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Electronic fetal monitoring

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https://www.readbyqxmd.com/read/29137550/reengineering-electronic-fetal-monitoring-interpretation-using-the-fetal-reserve-index-to-anticipate-the-need-for-emergent-operative-delivery
#1
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: The near-ubiquitous use of electronic fetal monitoring has failed to lower the rates of both cerebral palsy and emergency operative deliveries (EODs). Its performance metrics have low sensitivity, specificity, and predictive values for both. There are many EODs, but the vast majority have normal outcomes. The EODs, however, cause serious disruption in the delivery suite routine with increased complications, anxiety, and concern for all. METHODS: We developed the fetal reserve index (FRI) as multicomponent algorithm including 4 FHR components (analyzed individually), uterine activity, and maternal, obstetrical, and fetal risk factors to assess risk of cerebral palsy and EOD...
January 1, 2017: Reproductive Sciences
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/29026371/proportion-and-factors-associated-with-low-fifth-minute-apgar-score-among-singleton-newborn-babies-in-gondar-university-referral-hospital-north-west-ethiopia
#4
Temesgen Worku Gudayu
BACK GROUND: New born babies with low Apgar scores are at an increased risk of perinatal morbidity and mortality. OBJECTIVE: To assess proportion and factors associated with low 5(th) minute Apgar Apgar score among singleton newborn babies in Gondar University referral hospital; North West Ethiopia. METHODS: A cross-sectional study was conducted on singleton 261 live births from March - May, 2013. Data was collected from mother/newborn index using a structured and pre-tested questionnaire...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29016232/algorithm-for-the-management-of-asthma-in-pregnant-women-a-protocol-to-optimize-processes-in-healthcare
#5
Eva Martinez-Moragón, Auxiliadora Romero-Falcón, Juan Luis García-Rivero
Asthma is the most common chronic disease in pregnant women. Its evolution during pregnancy could improve, stay the same or worsen, especially in cases where there is a loss of clinical control. This can lead to maternal and fetal hypoxia with serious adverse perinatal outcomes. Areas covered: This article reviews physiological modifications in pregnancy, effects of pregnancy on asthma, and possible consequences on fetus development. Furthermore, it reviews evidence on assessment and both pharmacological and non-pharmacological management of asthma in pregnant and breastfeeding women as well as in acute exacerbations...
October 23, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28953855/from-apparent-death-to-birth-asphyxia-a-history-of-blame
#6
REVIEW
Michael Obladen
Since the 16th century, competition between midwives and surgeons has created a culture of blame around the difficult delivery. In the late 17th century, 100 years before oxygen was discovered, researchers associated "apparent death of the newborn" with impaired respiratory function of the placenta. The diagnosis "birth asphyxia" replaced the term "apparent death of the newborn" during the mass phobia of being buried alive in the 18th century. This shifted the interpretation from unavoidable fate to a preventable condition...
September 27, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28946843/intermittent-auscultation-versus-continuous-fetal-monitoring-exploring-factors-that-influence-birthing-unit-nurses-fetal-surveillance-practice-using-theoretical-domains-framework
#7
Andrea M Patey, Janet A Curran, Ann E Sprague, Jill J Francis, S Michelle Driedger, France Légaré, Louise Lemyre, Marie-Pascale A Pomey, Jeremy M Grimshaw
BACKGROUND: Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour. METHODS: Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance...
September 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28902389/women-s-experiences-of-continuous-fetal-monitoring-a-mixed-methods-systematic-review
#8
Alexandra Crawford, Dexter Hayes, Edward D Johnstone, Alexander E P Heazell
INTRODUCTION: Antepartum stillbirth is often preceded by detectable signs of fetal compromise, including changes in fetal heart rate and movement. It is hypothesised that continuous fetal monitoring could detect these signs more accurately and objectively than current forms of fetal monitoring and allow for timely intervention. This systematic review aimed to explore available evidence on women's experiences of continuous fetal monitoring to investigate its acceptability prior to clinical implementation and to inform clinical studies...
September 13, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28899619/first-do-the-experiment-do-computerised-interpretation-of-cardiotocography-and-other-widely-used-interventions-improve-newborn-outcomes
#9
REVIEW
Philip Steer
The introduction of continuous electronic fetal heart rate monitoring (EFM) in labour has coincided with a steady and remarkable fall in perinatal mortality. Whether this is cause or coincidence remains unclear because randomised trials have been underpowered. Attempts to improve the sensitivity and specificity of fetal compromise detection using fetal blood sampling and pH measurement, pulse oximetry, and fetal electrocardiogram analysis have failed to provide evidence of additional value in randomised trials...
November 2017: Early Human Development
https://www.readbyqxmd.com/read/28853105/different-approaches-to-detect-nanobacteria-in-patients-with-kidney-stones-an-infectious-cause-or-a-subset-of-life
#10
Hani Ansari, Abbas Akhavan Sepahi, Mohsen Akhavan Sepahi
PURPOSE: This research focused on the detection of nanobacteria in kidney stones of 30 Iranian patients without adding fetal bovine serum (FBS) to the culture media. MATERIALS AND METHODS: Nanobacteria were isolated from a nephro-ureterolithiasis extract of the urinary tract and kidney of patients and were cultured in the laboratory. The growth of nanobacteria was monitored using a spectrophotometer, and with inverted microscopy technique, their crystallization was analyzed after two days...
August 29, 2017: Urology Journal
https://www.readbyqxmd.com/read/28851241/obesity-s-impact-on-intrapartum-electronic-fetal-monitoring
#11
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/m(2)), Group 2 (30 < BMI < 40 kg/m(2)), and Group 3 (BMI ≥ 40 kg/m(2)). 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/28782502/hepatitis-c-in-pregnancy-screening-treatment-and-management
#12
Brenna L Hughes, Charlotte M Page, Jeffrey A Kuller
In the United States, 1-2.5% of pregnant women are infected with hepatitis C virus, which carries an approximately 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, and infection during pregnancy is associated with increased risk of adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of this document is to discuss the current evidence regarding hepatitis C virus in pregnancy and to provide recommendations on screening, treatment, and management of this disease during pregnancy...
August 4, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28743026/evaluation-of-the-ivet-%C3%A2-birth-monitoring-system-in-primiparous-dairy-heifers
#13
G Henningsen, H Marien, W Hasseler, M Feldmann, H-A Schoon, M Hoedemaker, K Herzog
The objective was to validate the iVET(®) birth monitoring system and to determine if it reduced fetal death in primiparous dairy heifers over a 1-y interval. There were 359 pregnant heifers enrolled; 167 heifers in the iVET(®) group were monitored electronically and the remaining 192 (controls) were monitored visually for onset of Stage 2 labor, according to routine farm management. In addition, as a reference, all heifers were observed throughout the study by two independent investigators. Calves born dead or that died within 24 h after birth were defined as stillborn...
July 10, 2017: Theriogenology
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
#14
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
#15
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/28655312/transplantation-of-human-fetal-pancreatic-progenitor-cells-ameliorates-renal-injury-in-streptozotocin-induced-diabetic-nephropathy
#16
Yongwei Jiang, Wenjian Zhang, Shiqing Xu, Hua Lin, Weiguo Sui, Honglin Liu, Liang Peng, Qing Fang, Li Chen, Jinning Lou
BACKGROUND: Diabetic nephropathy (DN) is a severe complication of diabetes mellitus (DM). Pancreas or islet transplantation has been reported to prevent the development of DN lesions and ameliorate or reverse existing glomerular lesions in animal models. Shortage of pancreas donor is a severe problem. Islets derived from stem cells may offer a potential solution to this problem. OBJECTIVE: To evaluate the effect of stem cell-derived islet transplantation on DN in a rat model of streptozotocin-induced DM...
June 27, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#17
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/28619702/computerized-childbirth-monitoring-tools-for-health-care-providers-managing-labor-a-scoping-review
#18
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
#19
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
#20
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...
June 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
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