapartum FHR tracings from 56 methadone-treated patients > or =36 weeks gestation with a control group of nonsubstance using patients matched for maternal age, parity, gestational age, and ethnicity...
February 2006: Journal of the Society for Gynecologic Investigation
C A Wong, B M Scavone, J P Slavenas, M I Vidovich, A M Peaceman, J N Ganchiff, T Strauss-Hoder, R J McCarthy
The purpose of this randomized, double blinded and controlled study was to determine the optimal dose of intrathecal fentanyl when combined with bupivacaine 2.5 mg for initiation of labor analgesia. Parous parturients with cervical dilation between 3 and 5 cm were randomized to receive intrathecal fentanyl 0 (control), 5, 10, 15, 20 or 25 micrograms, combined with bupivacaine 2.5 mg, followed by a lidocaine/epinephrine epidural test dose. Visual analog pain scores (VAPS) and the presence of side effects were determined every 15 min until the parturient requested additional analgesia...
January 2004: International Journal of Obstetric Anesthesia
M Van de Velde, A Teunkens, M Hanssens, E Vandermeersch, J Verhaeghe
UNLABELLED: Combined spinal epidural analgesia (CSE) for labor pain relief has become increasingly popular. However, the effect of intrathecal sufentanil on the incidence of uterine hyperactivity and fetal heart rate (FHR) abnormalities remains controversial. We hypothesized that the use of intrathecal sufentanil in a dose of 7.5 microg is more likely to induce a nonreassuring FHR tracing than a small dose of spinal sufentanil combined with bupivacaine or epidural analgesia. Three-hundred parturients were randomized into three groups...
April 2004: Anesthesia and Analgesia
M M Meydanli, E Calişkan, F Burak, M A Narin, R Atmaca
OBJECTIVES: To compare the effectiveness of 25 microg vs. 50 microg of intravaginal misoprostol for cervical ripening and labor induction beyond 41 weeks' gestation. METHODS: The study population consisted of 120 women not in active labor with a gestational age >41 weeks, singleton pregnancy with vertex presentation, reactive fetal heart rate tracing, amniotic fluid index >/=5, and Bishop score <5. Women were randomized to receive either 25 microg (n=60) or 50 microg (n=60) of intravaginal misoprostol...
June 2003: International Journal of Gynaecology and Obstetrics
Patrick M Mullin, Michael House, Richard H Paul, Deborah A Wing
OBJECTIVE: The purpose of this study was to compare intravaginal misoprostol with extra-amniotic saline solution infusion with concomitant oxytocin for cervical ripening and labor induction in viable pregnancies. STUDY DESIGN: Two hundred women with indications for labor induction and unfavorable cervices were assigned randomly to vaginal misoprostol or extra-amniotic saline solution infusion. Twenty-five micrograms of misoprostol was administered every 4 hours up to six doses, followed by intravenous oxytocin administration...
October 2002: American Journal of Obstetrics and Gynecology
Ruth Landau, Eduardo Schiffer, Michel Morales, Georges Savoldelli, Christian Kern
UNLABELLED: To determine the effects of clonidine with ropivacaine during epidural labor analgesia, we studied 66 nulliparous women in early active labor. Women were randomized to receive ropivacaine 0.1% 8 mL plus 75 microg of clonidine (Group 1), ropivacaine 0.2% 8 mL plus 0.5 mL of NaCl 0.9% (Group 2), or ropivacaine 0.2% 8 mL plus 75 microg of clonidine (Group 3) 5 min after a bupivacaine 7.5 mg with epinephrine 15 microg test dose. Upon request, additional analgesia with ropivacaine 0...
September 2002: Anesthesia and Analgesia
J M Crane, D C Young, K D Butt, K A Bennett, D Hutchens
OBJECTIVE: To estimate the incidence and timing of excessive uterine activity accompanying induction of labor with misoprostol using different routes (oral or vaginal) and forms (intact tablet or crushed) and to compare these with dinoprostone gel, oxytocin, and spontaneous labor. METHODS: This retrospective cohort study included 519 women at term who had labor induced and 86 women at term in spontaneous labor. Induction agents included misoprostol, dinoprostone, or oxytocin...
June 2001: Obstetrics and Gynecology
C A Wong, B M Scavone, M Loffredi, W Y Wang, A M Peaceman, J N Ganchiff
BACKGROUND: Regional analgesia for labor often is initiated with an intrathecal injection of a local anesthetic and opioid. The purpose of this prospective, randomized, blinded study was to determine the optimal dose of intrathecal sufentanil when combined with 2.5 mg bupivacaine for labor analgesia. METHODS: One hundred seventy parous parturients with cervical dilation between 3-5 cm were randomized to receive intrathecal 0 (control), 2.5, 5.0, 7.5, or 10.0 microg sufentanil combined with 2...
June 2000: Anesthesiology
Z Wang, W Li, W Ouyang, Y Ding, F Wang, L Xu, X Su
To evaluate the safety and efficacy of intravaginal misoprostol for cervical ripening in the third trimester, a randomized, double-blind, placebo-controlled trial was conducted in 85 patients indicated for induction of labor and with unfavorable cervices. They were randomly assigned to receive either intravaginal misoprostol (100 mg) or placebo placed in the posterior vaginal fornix. The Bishop score, fetal heart rate and Doppler blood flow velocity waveforms were measured before and 12 h after drug administration...
1998: Journal of Tongji Medical University, Tong Ji Yi Ke da Xue Xue Bao
M R Tremlett, P J Kelly, J Parkins, D Hughes, N Redfern
In this study, we have compared two different doses of clonidine (bolus of 25 micrograms and infusion of 19 micrograms h-1; bolus of 50 micrograms and infusion of 37 micrograms h-1, both added to 0.03% bupivacaine) with a control group of 0.03% bupivacaine alone. The study was performed in a randomized, double-blind manner, and a total of 45 patients were studied. Both clonidine regimens resulted in marked local anaesthetic sparing, with no change in the quality of analgesia. There was no difference in the severity of lower limb motor weakness and no difference in maternal sedation, although only a small number of patients were studied...
August 1999: British Journal of Anaesthesia
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