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Electronic fetal monitoring

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https://www.readbyqxmd.com/read/29761960/-research-on-algorithms-of-uterine-contraction-curve-analysis-and-its-real-time-status-identification
#1
Gaochao Liu, Yaosheng Lu, Zidong Lin, Lirui Guo, Xiaodong Li
Identification of real-time uterine contraction status is very significant to labor analgesia, but the traditional uterine contraction analysis algorithms and systems cannot meet the requirement. According to the situations mentioned above, this paper designs a set of algorithms for the real-time analysis of uterine contraction status. The algorithms include uterine contraction signal preprocessing, uterine contraction baseline extraction based on histogram and linear iteration and an algorithm for the real-time analysis of uterine contraction status based on finite state machines theory...
October 1, 2017: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
https://www.readbyqxmd.com/read/29758955/fetal-heart-rate-monitoring-device-using-condenser-microphone-sensor-validation-and-comparison-to-standard-devices
#2
Husna Azyan Binti Ahmad, Ismail M El-Badawy, Om Prakash Singh, Rozana Binti Hisham, M B Malarvili
BACKGROUND: Fetal heart rate (FHR) monitoring device is highly demanded to assess the fetus health condition in home environments. Conventional standard devices such as ultrasonography and cardiotocography are expensive, bulky and uncomfortable and consequently not suitable for long-term monitoring. Herein, we report a device that can be used to measure fetal heart rate in clinical and home environments. METHODS: The proposed device measures and displays the FHR on a screen liquid crystal display (LCD)...
April 27, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#3
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29683307/maternity-care-update-labor-and-delivery
#4
Andrew Smith, Wendy B Barr, Erin Bassett-Novoa, Nicholas LeFevre
Labor is defined as contractions with cervical change and active labor starts when the cervix is dilated 6 cm. Updated labor curves and definitions should be used to define labor dystocia. Oxytocin and amniotomy have important roles in the management of labor dystocia. Structured intermittent fetal monitoring should be considered for women with low-risk pregnancies but continuous electronic fetal monitoring still is used most commonly. Moderate fetal heart rate variability is the most reliable marker of fetal well-being...
April 2018: FP Essentials
https://www.readbyqxmd.com/read/29680084/no-197b-fetal-health-surveillance-intrapartum-consensus-guideline
#5
Robert Liston, Diane Sawchuck, David Young
OBJECTIVE: This guideline provides new recommendations pertaining to the application and documentation of fetal surveillance in the intrapartum period that will decrease the incidence of birth asphyxia while maintaining the lowest possible rate of obstetrical intervention. Pregnancies with and without risk factors for adverse perinatal outcomes are considered. This guideline presents an alternative classification system for antenatal fetal non-stress testing and intrapartum electronic fetal surveillance to what has been used previously...
April 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29673052/continuous-electronic-fetal-heart-rate-monitoring-in-labour-is-a-screening-test-not-a-diagnostic-test
#6
P J Steer
There has been controversy about the value of continuous electronic fetal heart rate recording ever since it was introduced in the 1960s. Frey et al (BJOG 2018 in this issue) assessed the relationship of abnormal fetal heart rate (FHR) patterns in labour with neonatal encephalopathy. The authors say "139 (of 342) women had no FHR tracing data within 60 minutes of delivery. This article is protected by copyright. All rights reserved.
April 19, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29626979/placental-exosomes-profile-in-maternal-and-fetal-circulation-in-intrauterine-growth-restriction-liquid-biopsies-to-monitoring-fetal-growth
#7
Jezid Miranda, Cristina Paules, Soumyalekshmi Nair, Andrew Lai, Carlos Palma, Katherin Scholz-Romero, Gregory E Rice, Eduard Gratacos, Fatima Crispi, Carlos Salomon
INTRODUCTION: Placenta-derived exosomes may represent an additional pathway by which the placenta communicates with the maternal system to induce maternal vascular adaptations to pregnancy and it may be affected during Fetal growth restriction (FGR). The objective of this study was to quantify the concentration of total and placenta-derived exosomes in maternal and fetal circulation in small fetuses classified as FGR or small for gestational age (SGA). METHODS: Prospective cohort study in singleton term gestations including 10 normally grown fetuses and 20 small fetuses, sub-classified into SGA and FGR accordingly to birth weight (BW) percentile and fetoplacental Doppler...
April 2018: Placenta
https://www.readbyqxmd.com/read/29621921/temporal-and-quantitative-associations-of-electronic-fetal-heart-rate-monitoring-patterns-and-neonatal-outcomes-%C3%A2
#8
Dotun Ogunyemi, Andrew Jovanovski, Perry Friedman, Brittany Sweatman, Ichchha Madan
OBJECTIVE: The objective of this study is to evaluate the associations of electronic fetal heart rate monitoring (EFM) patterns and adverse neonatal outcomes Study design: From 2013 to 2016; 12,067 term, singleton deliveries in labor ≥2 h with abnormal EFM defined as absent accelerations, variable, late or prolonged decelerations, tachycardia, bradycardia, or minimal variability were analyzed as any documentation during labor, in first hour and last hour of labor. Outcomes were composite neonatal adverse outcomes, neonatal intensive care unit (NICU) admission, neonatal hypoxia, neonatal hypoglycemia, umbilical artery pH, and base excess...
April 6, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29577914/the-importance-of-the-learning-process-in-st-analysis-interpretation-and-its-impact-in-improving-clinical-and-neonatal-outcomes
#9
Susanna Timonen, Kaisa Holmberg
BACKGROUND: Intrapartum fetal heart rate (FHR) monitoring was introduced with the goal to reduce fetal hypoxia and deaths. However, continuous FHR monitoring has been shown to have a high sensitivity but also a high false positive rate. To improve specificity, adjunctive technologies have been developed to identify fetuses at risk for intrapartum asphyxia. Intensive research on the value of ST-segment analysis of the fetal electrocardiogram (ECG) as an adjunct to standard electronic fetal monitoring (EFM) in lowering the rates of fetal metabolic acidosis and operative deliveries has been ongoing...
March 22, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29572752/development-of-a-smart-mobile-data-module-for-fetal-monitoring-in-e-healthcare
#10
Agathe Houzé de l'Aulnoit, Samuel Boudet, Michaël Génin, Pierre-François Gautier, Jessica Schiro, Denis Houzé de l'Aulnoit, Régis Beuscart
The fetal heart rate (FHR) is a marker of fetal well-being in utero (when monitoring maternal and/or fetal pathologies) and during labor. Here, we developed a smart mobile data module for the remote acquisition and transmission (via a Wi-Fi or 4G connection) of FHR recordings, together with a web-based viewer for displaying the FHR datasets on a computer, smartphone or tablet. In order to define the features required by users, we modelled the fetal monitoring procedure (in home and hospital settings) via semi-structured interviews with midwives and obstetricians...
March 23, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29527573/continuous-electronic-fetal-monitoring-during-labor-a-critique-and-a-reply-to-contemporary-proponents
#11
REVIEW
Thomas P Sartwelle, James C Johnston
A half century after continuous electronic fetal monitoring (EFM) became the omnipresent standard of care for the vast majority of labors in the developed countries, and the cornerstone for cerebral palsy litigation, EFM advocates still do not have any scientific evidence justifying EFM use in most labors or courtrooms. Yet, these EFM proponents continue rationalizing the procedure with a rhetorical fog of meaningless words, misleading statistics, archaic concepts, and a complete disregard for medical ethics...
January 2018: Surgery Journal
https://www.readbyqxmd.com/read/29489527/implementation-of-an-oxytocin-checklist-to-improve-clinical-outcomes
#12
Courtney Sundin, Lauren Mazac, Kathleen Ellis, Candon Garbo
BACKGROUND: Oxytocin is one of the most common drugs administered in obstetrics. Since its designation as a high-alert medication by the Institute for Safe Medication Practices in 2007, there has been much attention to oxytocin administration during labor. Oxytocin is generally safe when administered correctly, but adverse perinatal outcomes can occur during uterine tachysystole. PURPOSE: The purpose of this project was to evaluate and compare results of maternal and fetal outcomes of induction of labor for women at term prior to and after implementation of a newly developed oxytocin checklist...
May 2018: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29456579/splenic-cyst-as-a-rare-cause-of-fetal-abdominal-cystic-mass-a-multicenter-series-of-nine-cases-and-review-of-the-literature
#13
Waldo Sepulveda, Jose H Ochoa, Daniel Cafici, Amy E Wong, Federico Badano, Elena Andreeva, Elena Y Andreeva
Introduction: Congenital splenic cysts are a rare cause of abdominal cystic masses in the fetus. We describe nine cases of this condition, the largest reported experience to date. A review of the literature for similar cases was also performed. Methods: Cases of congenital splenic cyst were collected from three prenatal diagnostic centers and from a dedicated website of prenatal diagnosis. Information regarding clinical and sonographic findings was obtained by reviewing ultrasound reports and medical records...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/29447043/re-engineering-the-interpretation-of-electronic-fetal-monitoring-to-identify-reversible-risk-for-cerebral-palsy-a-case-control-series
#14
Mark I Evans, Robert D Eden, David W Britt, Shara M Evans, Barry S Schifrin
BACKGROUND: Even key opinion leaders now concede that electronic fetal monitoring (EFM) cannot reliably identify fetal acidemia which many vouch as the only labor mediated pathophysiologic precursor for cerebral palsy (CP). We have developed the "Fetal Reserve Index" - an algorithm combining five dynamic components of EFM (1. Rate, 2. Variability, 3. Accelerations, 4. Decelerations, and 5. Excessive uterine activity) considered individually that are combined with the presence of: 6...
February 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29437032/computerised-interpretation-of-the-fetal-heart-rate-during-labour-a-randomised-controlled-trial-infant
#15
Peter Brocklehurst, David Field, Keith Greene, Edmund Juszczak, Sara Kenyon, Louise Linsell, Chris Mabey, Mary Newburn, Rachel Plachcinski, Maria Quigley, Philip Steer, Liz Schroeder, Oliver Rivero-Arias
BACKGROUND: Continuous electronic fetal monitoring (EFM) in labour is widely used and computerised interpretation has the potential to increase its utility. OBJECTIVES: This trial aimed to find out whether or not the addition of decision support software to assist in the interpretation of the cardiotocograph (CTG) reduced the number of poor neonatal outcomes, and whether or not it was cost-effective. DESIGN: Two-arm individually randomised controlled trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29425167/-i-was-relieved-to-know-that-my-baby-was-safe-women-s-attitudes-and-perceptions-on-using-a-new-electronic-fetal-heart-rate-monitor-during-labor-in-tanzania
#16
Sara Rivenes Lafontan, Johanne Sundby, Hege L Ersdal, Muzdalifat Abeid, Hussein L Kidanto, Columba K Mbekenga
To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively...
February 9, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29408586/a-prospective-cohort-study-of-fetal-heart-rate-monitoring-deceleration-area-is-predictive-of-fetal-acidemia
#17
Alison G Cahill, Methodius G Tuuli, Molly J Stout, Julia D López, George A Macones
BACKGROUND: Intrapartum electronic fetal monitoring is the most commonly used tool in obstetrics in the United States; however, which electronic fetal monitoring patterns predict acidemia remains unclear. OBJECTIVE: This study was designed to describe the frequency of patterns seen in labor using modern nomenclature, and to test the hypothesis that visually interpreted patterns are associated with acidemia and morbidities in term infants. We further identified patterns prior to delivery, alone or in combination, predictive of acidemia and neonatal morbidity...
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29349772/does-the-use-of-diagnostic-technology-reduce-fetal-mortality
#18
Jostein Grytten, Irene Skau, Rune Sørensen, Anne Eskild
OBJECTIVE: To examine the effect that the introduction of new diagnostic technology in obstetric care has had on fetal death. DATA SOURCE: The Medical Birth Registry of Norway provided detailed medical information for approximately 1.2 million deliveries from 1967 to 1995. Information about diagnostic technology was collected directly from the maternity units, using a questionnaire. STUDY DESIGN: The data were analyzed using a hospital fixed-effects regression with fetal mortality as the outcome measure...
January 19, 2018: Health Services Research
https://www.readbyqxmd.com/read/29329576/spontaneous-prematurity-in-fetuses-with-congenital-diaphragmatic-hernia-a-retrospective-cohort-study-about-prenatal-predictive-factors
#19
Bruna Maria Lopes Barbosa, Agatha S Rodrigues, Mario Henrique Burlacchini Carvalho, Roberto Eduardo Bittar, Rossana Pulcineli Vieira Francisco, Lisandra Stein Bernardes
BACKGROUND: To evaluate possible predictive factors of spontaneous prematurity in fetuses with congenital diaphragmatic hernia (CDH). METHODS: A retrospective cohort study was performed. Inclusion criteria were presence of CDH; absence of fetoscopy; absence of karyotype abnormality; maximum of one major malformation associated with diaphragmatic hernia; ultrasound monitoring at the Obstetrics Clinic of Clinicas Hospital at the University of São Paulo School of Medicine, from January 2001 to October 2014...
January 12, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29258525/advancing-perinatal-patient-safety-through-application-of-safety-science-principles-using-health-it
#20
Jennifer Webb, Asta Sorensen, Samantha Sommerness, Beth Lasater, Kamila Mistry, Leila Kahwati
BACKGROUND: The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety. METHODS: Semi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality's (AHRQ's) Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation...
December 19, 2017: BMC Medical Informatics and Decision Making
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