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Intrapartum fetal monitoring

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https://www.readbyqxmd.com/read/27886948/variation-in-hospital-intrapartum-practices-and-association-with-cesarean-rate
#1
Lisbet S Lundsberg, Jessica L Illuzzi, Aileen M Gariepy, Sangini S Sheth, Christian M Pettker, Henry C Lee, Heather S Lipkind, Xiao Xu
OBJECTIVE: To examine hospital variation in intrapartum care and its relationship with cesarean rates. DESIGN: Cross-sectional survey. SETTING: Connecticut and Massachusetts hospitals providing obstetric services. PARTICIPANTS: Nurse managers or other clinical staff knowledgeable about intrapartum care. METHODS: We assessed labor and birth unit capacity and staffing, fetal monitoring, labor management, intrapartum interventions, newborn care, quality assurance, and performance review practices...
November 22, 2016: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/27825311/criteria-based-audit-to-improve-quality-of-care-of-foetal-distress-standardising-obstetric-care-at-a-national-referral-hospital-in-a-low-resource-setting-tanzania
#2
Andrew H Mgaya, Helena Litorp, Hussein L Kidanto, Lennarth Nyström, Birgitta Essén
BACKGROUND: In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. METHODS: During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited...
November 8, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27794572/the-value-of-the-cerebroplacental-ratio-for-the-prediction-of-intrapartum-fetal-monitoring-in-low-risk-term-pregnancies
#3
Jing Liu, Guang Song, Ge Zhao, Tao Meng
AIM: The study aimed to investigate the use of fetal cerebroplacental ratio (CPR) to identify fetuses at high risk before labor due to the brain sparing phenomenon. MATERIALS AND METHODS: Four hundred and seventy-six singleton pregnancies were enrolled in this study. The CPR was recorded within 1 week of delivery and labor was managed according to local protocols and guidelines. Intrapartum and neonatal outcome details were recorded. RESULTS: The CPR values of fetuses subsequently presenting category III intrapartum electronic fetal monitoring (EFM) or category II EFM without improvement (category IIB EFM) or with progression to category III (category IIC EFM) were significantly lower...
October 29, 2016: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/27769196/cardiotocography-in-breech-versus-vertex-delivery-an-examiner-blinded-cross-sectional-nested-case-control-study
#4
Elli Toivonen, Outi Palomäki, Heini Huhtala, Jukka Uotila
BACKGROUND: The safety of vaginal breech delivery has been debated for decades. Although it has been shown to predispose infants to immediate depression, several observational studies have also shown that attempting vaginal breech delivery does not increase perinatal morbidity or low Apgar score at the age of five minutes. Cardiotocography monitoring is recommended during vaginal breech delivery, but comparative data describing differences between cardiotocography tracings in breech and vertex deliveries is scarce...
October 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27734746/why-stan-might-not-be-dead
#5
Serena Xodo, Gabriele Saccone, Ewoud Schuit, Isis Amer-Wåhlin, Vincenzo Berghella
Recently, a meta-analysis, including 26,526 laboring vertex singletons at term, summarized all available level-1 data from six high-quality randomized clinical trials on the use of ST analysis (STAN) during labor as an adjunct to conventional intrapartum fetal heart rate monitoring. The meta-analysis showed that STAN did not improve perinatal outcomes or decrease cesarean deliveries. Nonetheless there are still reasons to believe STAN may have a role in the future research on intrapartum fetal monitoring. Out of six trials included in the meta-analysis, two included all cephalic singletons in labor, and four enrolled only high-risk pregnant women...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27684833/use-of-the-glidescope-video-laryngoscope-for-intubation-during-ex-utero-intrapartum-treatment-in-a-fetus-with-a-giant-cyst-of-the-4th-branchial-cleft-a-case-report
#6
Sung Hye Byun, So Young Lee, Seong Yeon Hong, Taeha Ryu, Baek Jin Kim, Jin Yong Jung
INTRODUCTION: In fetuses who are predicted to be at risk of catastrophic airway obstruction at delivery, the ex utero intrapartum treatment (EXIT) procedure is useful for securing the fetal airway while maintaining fetal oxygenation via placental circulation. Factors, including poor posture of the fetus and physician, narrow visual field, and issues of contamination in the aseptic surgical field, make fetal intubation during the EXIT procedure difficult. Herein, we report our experience of the usefulness of the GlideScope video laryngoscope (GVL) for intubation during the EXIT procedure...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27651624/admission-cardiotocography-a-predictor-of-neonatal-outcome
#7
Vishnu Bhartiya, Richa Sharma, Anand Kumar, Himsweta Srivastava
BACKGROUND: Screening for fetal distress is a big challenge for obstetricians. Labor admission test by cardiotocography (CTG) can be utilized to differentiate between mothers, in whom continuous fetal monitoring is needed and those who can be managed by intermittent auscultation. Admission CTG is commonly used screening test which aims to identify on admission to the delivery unit the fetus at increased risk of intrapartum hypoxia. We conducted a study to evaluate the efficacy of CTG in low- and high-risk women...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27581467/incidence-of-intrapartum-stillbirth-and-associated-risk-factors-in-tertiary-care-setting-of-nepal-a-case-control-study
#8
Ashish Kc, Johan Wrammert, Uwe Ewald, Robert B Clark, Jageshwor Gautam, Gehanath Baral, Kedar P Baral, Mats Målqvist
BACKGROUND: Each year, 1.2 million intrapartum stillbirths occur globally. In Nepal, about 50 % of the total number of stillbirths occur during the intrapartum period. An understanding of the risk factors associated with intrapartum stillbirth will facilitate the development of preventative strategies to reduce the associated burden of death. This study was conducted in a tertiary-care setting with the aim to identify risk factors associated with intrapartum stillbirth. METHODS: A case-control study was completed from July 2012 to September 2013...
2016: Reproductive Health
https://www.readbyqxmd.com/read/27566222/practice-variation-in-the-management-of-intrapartum-fetal-distress-in-the-netherlands-and-the-western-world
#9
Lauren M Bullens, Suzanne Moors, Pieter J van Runnard Heimel, M Beatrijs van der Hout-van der Jagt, S Guid Oei
OBJECTIVE: Solid evidence on the effect of intrauterine resuscitation on neonatal outcome is limited, and superiority of one intervention over the others is not clear. We therefore surveyed the clinical practice variation in fetal monitoring and the management of fetal distress during labor, in Dutch labor wards. In addition, we have compared recommendations from international guidelines. STUDY DESIGN: We conducted a survey among all 86 Dutch hospitals, using a questionnaire on fetal monitoring and management of fetal distress...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27566218/interobserver-agreement-in-ctg-interpretation-using-the-2015-figo-guidelines-for-intrapartum-fetal-monitoring
#10
Mariana Rei, Sara Tavares, Pedro Pinto, Ana P Machado, Sofia Monteiro, Antónia Costa, Cristina Costa-Santos, João Bernardes, Diogo Ayres-De-Campos
BACKGROUND: Visual analysis of cardiotocographic (CTG) tracings has been shown to be prone to poor intra- and interobserver agreement when several interpretation guidelines are used, and this may have an important impact on the technology's performance. OBJECTIVES: The aim of this study was to evaluate agreement in CTG interpretation using the new 2015 FIGO guidelines on intrapartum fetal monitoring. STUDY DESIGN: A pre-existing database of intrapartum CTG tracings was used to sequentially select 151 cases acquired with a fetal electrode, with duration exceeding 60minutes, and signal loss less than 15%...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27543442/labor-and-birth-care-satisfaction-associated-with-medical-interventions-and-accompaniment-during-labor-among-chilean-women
#11
Fiona Weeks, Loreto Pantoja, Jovita Ortiz, Jennifer Foster, Gabriel Cavada, Lorena Binfa
INTRODUCTION: Satisfaction with care during labor and birth has been associated with various obstetric variables. The purpose of this study was to determine which labor and birth procedures are significant predictors of maternal patient satisfaction in a large cross-sectional sample. METHODS: An observational, cross-sectional study of 1660 women giving birth in Chilean public hospital facilities was conducted from 2012 to 2013. Data were collected from 9 different hospitals in 8 regions of Chile using 2 instruments, including the American College of Nurse-Midwives Intrapartum Care Data Set and a locally validated measure of maternal well-being...
August 20, 2016: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/27542350/inadequate-fetal-heart-rate-monitoring-and-poor-use-of-partogram-associated-with-intrapartum-stillbirth-a-case-referent-study-in-nepal
#12
Ashish Kc, Johan Wrammert, Robert B Clark, Uwe Ewald, Mats Målqvist
BACKGROUND: Newborns are at the greatest risk for dying during the intrapartum period, including labor and delivery, and the first day of life. Fetal heart rate monitoring (FHRM) and partogram use to track labor progress are evidence-based techniques that can help to identify maternal and fetal risk factors so that these can be addressed early. The objective of this study was to assess health worker adherence to protocols for FHRM and partogram use during the intrapartum period, and to assess the association between adherence and intrapartum stillbirth in a tertiary hospital of Nepal...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27539929/does-st-analysis-of-fetal-ecg-reduce-cesarean-section-rate-for-fetal-distress
#13
G Straface, G Scambia, V Zanardo
OBJECTIVE: Each pregravidic, gestational or intrapartum complication may, per se, have a different impact on the operative delivery rate, regardless of wich fetal monitoring system was adopted. We wanted to verify if CTG plus ST interval analysis (STAN) of fetal ECG might be able to reduce the number of operative delivery for fetal distress in high-risk pregnancies compared to low-risk women monitored with CTG alone. MATERIALS AND METHODS: In this cohort study, we evaluated 100 high risk pregnancies consecutively with STAN® S31 (Neoventa Medical, Gotenburg, Sweden) and 160 low risk pregnancies consecutively with continuous CTG (Hewlett Packard, 50 IP)...
August 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27457394/-current-status-and-recommendations-for-intrapartum-monitoring-of-fetal-heart-rate
#14
A Měchurová, P Velebil, L Hruban, P Janků
UNLABELLED: Monitoring of fetal heart rate is one of the basic components of obstetrical care, in which the cardiotocography remains the gold standard and screening method in early diagnosis of fetal hypoxia, even after introduction of other selective methods of intrauterine monitoring of fetal well-being. The review article is divided into several parts: pathophysiology of fetal oxygenation, fetal heart rate and changes of fetal hemodynamics, and rules for fetal heart rate auscultation...
April 2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27190897/evaluation-of-clinical-diagnosis-of-fetal-distress-and-perinatal-outcome-in-a-low-resource-nigerian-setting
#15
Leonard Ogbonna Ajah, Perpetus Chudi Ibekwe, Fidelis Agwu Onu, Ogah Emeka Onwe, Thecla Chinonyelum Ezeonu, Innocent Omeje
INTRODUCTION: Fetal distress has been shown to contribute to the increasing caesarean section rate. There has been controversy on the usefulness of clinical diagnosis of fetal distress using only the intermittent counting of the fetal heart rate and/or passage of meconium-stained liquor. AIM: To evaluate the clinical diagnosis of fetal distress and the perinatal outcome. MATERIALS AND METHODS: This was a retrospective study in which the case records of the patients, who were diagnosed of fetal distress at Federal Teaching Hospital, Abakaliki, Nigeria, from January 1, 2008 to December 31, 2014, were collated...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27182782/high-dose-desflurane-for-tocolysis-during-intrapartum-myelomeningocele-repair-in-a-patient-with-post-adriamycin-cardiomyopathy
#16
Jonathan T Ho, Jeffrey M Feldman
High-dose desflurane is an uncommon need during general anesthesia. At our institution, open fetal surgery cases are managed with high desflurane concentrations to ensure uterine relaxation. We present a case of a 32-year-old parturient with a history of mild cardiomyopathy undergoing open fetal myelomeningocele repair. Phenylephrine and dopamine infusions helped maintain hemodynamic stability at 18% desflurane, while cardiac function was monitored with transthoracic echocardiography. This case is notable for the unknown risk of using high-dose desflurane with a preexisting cardiomyopathy and raises the question of the acceptable maternal risk in the setting of fetal surgery...
July 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27177514/a-study-of-fresh-stillbirths-weighing-2500g-or-more-at-three-academic-hospitals-in-south-africa
#17
Marlene Bothma, Eckhart J Buchmann
OBJECTIVE: To determine the frequency of fresh stillbirths weighing 2500g or more, to assess the risk factors and direct obstetric causes, and to describe avoidable factors in terms of substandard intrapartum management. METHODS: A prospective, cross-sectional, descriptive study was conducted at three obstetric teaching units in Johannesburg, South Africa. Data were consecutively collected for 6months at each of the hospitals, leading to an 18-month data collection period from May 1, 2011, to October 31, 2012...
August 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27140936/what-we-have-learned-about-intrapartum-fetal-monitoring-trials-in-the-mfmu-network
#18
REVIEW
Steven L Bloom, Michael Belfort, George Saade
The vast majority of pregnant women are subjected to electronic fetal heart monitoring during labor. There is limited evidence to support its benefit compared with intermittent auscultation. In addition, there is significant variability in interpretation and its false-positive rate is high. The latter may have contributed to the rise in operative deliveries. In order to address the critical need for better approaches to intrapartum monitoring, the MFMU Network has completed two large multisite randomized trials, one to evaluate fetal pulse oximetry and the other to evaluate fetal ECG ST segment analysis (STAN)...
August 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27098566/does-st-analysis-have-a-place-in-electronic-fetal-monitoring
#19
Tamara L Turnbull, Ben Willem J Mol, Geoff Matthews, Chris Wilkinson, Edwin Chandraharan, Sabrina Kuah
Intrapartum cardiotocography (CTG) has a high false positive rate. This has contributed to the rapid increase in obstetric interventions without a strong improvement in perinatal outcomes. We explore the role of ST analysis (STAN®) as an adjunct to CTG in identifying fetal asphyxia during labour. We conclude that STAN(®) reduces the rate of fetal blood sampling and instrumental vaginal deliveries, and has potential to reduce the number of Australian operative interventions without compromising neonatal outcome...
April 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27063066/corrigendum-to-figo-consensus-guidelines-on-intrapartum-fetal-monitoring-physiology-of-fetal-oxygenation-and-the-main-goals-of-intrapartum-fetal-monitoring-int-j-gynecol-obstet-131-2015-5-8
#20
Diogo Ayres-de-Campos, Sabaratnam Arulkumaran
No abstract text is available yet for this article.
May 2016: International Journal of Gynaecology and Obstetrics
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