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Electronic fetal monitoring

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https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#1
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...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28619702/computerized-childbirth-monitoring-tools-for-health-care-providers-managing-labor-a-scoping-review
#2
Michael S Balikuddembe, Nazarius M Tumwesigye, Peter K Wakholi, Thorkild Tylleskär
BACKGROUND: Proper monitoring of labor and childbirth prevents many pregnancy-related complications. However, monitoring is still poor in many places partly due to the usability concerns of support tools such as the partograph. In 2011, the World Health Organization (WHO) called for the development and evaluation of context-adaptable electronic health solutions to health challenges. Computerized tools have penetrated many areas of health care, but their influence in supporting health staff with childbirth seems limited...
June 15, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28591756/the-fetal-reserve-index-re-engineering-the-interpretation-and-responses-to-fetal-heart-rate-patterns
#3
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/28562129/fetal-response-to-intramuscular-epinephrine-for-anaphylaxis-during-maternal-penicillin-desensitization-for-secondary-syphilis
#4
Shan Shan Wu, Tina Abraham, Chelsea Michaud, Brian Peppers, Andrea Ward, Stacey Ehrenberg Buchner, Catalina V Teba, Haig Tcheurekdjian, Robert Hostoffer, Devi Jhaveri
Penicillin desensitization is indicated in pregnant patients with severe allergies to penicillin with syphilis. The immediate effects of intramuscular epinephrine on the fetus during desensitization remain unreported. We describe a pregnant patient with secondary syphilis and penicillin allergy who developed anaphylaxis during penicillin desensitization. Anaphylaxis resolved after administration of intramuscular epinephrine. Throughout the procedure, continuous electronic fetal monitoring showed a stable fetus without a decrease in variability, tachycardia, decelerations or signs of fetal distress...
May 31, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28341515/computerised-interpretation-of-fetal-heart-rate-during-labour-infant-a-randomised-controlled-trial
#5
(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
https://www.readbyqxmd.com/read/28301895/association-of-fetal-heart-rate-baseline-change-and-neonatal-outcomes
#6
Michael Yang, Molly J Stout, Julia D López, Ryan Colvin, George A Macones, Alison G Cahill
Objective The objective of this study was to describe the incidence of baseline change within normal range during labor and its prediction of neonatal outcomes. Materials and Methods This was a prospective cohort of singleton, nonanomalous, term neonates with continuous electronic fetal monitoring and normal baseline fetal heart rate throughout the last 2 hours of labor. We determined baseline in 10-minute segments using Eunice Kennedy Shriver National Institute of Child Health and Human Development criteria...
March 16, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#7
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#8
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28125772/cardiotocography-versus-intermittent-auscultation-of-fetal-heart-on-admission-to-labour-ward-for-assessment-of-fetal-wellbeing
#9
REVIEW
Declan Devane, Joan G Lalor, Sean Daly, William McGuire, Anna Cuthbert, Valerie Smith
BACKGROUND: The admission cardiotocograph (CTG) is a commonly used screening test consisting of a short (usually 20 minutes) recording of the fetal heart rate (FHR) and uterine activity performed on the mother's admission to the labour ward. This is an update of a review published in 2012. OBJECTIVES: To compare the effects of admission cardiotocography with intermittent auscultation of the FHR on maternal and infant outcomes for pregnant women without risk factors on their admission to the labour ward...
January 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28121831/committee-opinion-no-687-approaches-to-limit-intervention-during-labor-and-birth
#10
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28121830/committee-opinion-no-687-summary-approaches-to-limit-intervention-during-labor-and-birth
#11
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27908902/electronic-fetal-monitoring-cerebral-palsy-and-caesarean-section-assumptions-versus-evidence
#12
Karin B Nelson, Thomas P Sartwelle, Dwight J Rouse
No abstract text is available yet for this article.
December 1, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27810967/electronic-fetal-monitoring-are-we-asking-the-correct-questions
#13
EDITORIAL
Max Wiznitzer
No abstract text is available yet for this article.
November 3, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27794572/the-value-of-the-cerebroplacental-ratio-for-the-prediction-of-intrapartum-fetal-monitoring-in-low-risk-term-pregnancies
#14
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/27751795/the-limits-of-electronic-fetal-heart-rate-monitoring-in-the-prevention-of-neonatal-metabolic-acidemia
#15
Steven L Clark, Emily F Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training, and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: The purpose of this study was to validate a recently published algorithm for the management of category II fetal heart rate tracings, to examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring, and to examine critically the limits of electronic fetal heart rate monitoring in the prevention of neonatal metabolic acidemia...
February 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27585242/nuchal-cord-is-it-really-the-silent-risk-of-pregnancy
#16
Hatice Akkaya, Barış Büke, Meryem Kuru Pekcan, Kıvanç Şahin, Gülsüm Uysal, Gülin Feykan Yeğin, Ayşe Filiz Avşar, Fulya Çağlı
OBJECTIVE: To evaluate the relationship between entanglement of umbilical cord around the fetal neck and adverse perinatal outcomes. METHODS: In this prospective cohort study, perinatal outcomes of 218 pregnancies complicated with nuchal cord (NC) (study group) were compared with 190 uncomplicated pregnancies (control group). Main outcome measures were umbilical cord pH values, APGAR scores and cesarean section (C/S) rates. Fetal distress was stated as an abnormal heart rate pattern on electronic fetal heart monitorization...
September 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27565450/electronic-fetal-monitoring-and-cesarean-birth-a-scoping-review
#17
REVIEW
Mary T Paterno, Kathleen McElroy, Mary Regan
BACKGROUND: In many United States hospitals, electronic fetal monitoring (EFM) is used continuously during labor for all patients regardless of risk status. Application of EFM, particularly at labor admission, may trigger a chain of interventions resulting in increased risk for cesarean birth among low-risk women. The goal of this review was to summarize evidence on use of EFM during low-risk labors and identify gaps in research. METHODS: We conducted a scoping review of studies published in English since 1996 that addressed the relationship between EFM use and cesarean among low-risk women...
December 2016: Birth
https://www.readbyqxmd.com/read/27520600/patient-safety-implications-of-electronic-alerts-and-alarms-of-maternal-fetal-status-during-labor
#18
REVIEW
Kathleen Rice Simpson, Audrey Lyndon, Leigh Ann Davidson
When nurses care for women during labor, they encounter numerous alerts and alarms from electronic fetal monitors and their surveillance systems. Notifications of values of physiologic parameters for a woman and fetus that may be outside preset limits are generated via visual and audible cues. There is no standardization of these alert and alarm parameters among electronic fetal monitoring vendors in the United States, and there are no data supporting their sensitivity and specificity. Agreement among professional organizations about physiologic parameters for alerts and alarms commonly used during labor is lacking...
August 2016: Nursing for Women's Health
https://www.readbyqxmd.com/read/27465461/the-more-things-change-the-more-they-stay-the-same-thirty-years-of-fetal-monitoring-in-perspective
#19
Lisa A Miller
Thirty years ago, the inaugural issue of The Journal of Perinatal & Neonatal Nursing was published and the entire perinatal portion of the journal was devoted to electronic fetal monitoring (EFM). This article provides a historical perspective on EFM in perinatal care since the 1980s by exploring the similarities and differences of the state of the science presented in that first issue. Both EFM and intermittent auscultation are discussed.
July 2016: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/27445252/neurological-fallacies-leading-to-malpractice-a-case-studies-approach
#20
REVIEW
James C Johnston, Knut Wester, Thomas P Sartwelle
A young woman presents with an intracranial arachnoid cyst. Another is diagnosed with migraine headache. An elderly man awakens with a stroke. And a baby delivered vaginally after 2 hours of questionable electronic fetal monitoring patterns grows up to have cerebral palsy. These seemingly disparate cases share a common underlying theme: medical myths. Myths that may lead not only to misdiagnosis and treatment harms but to seemingly never-ending medical malpractice lawsuits, potentially culminating in a settlement or judgment against an unsuspecting neurologist...
August 2016: Neurologic Clinics
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