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Electronic fetal monitoring

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
Max Wiznitzer
No abstract text is available yet for this article.
November 3, 2016: Journal of Child Neurology
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
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...
October 14, 2016: American Journal of Obstetrics and Gynecology
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
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
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
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
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
Matthew H Loichinger, Autumn J Broady, Kelly Yamasato, Emily Mills, P Gordon McLemore, Dena Towner
OBJECTIVE: Pregnant patients receiving hemodialysis (HD) have long hospital stays for the purpose of electronic fetal monitoring (EFM) during HD, which allows for monitoring of fetal well-being. However, more frequent dialysis allows for smaller fluid shifts, preventing maternal hypotension. Our aim was to determine differences in rates of EFM abnormalities during HD versus non-stress testing (NST) off dialysis for gravid women with renal failure. METHODS: Retrospective cohort study over a 13-year period (2000-2013) identified five patients with renal failure in pregnancy...
July 12, 2016: Journal of Maternal-fetal & Neonatal Medicine
William T Schnettler, Ary L Goldberger, Steven J Ralston, Madalena Costa
BACKGROUND: Visual non-stress test interpretation lacks the optimal specificity and observer-agreement of an ideal screening tool for intrauterine fetal demise (IUFD) syndrome prevention. Computational methods based on traditional heart rate variability have also been of limited value. Complexity analysis probes properties of the dynamics of physiologic signals that are otherwise not accessible and, therefore, might be useful in this context. OBJECTIVE: To explore the association between fetal heart rate (FHR) complexity analysis and subsequent IUFD...
August 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Kaori Michikata, Hiroshi Sameshima, Hirotoshi Urabe, Syuichi Tokunaga, Yuki Kodama, Tsuyomu Ikenoue
Objective. The improvement of the accuracy of fetal heart rate (FHR) pattern interpretation to improve perinatal outcomes remains an elusive challenge. We examined the impact of an FHR centralization system on the incidence of neonatal acidemia and cesarean births. Methods. We performed a regional, population-based, before-and-after study of 9,139 deliveries over a 3-year period. The chi-squared test was used for the statistical analysis. Results. The before-and-after study showed no difference in the rates of acidemia, cesarean births, or perinatal death in the whole population...
2016: Journal of Pregnancy
Honghong Chang, Haochun Zhang, Jia Lv, Bing Zhang, Wenlong Wei, Jingang Guo
Highly sensitive determination of tumour markers is the key for early diagnosis of cancer. Herein, triple signal amplification strategy resulting from polymer nanospheres, Pt NPs, and DNAzyme was proposed in the developed electrochemical immunosensor. First, electroactive polymer nanospheres were synthesized by infinite coordination polymerization of ferrocenedicarboxylic acid, which could generate strong electrochemical signals due to plentiful ferrocene molecules. Further, the polymer nanospheres were functionalized by Pt NPs and DNAzyme (hemin/G-quadruplex) with the ability of catalyzing H2O2, which contributes to enhance the electrochemical signals...
December 15, 2016: Biosensors & Bioelectronics
Sara Wickham
In this column, Sara Wickham takes a sideways look at issues relevant to midwives, students, women and families, inviting us to sit down with a cup of tea and ponder what we think we know. Research has consistently failed to show that electronic fetal monitoring makes a positive difference to women or babies. Yet this technology continues to be used, with some units now using central monitoring systems. This article considers the results of a study showing the effect of these on women's experiences, comparing the value of monitors and midwives...
May 2016: Practising Midwife
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
Karen E Hannaford, Molly J Stout, Chris D Smyser, Amit Mathur, Alison G Cahill
Objective We evaluated electronic fetal (heart rate) monitoring (EFM) patterns among very preterm infants with and without intraventricular hemorrhage (IVH) to evaluate the test characteristics of EFM for the prediction of IVH. Study Design We performed a case-control study of preterm infants born ≤ 30 weeks' gestation over a 6-year period. We evaluated differences in EFM patterns between those (cases) with and without IVH (controls). The relative odds ratio of observing differences in EFM patterns between cases and controls was calculated...
December 2016: American Journal of Perinatology
Francesca Cecchinato, Saba Atefyekta, Ann Wennerberg, Martin Andersson, Ryo Jimbo, Julia R Davies
OBJECTIVE: Mesoporous (MP) titania films used as implant coatings have recently been considered as release systems for controlled administration of magnesium to enhance initial osteoblast proliferation in vitro. Tuning of the pore size in such titania films is aimed at increasing the osteogenic potential through effects on the total loading capacity and the release profile of magnesium. METHODS: In this study, evaporation-induced self-assembly (EISA) was used with different structure-directing agents to form three mesoporous films with average pore sizes of 2nm (MP1), 6nm (MP2) and 7nm (MP3)...
July 2016: Dental Materials: Official Publication of the Academy of Dental Materials
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
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 labor. We conclude that STAN® reduces the rate of fetal blood sampling and instrumental vaginal deliveries, and has the potential to reduce the number of Australian operative interventions without compromising neonatal outcome...
March 2017: Journal of Maternal-fetal & Neonatal Medicine
Hanqi Wang, Fang Cheng, Wen Shen, Gang Cheng, Jing Zhao, Wei Peng, Jingping Qu
UNLABELLED: Natural amino acids are zwitterionic molecules and the good biocompatibility promises them potential candidates as anti-fouling materials. Here, we developed a new method to functionalize silica nanoparticles with a natural amino acid-based anti-fouling layer. Amino acids were covalently immobilized on 3-aminopropyltriethoxysilane modified silica nanoparticles using divinyl sulfone through a two-step reaction in aqueous solution at room temperature. The progress was monitored with NMR, X-ray photoelectron spectroscopy (XPS), transmission electron microscope (TEM) and zeta potential measurements...
August 2016: Acta Biomaterialia
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