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Intrapartum fetal monitoring

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https://www.readbyqxmd.com/read/29201670/coexistent-circumvallate-placenta-and-battledore-insertion-of-umbilical-cord-resulting-in-grave-obstetric-outcome-a-case-report
#1
Nalini Sharma, Rituparna Das, Sushila Salam, Roma Jethani, Ahanthem Santa Singh
Background: Various placental and cord abnormalities have been known to adversely affect the obstetric outcome. Circumvallate placenta and Battledore insertion of the umbilical cord are both rare and known to be associated with poor obstetric outcome individually. Case Presentation: In this case report, the woman presented at 8 months of gestation with preeclampsia with IUFD to North Easter Indira Gandhi Regional Institute of Health and Medical Science Shillong on 22/7/16 and delivered a macerated fetus vaginally...
October 2017: Journal of Reproduction & Infertility
https://www.readbyqxmd.com/read/29096560/a-novel-modality-for-intrapartum-fetal-heart-rate-monitoring
#2
Eran Ashwal, Shiri Shinar, Amir Aviram, Sharon Orbach, Yariv Yogev, Liran Hiersch
BACKGROUND: Intrapartum fetal heart rate (FHR) monitoring is well recommended during labor to assess fetal wellbeing. Though commonly used, the external Doppler and fetal scalp electrode monitor have significant shortcomings. Lately, non-invasive technologies were developed as possible alternatives. OBJECTIVE: The objective of this study is to compare the accuracy of FHR trace using novel Electronic Uterine Monitoring (EUM) to that of external Doppler and fetal scalp electrode monitor...
November 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29078943/update-on-fetal-monitoring-overview-of-approaches-and-management-of-category-ii-tracings
#3
REVIEW
Nandini Raghuraman, Alison G Cahill
Electronic fetal monitoring (EFM) is widely used to assess fetal status in labor. Use of intrapartum continuous EFM is associated with a lower risk of neonatal seizures but a higher risk of cesarean or operative delivery. Category II fetal heart tracings (FHTs) are indeterminate in their ability to predict fetal acidemia. Certain patterns of decelerations and variability within this category may be predictive of neonatal morbidity. Adjunct tests of fetal well-being can be used during labor to further triage patients...
December 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29049070/noninfectious-fever-in-the-near-term-pregnant-rat-induces-fetal-brain-inflammation-a-model-for-the-consequences-of-epidural-associated-maternal-fever
#4
Scott Segal, Carlo Pancaro, Iwona Bonney, James E Marchand
BACKGROUND: Women laboring with epidural analgesia experience fever much more frequently than do women who chose other forms of analgesia, and maternal intrapartum fever is associated with numerous adverse consequences, including brain injury in the fetus. We developed a model of noninfectious inflammatory fever in the near-term pregnant rat to simulate the pathophysiology of epidural-associated fever and hypothesized that it would produce fetal brain inflammation. METHODS: Twenty-four pregnant Sprague-Dawley rats were studied at 20 days gestation (term: 22 days)...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28851241/obesity-s-impact-on-intrapartum-electronic-fetal-monitoring
#5
Brian Brocato, David Lewis, Madhuri Mulekar, Susan Baker
OBJECTIVE: The objective of this study is to evaluate the impact maternal obesity has on the percentage of unmonitored electronic fetal monitoring (EFM). STUDY DESIGN: Women undergoing induction of labor at term were categorized into three groups: Group 1 (body mass index (BMI) < 30 kg/m2), Group 2 (30 < BMI < 40 kg/m2), and Group 3 (BMI ≥ 40 kg/m2). External EFM tracings were reviewed from the time of induction of labor until amniotomy; the percentage of time off of EFM was calculated...
September 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28832100/consensus-on-use-of-insulins-in-gestational-diabetes
#6
Kalyan Kumar Gangopadhyay, J J Mukherjee, R K Sahay
INTRODUCTION: Gestational Diabetes Mellitus (GDM), diabetes diagnosed during pregnancy is associated with maternal (caesarean delivery, hypoglycaemia, hyperbilirubinaemia, shoulder dystocia, pre-term delivery and birth trauma) and fetal (Hyperbilirubinaemia in offspring, Neonatal hypoglycaemia, Macrosomia) complications. Despite, insulin being the standard treatment for GDM cases, there is no existing comprehensive consensus update on use of insulin in Indian patients with GDM. OBJECTIVE: To provide simple and easily implementable guidelines to healthcare physicians on use of insulin in GDM...
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28800671/-outcomes-of-planned-out-of-hospital-and-low-risk-hospital-births-in-lower-saxony
#7
Antje Petersen, Lea-Marie Köhler, Christiane Schwarz, Bernhard Vaske, Mechthild M Gross
Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28780500/perinatal-risk-factors-for-neonatal-encephalopathy-an-unmatched-case-control-study
#8
Cally J Tann, Margaret Nakakeeto, Barbara A Willey, Margaret Sewegaba, Emily L Webb, Ibby Oke, Emmanuel Derek Mutuuza, Donald Peebles, Margaret Musoke, Kathryn A Harris, Neil J Sebire, Nigel Klein, Jennifer J Kurinczuk, Alison M Elliott, Nicola J Robertson
OBJECTIVE: Neonatal encephalopathy (NE) is the third leading cause of child mortality. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. This study examined perinatal risks factor for NE in Uganda. DESIGN: Unmatched case-control study. SETTING: Mulago National Referral Hospital, Kampala, Uganda. METHODS: 210 term infants with NE and 409 unaffected term infants as controls were recruited over 13 months...
August 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28707059/a-prospective-cohort-study-on-the-prediction-of-fetal-distress-and-neonatal-status-with-arterial-and-venous-doppler-measurements-in-appropriately-grown-term-fetuses
#9
Ihsan Atabay, Semir Kose, Erkan Cagliyan, Bora Baysal, Ebru Yucesoy, Sabahattin Altunyurt
PURPOSE: To assess the predictive power of the cerebro-placental ratio (CPR) and the venous-arterial index (VAI) for the development of intrapartum fetal distress (FD) and neonatal intensive care unit (NICU) admission. METHODS: Fetal umbilical artery, middle cerebral artery and umbilical vein Doppler measurements were obtained before the active phase of labor in 311 singleton pregnancies at ≥37 weeks. A continuous electronic fetal monitorization was applied, and an umbilical cord blood sample was obtained for each participant...
October 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28681500/continuous-support-for-women-during-childbirth
#10
REVIEW
Meghan A Bohren, G Justus Hofmeyr, Carol Sakala, Rieko K Fukuzawa, Anna Cuthbert
BACKGROUND: Historically, women have generally been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has often become the exception rather than the routine. OBJECTIVES: The primary objective was to assess the effects, on women and their babies, of continuous, one-to-one intrapartum support compared with usual care, in any setting. Secondary objectives were to determine whether the effects of continuous support are influenced by:1...
July 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28668289/foley-catheterisation-versus-oral-misoprostol-for-induction-of-labour-in-hypertensive-women-in-india-inform-a-multicentre-open-label-randomised-controlled-trial
#11
Shuchita Mundle, Hillary Bracken, Vaishali Khedikar, Jayashree Mulik, Brian Faragher, Thomas Easterling, Simon Leigh, Paul Granby, Alan Haycox, Mark A Turner, Zarko Alfirevic, Beverly Winikoff, Andrew D Weeks
BACKGROUND: Between 62 000 and 77 000 women die annually from pre-eclampsia and eclampsia. Prompt delivery, preferably by the vaginal route, is vital for good maternal and neonatal outcomes. Two low-cost interventions-low-dose oral misoprostol tablets and transcervical Foley catheterisation-are already used in low-resource settings. We aimed to compare the relative risks and benefits of these interventions. METHODS: We undertook this multicentre, open-label, randomised controlled trial in two public hospitals in Nagpur, India...
August 12, 2017: Lancet
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#12
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13 (T13) or 18 (T18) and compare these between maternal-fetal medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents and compare those of MFM practitioners with non-MFM providers...
July 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28595604/functionality-and-acceptability-of-a-wireless-fetal-heart-rate-monitoring-device-in-term-pregnant-women-in-rural-southwestern-uganda
#13
Godfrey R Mugyenyi, Esther C Atukunda, Joseph Ngonzi, Adeline Boatin, Blair J Wylie, Jessica E Haberer
BACKGROUND: Over 3 million stillbirths occur annually in sub Saharan Africa; most occur intrapartum and are largely preventable. The standard of care for fetal heart rate (FHR) assessment in most sub-Saharan African settings is a Pinard Stethoscope, limiting observation to one person, at one point in time. We aimed to test the functionality and acceptability of a wireless FHR monitor that could allow for expanded monitoring capacity in rural Southwestern Uganda. METHODS: In a mixed method prospective study, we enrolled 1) non-laboring healthy term pregnant women to wear the device for 30 min and 2) non-study clinicians to observe its use...
June 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28591756/the-fetal-reserve-index-re-engineering-the-interpretation-and-responses-to-fetal-heart-rate-patterns
#14
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: Electronic fetal monitoring (EFM) correlates poorly with neonatal outcome. We present a new metric: the "Fetal Reserve Index" (FRI), formally incorporating EFM with maternal, obstetrical, fetal risk factors, and excessive uterine activity for assessment of risk for cerebral palsy (CP). METHODS: We performed a retrospective, case-control series of 50 term CP cases with apparent intrapartum neurological injury and 200 controls. All were deemed neurologically normal on admission...
June 8, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28526449/predictors-of-vaginal-delivery-in-medically-indicated-early-preterm-induction-of-labor
#15
Rachel A Sievert, Spencer G Kuper, Victoria C Jauk, Melissa Parrish, Joseph R Biggio, Lorie M Harper
BACKGROUND: When delivery is indicated prior to 34 weeks, many providers perform a cesarean delivery rather than induce labor based on perceptions of a high failure rate. Given the morbidity of cesarean delivery, an accurate estimate of the success rate and factors associated with success in preterm induction of labor is important in management decisions. OBJECTIVE: We sought to develop a prediction model for successful induction of labor in preterm patients using factors known at the time the decision is made to deliver...
September 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28403965/understanding-fetal-physiology-and-second-line-monitoring-during-labor
#16
REVIEW
C Garabedian, J De Jonckheere, L Butruille, P Deruelle, L Storme, V Houfflin-Debarge
Cardiotocography (CTG) is a technique used to monitor intrapartum fetal condition and is one of the most common obstetric procedures. Second line methods of fetal monitoring have been developed in an attempt to reduce unnecessary interventions due to continuous cardiotocography and to better identify fetuses at risk of intrapartum asphyxia. The acid-base balance of the fetus is evaluated by fetal blood scalp samples, the modification of the myocardial oxygenation by the fetal ECG ST-segment analysis (STAN) and the autonomic nervous system by the power spectral analysis of the fetal heart variability...
February 2017: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/28392944/monitoring-fetal-heart-rate-during-labor-a-comparison-of-three-methods
#17
COMPARATIVE STUDY
Tammy Y Euliano, Shalom Darmanjian, Minh Tam Nguyen, John D Busowski, Neil Euliano, Anthony R Gregg
The purpose of the study was to compare the accuracy of a noninvasive fetal heart rate monitor with that of ultrasound, using a fetal scalp electrode as the gold standard, in laboring women of varying body habitus, throughout labor and delivery. Laboring women requiring fetal scalp electrode were monitored simultaneously with the investigational device (noninvasive fetal ECG), ultrasound, and fetal scalp electrode. An algorithm extracted the fetal heart rate from the noninvasive fetal ECG signal. Each noninvasive device recording was compared with fetal scalp electrode with regard to reliability by positive percent agreement and accuracy by root mean squared error...
2017: Journal of Pregnancy
https://www.readbyqxmd.com/read/28369712/computerized-data-driven-interpretation-of-the-intrapartum-cardiotocogram-a-cohort-study
#18
Antoniya Georgieva, Christopher W G Redman, Aris T Papageorghiou
INTRODUCTION: Continuous intrapartum fetal monitoring remains a significant clinical challenge. We propose using cohorts of routinely collected data. We aim to combine non-classical (data-driven) and classical cardiotocography features with clinical features into a system (OxSys), which generates automated alarms for the fetus at risk of intrapartum hypoxia. We hypothesize that OxSys can outperform clinical diagnosis of "fetal distress", when optimized and tested over large retrospective data sets...
July 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28350703/rf-safety-analysis-of-a-novel-ultra-wideband-fetal-monitoring-system
#19
Jerrold T Bushberg, J Paul Tupin
The LifeWave Ultra-Wideband RF sensor (LWUWBS) is a monitoring solution for a variety of physiologic assessment applications, including maternal fetal monitoring in both the antepartum and intrapartum periods. The system uses extremely low power radio frequency (RF) ultra-wide band (UWB) signals to provide continuous fetal heart rate and contractions monitoring during labor and delivery. Even with the incorporation of three very conservative assumptions, (1) concentration of the RF energy in 1 cm, (2) minimal (2...
May 2017: Health Physics
https://www.readbyqxmd.com/read/28341515/computerised-interpretation-of-fetal-heart-rate-during-labour-infant-a-randomised-controlled-trial
#20
(no author information available yet)
BACKGROUND: Continuous electronic fetal heart-rate monitoring is widely used during labour, and computerised interpretation could increase its usefulness. We aimed to establish whether the addition of decision-support software to assist in the interpretation of cardiotocographs affected the number of poor neonatal outcomes. METHODS: In this unmasked randomised controlled trial, we recruited women in labour aged 16 years or older having continuous electronic fetal monitoring, with a singleton or twin pregnancy, and at 35 weeks' gestation or more at 24 maternity units in the UK and Ireland...
April 29, 2017: Lancet
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