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Cardiotocography

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https://www.readbyqxmd.com/read/29690730/-a-clinical-retrospective-study-on-160-cases-of-multiple-umbilical-cord-around-the-neck
#1
Y Q Zhang, W Zhao, K T Chu, Y Zhao, L P Chen, Y Yu, X J Han
Objective: To compare the neonatal and maternal outcomes between the patients with umbilical cord around the neck (≥3 loops) and with (1 or 2 loops). Methods: A retrospective analysis was conducted on the clinical data of 160 cases with multiple umbilical cord around the neck (≥3 loops) in the Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University between January 2014 and April 2017.For each case, two control women who gave birth at the same day with vertex position and singletons were selected...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29622500/max-dd-dt-a-novel-parameter-to-assess-fetal-cardiac-contractility-and-a-substitute-for-max-dp-dt
#2
Yasuyuki Fujita, Ryo Kiyokoba, Yasuo Yumoto, Kiyoko Kato
Aortic pulse waveforms are composed of a forward wave from the heart and a reflection wave from the periphery. We focused on this forward wave and suggested a new parameter, the maximum slope of aortic pulse waveforms (max dD/dt), for fetal cardiac contractility. Max dD/dt was calculated from fetal aortic pulse waveforms recorded with an echo-tracking system. A normal range of max dD/dt was constructed in 105 healthy fetuses using linear regression analysis. Twenty-two fetuses with suspected fetal cardiac dysfunction were divided into normal and decreased max dD/dt groups, and their clinical parameters were compared...
April 2, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29536649/hyperbaric-oxygenation-and-glucose-amino-acids-substitution-in-human-severe-placental-insufficiency
#3
Michael Tchirikov, Erich Saling, Gauri Bapayeva, Michael Bucher, Oliver Thews, Gregor Seliger
In the first case, the AA and glucose were infused through a perinatal port system into the umbilical vein at 30 weeks' gestation due to severe IUGR. The patient received daily hyperbaric oxygenation (HBO, 100% O2 ) with 1.4 atmospheres absolute for 50 min for 7 days. At 31+4  weeks' gestation, the patient gave birth spontaneously to a newborn weighing 1378 g, pH 7.33, APGAR score 4/6/intubation. In follow-up examinations at 5 years of age, the boy was doing well without any neurological disturbance or developmental delay...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29527962/neonatal-hypoxia-of-the-second-twin-after-vaginal-delivery-of-the-first-twin-what-matters
#4
Paola Algeri, Clelia Callegari, Davide Paolo Bernasconi, Maddalena Incerti, Sabrina Cozzolino, Giuseppe Paterlini, Salvatore Andrea Mastrolia, Francesca Pellizzoni, Patrizia Vergani
OBJECTIVE: Optimal management of twin deliveries is controversial. We aimed to assess potential risk factors correlated to the development of hypoxia in the second twin after vaginal delivery of the first twin. STUDY DESIGN: This is a retrospective observational study including diamniotic twin pregnancies delivering at our Institution at 35 weeks of gestational age or more, weighing ≥ 1800 g. Hypoxia was defined as at least one of the following: Apgar score < 5 at 10', neonatal resuscitation for > 10 minutes, neonatal acidosis (pH ≤ 7 and/or BE ≥ 12 mmol/L)...
March 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29511418/obstetrics-at-decisive-crossroads-regarding-pattern-recognition-of-fetal-heart-rate-decelerations-scientific-principles-and-lessons-from-memetics
#5
REVIEW
Shashikant L Sholapurkar
The survival of cardiotocography (CTG) as a tool for intrapartum fetal monitoring seems threatened somewhat unjustifiably and unwittingly despite the absence of better alternatives. Fetal heart rate (FHR) decelerations are center-stage (most important) in the interpretation of CTG with maximum impact on three-tier classification. The pattern-discrimination of FHR decelerations is inexorably linked to their nomenclature. Unscientific or flawed nomenclature of decelerations can explain the dysfunctional CTG interpretation leading to errors in detection of acidemic fetuses...
April 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29507022/pregnancy-in-a-patient-with-portal-hypertension-secondary-to-liver-cirrhosis
#6
Faith Jelagat Lelei-Mailu, Charles Muriuki Mariara
This case report is of a 32-year-old woman of African descent on follow-up for pregnancy in the background of portal hypertension due to liver cirrhosis. She had initially been treated for chronic hepatitis B infection with lamivudine and tenofovir, complicated by portal hypertension and variceal bleeding that thrice required banding. Her pregnancy was uneventful until 31 weeks gestation when she presented with dyspnoea. On examination and investigation, she had oedema, bilateral pleural effusions and ascites...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29505915/the-influence-of-betamethasone-on-fetal-heart-rate-variability-obtained-by-non-invasive-fetal-electrocardiogram-recordings
#7
Kim M J Verdurmen, Guy J J Warmerdam, Carlijn Lempersz, Alexandra D J Hulsenboom, Joris Renckens, Jeanne P Dieleman, Rik Vullings, Judith O E H van Laar, S Guid Oei
BACKGROUND: Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm labour. Fetal heart rate variability is one of the most important parameters to assess in fetal monitoring, since it is a reliable indicator for fetal distress. AIM: To describe the effect of betamethasone on fetal heart rate variability, by applying spectral analysis on non-invasive fetal electrocardiogram recordings. STUDY DESIGN: Prospective cohort study...
March 2, 2018: Early Human Development
https://www.readbyqxmd.com/read/29495906/safety-of-a-physical-therapy-protocol-for-women-with-preeclampsia-a-randomized-controlled-feasibility-trial
#8
Tawana Vicente Bertagnolli, Michelle de Souza Rangel Machado, Cristine Jorge Homsi Ferreira, Jackeline de Souza Rangel Machado, Geraldo Duarte, Ricardo Carvalho Cavalli
OBJECTIVE: To assess the feasibility and safety of a physiotherapy protocol applied to pregnant women with preeclampsia. METHODS: Randomized, controlled, single-blind feasibility study, with 24 hospitalized pregnant women with preeclampsia. The intervention group received one session of the physiotherapy. The control group remained under the routine care of the hospital. The primary outcomes were Doppler velocimetry, cardiotocography, and maternal-fetal hemodynamics...
March 1, 2018: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/29475210/-comparison-of-international-guidelines-for-the-application-of-cardiotocography
#9
Phillip Schulten Sebastian, Jan Philip Suppelna, Timoleon Dagres, Günter Noè, Michael Anapolski, Joscha Reinhard, Harald Krentel, Clemens Tempfer, Sven Schiermeier
OBJECTIVE: This study examines the recommendations of international guidelines on the use of antepartum and intrapartum cardiotocography. MATERIAL AND METHODS: The guidelines of Germany, Canada, UK, USA, Sri Lanka, Australia as well as FIGO have been compared. The recommendations on the use of cardiotocography were separately evaluated for antepartum and intrapartum use. RESULTS: Antepartum: In risk-free pregnancies the use of cardiotocography is not recommended in all countries...
February 23, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29454359/change-in-practice-a-qualitative-exploration-of-midwives-and-doctors-views-about-the-introduction-of-stan-monitoring-in-an-australian-hospital
#10
M E Mayes, C Wilkinson, S Kuah, G Matthews, D Turnbull
BACKGROUND: The present study examines the introduction of an innovation in intrapartum foetal monitoring practice in Australia. ST-Analysis (STan) is a technology that adds information to conventional fetal monitoring (cardiotocography) during labour, with the aim of reducing unnecessary obstetric intervention. Adoption of this technology has been controversial amongst obstetricians and midwives, particularly as its use necessitates a more invasive means of monitoring (a scalp clip), compared to external monitoring from cardiotocography alone...
February 17, 2018: BMC Health Services Research
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
G J J Warmerdam, R Vullings, J O E H Van Laar, M B Van der Hout-Van der Jagt, J W M Bergmans, L Schmitt, S G Oei
OBJECTIVE: Monitoring of the fetal condition during labor is currently performed by cardiotocograpy (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...
February 28, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29301439/use-of-lactate-pro-tm-2-for-measurement-of-fetal-scalp-blood-lactate-during-labor-proposing-new-cutoffs-for-normality-preacidemia-and-acidemia-a-cross-sectional-study
#18
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 ProTM 2 based on the comparison of lactate values measured with Lactate ProTM and Lactate ProTM 2...
January 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29288489/waterbirth-in-sweden-a-comparative-study
#19
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 those of 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...
March 2018: 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
#20
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
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