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Cardiotocography

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https://www.readbyqxmd.com/read/29438070/successfully-reducing-newborn-asphyxia-in-the-labour-unit-in-a-large-academic-medical-centre-a-quality-improvement-project-using-statistical-process-control
#1
Rikke von Benzon Hollesen, Rie Laurine Rosenthal Johansen, Christina Rørbye, Louise Munk, Pierre Barker, Anette Kjaerbye-Thygesen
BACKGROUND: A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. METHODS: The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network...
February 3, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29433368/teaching-childbirth-with-high-fidelity-simulation-is-it-better-observing-the-scenario-during-the-briefing-session
#2
Marcos J Cuerva, Carlos S Piñel, Lourdes Martin, Jose A Espinosa, Octavio J Corral, Nicolás Mendoza
The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29428065/ectg-an-automatic-procedure-to-extract-digital-cardiotocographic-signals-from-digital-images
#3
Agnese Sbrollini, Angela Agostinelli, Ilaria Marcantoni, Micaela Morettini, Luca Burattini, Francesco Di Nardo, Sandro Fioretti, Laura Burattini
BACKGROUND AND OBJECTIVE: Cardiotocography (CTG), consisting in the simultaneous recording of fetal heart rate (FHR) and maternal uterine contractions (UC), is a popular clinical test to assess fetal health status. Typically, CTG machines provide paper reports that are visually interpreted by clinicians. Consequently, visual CTG interpretation depends on clinician's experience and has a poor reproducibility. The lack of databases containing digital CTG signals has limited number and importance of retrospective studies finalized to set up procedures for automatic CTG analysis that could contrast visual CTG interpretation subjectivity...
March 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29422214/evidence-based-national-guidelines-for-the-management-of-suspected-fetal-growth-restriction-comparison-consensus-and-controversy
#4
REVIEW
Lesley M McCowan, Francesc Figueras, Ngaire H Anderson
Small for gestational age is usually defined as an infant with a birthweight <10th centile for a population or customized standard. Fetal growth restriction refers to a fetus that has failed to reach its biological growth potential because of placental dysfunction. Small-for-gestational-age babies make up 28-45% of nonanomalous stillbirths, and have a higher chance of neurodevelopmental delay, childhood and adult obesity, and metabolic disease. The majority of small-for-gestational-age babies are not recognized before birth...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29422211/outcome-in-early-onset-fetal-growth-restriction-is-best-combining-computerized-fetal-heart-rate-analysis-with-ductus-venosus-doppler-insights-from-the-trial-of-umbilical-and-fetal-flow-in-europe
#5
REVIEW
Tiziana Frusca, Tullia Todros, Christoph Lees, Caterina M Bilardo
BACKGROUND: Early-onset fetal growth restriction represents a particular dilemma in clinical management balancing the risk of iatrogenic prematurity with waiting for the fetus to gain more maturity, while being exposed to the risk of intrauterine death or the sequelae of acidosis. OBJECTIVE: The Trial of Umbilical and Fetal Flow in Europe was a European, multicenter, randomized trial aimed to determine according to which criteria delivery should be triggered in early fetal growth restriction...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29406989/excessive-fetal-movements-are-a-sign-of-fetal-compromise-which-merits-further-examination
#6
Alexander E P Heazell, Tomasina Stacey, Louise M O'Brien, Edwin A Mitchell, Jane Warland
Changes in fetal movement are associated with increased risk of stillbirth after 28 weeks of pregnancy. The majority of studies have focussed on maternal perception of reduced fetal movements, which is associated with stillbirth via placental dysfunction. Recent studies have also described an association between a single episode of excessive fetal movements and late stillbirth. We present a hypothesis that a sudden episode of excessive fetal activity indicates fetal compromise relating to underlying disturbance of the in utero environment, which if it persists can lead to fetal death...
February 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29350194/detection-rate-of-fetal-distress-using-contraction-dependent-fetal-heart-rate-variability-analysis
#7
Guy J J Warmerdam, Rik Vullings, Judith O E H Van Laar, M Beatrijs Van der Hout-Van der Jagt, Jan W M Bergmans, Lars Schmitt, S Guid Oei
Monitoring of the fetal condition during labor is currently performed by cardiotocography (CTG). Despite the use of CTG in clinical practice, CTG interpretation suffers from a high inter- and intra-observer variability and a low specificity. In addition to CTG, analysis of fetal heart rate variability (HRV) has been shown to provide information on fetal distress. However, fetal HRV can be strongly influenced by uterine contractions, particularly during the second stage of labor. Therefore, the aim of this study is to examine if distinguishing contractions from rest periods can improve the detection rate of HRV features for fetal distress during the second stage of labor...
January 19, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29301439/use-of-lactate-protm2-for-measurement-of-fetal-scalp-blood-lactate-during-labor-proposing-new-cutoffs-for-normality-preacidemia-and-acidemia-a-cross-sectional-study
#8
L Iorizzo, T W Klausen, E Wiberg-Itzel, F Ovin, N Wiberg
OBJECTIVE: Measurement of fetal scalp blood lactate is a supplementary tool to cardiotocography in the case of a non-reassuring tracing. Several hand-held lactate meters have been launched, all with differentials in absolute values. Therefore, the reference intervals must be calculated for each device. The internationally accepted reference interval is based on measurement with Lactate ProTM with recently got out of production. The aim of this study was to propose cutoffs for normality, preacidemia, and acidemia in fetal scalp blood for Lactate ProTM2 based on the comparison of lactate values measured with Lactate ProTM and Lactate ProTM2...
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29288489/waterbirth-in-sweden-a-comparative-study
#9
Hanna Ulfsdottir, Sissel Saltvedt, Susanne Georgsson
INTRODUCTION: The literature describes advantages for mothers giving birth in water, but waterbirth is controversial in Sweden and has not been offered at hospitals until recently. This study aimed to describe and compare the characteristics and outcome of waterbirths with spontaneous vaginal births at the same clinics. MATERIAL AND METHODS: A retrospective cohort study was conducted on all waterbirths at two maternity units in Sweden from March 2014 to November 2015 (n=306), and a consecutively selected comparison group of 306 women having conventional spontaneous vaginal births...
December 29, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29284453/a-pilot-exploratory-investigation-on-pregnant-women-s-views-regarding-stan-fetal-monitoring-technology
#10
Kate Bryson, Chris Wilkinson, Sabrina Kuah, Geoff Matthews, Deborah Turnbull
BACKGROUND: Women's views are critical for informing the planning and delivery of maternity care services. ST segment analysis (STan) is a promising method to more accurately detect when unborn babies are at risk of brain damage or death during labour that is being trialled for the first time in Australia. This is the first study to examine women's views about STan monitoring in this context. METHODS: Semi-structured interviews were conducted with pregnant women recruited across a range of clinical locations at the study hospital...
December 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29248699/machine-learning-ensemble-modelling-to-classify-caesarean-section-and-vaginal-delivery-types-using-cardiotocography-traces
#11
Paul Fergus, Malarvizhi Selvaraj, Carl Chalmers
Human visual inspection of Cardiotocography traces is used to monitor the foetus during labour and avoid neonatal mortality and morbidity. The problem, however, is that visual interpretation of Cardiotocography traces is subject to high inter and intra observer variability. Incorrect decisions, caused by miss-interpretation, can lead to adverse perinatal outcomes and in severe cases death. This study presents a review of human Cardiotocography trace interpretation and argues that machine learning, used as a decision support system by obstetricians and midwives, may provide an objective measure alongside normal practices...
December 8, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29245247/accuracy-of-intrapartum-fetal-blood-gas-analysis-by-scalp-sampling-a-retrospective-cohort-study
#12
Ziad Hilal, Jennifer Mrkvicka, Günther A Rezniczek, Askin Dogan, Clemens B Tempfer
Fetal blood gas analysis (FBGA) using scalp blood is commonly used to identify serious fetal distress. However, there is a lack of data regarding its accuracy and reliability. The aim of this study was to determine the positive predictive value (PPV) and negative predictive value (NPV) of FBGA for predicting postpartum acidosis in case of nonreassuring fetal heart rate tracings (NRFHRT). To this end, we conducted a retrospective cohort study of singleton term deliveries with NRFHRT according to Fédération Internationale de Gynécologie et d'Obstétrique and Fisher cardiotocography scores undergoing FBGA in a university hospital...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29235099/variations-from-morning-to-afternoon-of-middle-cerebral-and-umbilical-artery-blood-flow-and-fetal-heart-rate-variability-and-fetal-characteristics-in-the-normally-developing-fetus
#13
Tehila Avitan, Ari Sanders, Ursula Brain, Dan Rurak, Tim F Oberlander, Ken Lim
OBJECTIVE: To determine if there are changes in maternal uterine blood flow, fetal brain blood flow, fetal heart rate variability, and umbilical blood flow between morning (AM) and afternoon (PM) in healthy, uncomplicated pregnancies. STUDY DESIGN: In this prospective study, 68 uncomplicated singleton pregnancies (mean 35 + 0.7 weeks gestation) underwent a standard observational protocol at both 08:00 (AM) and 13:30 (PM) of the same day. This protocol included Doppler measurements of uterine, umbilical, and fetal middle cerebral artery (MCA) volume flow parameters (flow, HR, peak systolic velocity [PSV], PI, and RI) followed by computerized cardiotocography...
December 13, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29219011/meconium-aspiration-syndrome-risk-factors-and-predictors-of-severity
#14
Cláudia Patrícia Lourenço Oliveira, Filipa Flôr-de-Lima, Gustavo Marcondes Duarte Rocha, Ana Paula Machado, Maria Hercília Ferreira Guimarães Pereira Areias
PURPOSE: To identify risk factors and predictors of severity associated with meconium aspiration syndrome (MAS) in the patients admitted to the neonatal intensive care unit (NICU). MATERIALS AND METHODS: Retrospective study including newborns admitted, between 2005 and 2015, with a diagnosis of MAS. RESULTS: Of the newborns admitted to the NICU, 0.66% were diagnosed with MAS. These had higher prevalence of caesarean delivery (p < .001), nonreassuring or abnormal cardiotocography (CTG) (p < ...
December 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29215160/new-figo-and-swedish-intrapartum-cardiotocography-classification-systems-incorporated-in-the-fetal-ecg-st-analysis-stan-interpretation-algorithm-agreements-and-discrepancies-in-cardiotocography-classification-and-evaluation-of-significant-st-events
#15
Per Olofsson, Håkan Norén, Ann Carlsson
INTRODUCTION: The updated intrapartum cardiotocography (CTG) classification system by FIGO in 2015 (FIGO2015) and the FIGO2015-approached classification by the Swedish Society of Obstetricians and Gynecologist in 2017 (SSOG2017) are not harmonized with the fetal ECG ST analysis (STAN) algorithm from 2007 (STAN2007). The study aimed to reveal homogeneity and agreement between the systems in classifying CTG and ST events, and relate them to maternal and perinatal outcomes. MATERIAL AND METHODS: Among CTG traces with ST events, 100 traces originally classified as normal, 100 as suspicious and 100 as pathological were randomly selected from a STAN database and classified by two experts in consensus...
February 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29201590/investigating-ph-based-evaluation-of-fetal-heart-rate-fhr-recordings
#16
George Georgoulas, Petros Karvelis, Jiří Spilka, Václav Chudáček, Chrysostomos D Stylios, Lenka Lhotská
Cardiotocography (CTG) is a standard tool for the assessment of fetal well-being during pregnancy and delivery. However, its interpretation is associated with high inter- and intra-observer variability. Since its introduction there have been numerous attempts to develop computerized systems assisting the evaluation of the CTG recording. Nevertheless these systems are still hardly used in a delivery ward. Two main approaches to computerized evaluation are encountered in the literature; the first one emulates existing guidelines, while the second one is more of a data-driven approach using signal processing and computational methods...
2017: Health and Technology
https://www.readbyqxmd.com/read/29159882/cardiotocography-versus-intermittent-auscultation-of-foetal-heart-on-admission-to-labour-ward-for-assessment-of-foetal-wellbeing
#17
Amanda Wilson
No abstract text is available yet for this article.
November 21, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29089896/a-comparative-study-on-fetal-heart-rates-estimated-from-fetal-phonography-and-cardiotocography
#18
Emad A Ibrahim, Shamsa Al Awar, Zuhur H Balayah, Leontios J Hadjileontiadis, Ahsan H Khandoker
The aim of this study is to investigate that fetal heart rates (fHR) extracted from fetal phonocardiography (fPCG) could convey similar information of fHR from cardiotocography (CTG). Four-channel fPCG sensors made of low cost (<$1) ceramic piezo vibration sensor within 3D-printed casings were used to collect abdominal phonogram signals from 20 pregnant mothers (>34 weeks of gestation). A novel multi-lag covariance matrix-based eigenvalue decomposition technique was used to separate maternal breathing, fetal heart sounds (fHS) and maternal heart sounds (mHS) from abdominal phonogram signals...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29060570/statistical-baseline-assessment-in-cardiotocography
#19
Angela Agostinelli, Eleonora Braccili, Enrico Marchegiani, Riccardo Rosati, Agnese Sbrollini, Luca Burattini, Micaela Morettini, Francesco Di Nardo, Sandro Fioretti, Laura Burattini
Cardiotocography (CTG) is the most common non-invasive diagnostic technique to evaluate fetal well-being. It consists in the recording of fetal heart rate (FHR; bpm) and maternal uterine contractions. Among the main parameters characterizing FHR, baseline (BL) is fundamental to determine fetal hypoxia and distress. In computerized applications, BL is typically computed as mean FHR±ΔFHR, with ΔFHR=8 bpm or ΔFHR=10 bpm, both values being experimentally fixed. In this context, the present work aims: to propose a statistical procedure for ΔFHR assessment; to quantitatively determine ΔFHR value by applying such procedure to clinical data; and to compare the statistically-determined ΔFHR value against the experimentally-determined ΔFHR values...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29060433/ctg-analyzer-a-graphical-user-interface-for-cardiotocography
#20
Agnese Sbrollini, Angela Agostinelli, Luca Burattini, Micaela Morettini, Francesco Di Nardo, Sandro Fioretti, Laura Burattini
Cardiotocography (CTG) is the most commonly used test for establishing the good health of the fetus during pregnancy and labor. CTG consists in the recording of fetal heart rate (FHR; bpm) and maternal uterine contractions (UC; mmHg). FHR is characterized by baseline, baseline variability, tachycardia, bradycardia, acceleration and decelerations. Instead, UC signal is characterized by presence of contractions and contractions period. Such parameters are usually evaluated by visual inspection. However, visual analysis of CTG recordings has a well-demonstrated poor reproducibility, due to the complexity of physiological phenomena affecting fetal heart rhythm and being related to clinician's experience...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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