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Fetal heart rate monitoring

Hadis Biglari, Reza Sameni
Fetal motility is a widely accepted indicator of the well-being of a fetus. In previous research, it has be shown that fetal motion (FM) is coherent with fetal heart rate accelerations and an indicator for active/rest cycles of the fetus. The most common approach for FM and fetal heart rate (FHR) assessment is by Doppler ultrasound (DUS). While DUS is the most common approach for studying the mechanical activities of the heart, noninvasive fetal electrocardiogram (ECG) and magnetocardiogram (MCG) recording and processing techniques have been considered as a possible competitor (or complement) for the DUS...
October 24, 2016: Physiological Measurement
Kim M J Verdurmen, Alexandra D J Hulsenboom, Judith O E H van Laar, S Guid Oei
INTRODUCTION: Tocolytics may cause changes in fetal heart rate pattern, while fetal heart rate variability is an important marker of fetal wellbeing. We aim to systematically review the literature on how tocolytic drugs affect fetal heart rate variability. MATERIAL AND METHODS: We searched CENTRAL, PubMed, and EMBASE up to June 2016. Studies published in English, using computerized or visual analysis to describe the effect of tocolytics on heart rate variability in human fetuses were included...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Steven L Clark, Emily 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: To validate a recently published algorithm for the management of category II fetal heart rate tracings , examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring and critically examine the limits of EFHRM in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
Serena Xodo, Gabriele Saccone, Ewoud Schuit, Isis Amer-Wåhlin, Vincenzo Berghella
Recently, a meta-analysis, including 26,526 laboring vertex singletons at term, summarized all available level-1 data from six high-quality randomized clinical trials on the use of ST analysis (STAN) during labor as an adjunct to conventional intrapartum fetal heart rate monitoring. The meta-analysis showed that STAN did not improve perinatal outcomes or decrease cesarean deliveries. Nonetheless there are still reasons to believe STAN may have a role in the future research on intrapartum fetal monitoring. Out of six trials included in the meta-analysis, two included all cephalic singletons in labor, and four enrolled only high-risk pregnant women...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Salvatore Tagliaferri, Francesca Giovanna Esposito, Adelaide Ippolito, Flavia Mereghini, Giovanni Magenes, Pasquale Martinelli, Marta Campanile, Maria Gabriella Signorini
BACKGROUND: The objective of this article is to provide an overview of the clinical experience of our telemedicine network (TOCOMAT) for fetal well-being assessment through computerized Cardiotocography (cCTG), analyzing cultural, socioeconomic, and environmental conditions of pregnant women and its economic sustainability over time. MATERIALS AND METHODS: We used the central data store, including all cCTG records collected in Campania region (Italy) during 17 years of activity...
September 19, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Tomasz Fuchs, Krzysztof Grobelak, Michał Pomorski, Mariusz Zimmer
BACKGROUND: Cardiotocography (CTG) is the most widely used procedure despite its low specificity for fetal acidosis and poor perinatal outcome. Fetal electrocardiography (fECG) with transabdominal electrodes is a new, non-invasive and promising method with greater potential for detecting impairment of fetal circulation. This study is the first that attempts to assess the usefulness of fECG in comparison to CTG during antepartum period. OBJECTIVES: To determine if a single fECG examination along with CTG tracing and Doppler flow measurement in the fetal vessels has any additional clinical value in normal and intrauterine growth restricted (IUGR) fetuses...
March 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Gerson Weiss, Sam Teichman, Dennis Stewart, David Nader, Susan Wood, Peter Breining, Elaine Unemori
BACKGROUND: Nonclinical studies indicate that the hormone relaxin is a good candidate for a safe cervical ripening agent that does not cause uterine contractions. METHODS: This Phase II study (conducted November 2, 2005-October 20, 2006) was a randomised, double blind, placebo controlled trial testing 24-h intravenous infusion of serelaxin (recombinant human relaxin) or placebo for cervical ripening in 72 healthy, primiparous women. Eligible subjects had a singleton pregnancy ≥40 weeks, were planned for elective induction, had vertex presentation of the fetus, intact membranes and a Bishop score at screening ≤4...
2016: BMC Pregnancy and Childbirth
Habiba Kapaya, Fiona Broughton Pipkin, Barrie Hayes-Gill, Pamela V Loughna
BACKGROUND: Previous researchers have studied circadian changes in the fetal heart rate (FHR) on small sample sizes and in a strictly controlled environment. This study was undertaken to investigate these changes during the late second and third trimesters, using a portable fetal electrocardiogram recording device (Monica AN24) in pregnant women in home and hospital environments with unrestricted mobility. METHODS: This was a prospective cohort study of 54 pregnant women with uncomplicated singleton pregnancies between 25 and 40 weeks gestation...
2016: Maternal Health, Neonatology and Perinatology
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
Ashish Kc, Johan Wrammert, Uwe Ewald, Robert B Clark, Jageshwor Gautam, Gehanath Baral, Kedar P Baral, Mats Målqvist
BACKGROUND: Each year, 1.2 million intrapartum stillbirths occur globally. In Nepal, about 50 % of the total number of stillbirths occur during the intrapartum period. An understanding of the risk factors associated with intrapartum stillbirth will facilitate the development of preventative strategies to reduce the associated burden of death. This study was conducted in a tertiary-care setting with the aim to identify risk factors associated with intrapartum stillbirth. METHODS: A case-control study was completed from July 2012 to September 2013...
2016: Reproductive Health
Jean Jacob, Ashish Alexander, Shoba Philip, Anoop Thomas
A pregnant patient in second trimester scheduled for posterior fossa craniotomy in prone position is a challenge for the anesthesiologist. Things to consider are physiological changes during pregnancy, non-obstetric surgery in pregnant patients, neuroanesthetic principles, effects of prone positioning, and need for fetal heart rate (FHR) monitoring. We have described the anesthetic management of this case and discussed intra-operative FHR monitoring including controversies about its role, indications, and various options available as per fetal gestational age...
September 2016: Journal of Clinical Anesthesia
Fiona Weeks, Loreto Pantoja, Jovita Ortiz, Jennifer Foster, Gabriel Cavada, Lorena Binfa
INTRODUCTION: Satisfaction with care during labor and birth has been associated with various obstetric variables. The purpose of this study was to determine which labor and birth procedures are significant predictors of maternal patient satisfaction in a large cross-sectional sample. METHODS: An observational, cross-sectional study of 1660 women giving birth in Chilean public hospital facilities was conducted from 2012 to 2013. Data were collected from 9 different hospitals in 8 regions of Chile using 2 instruments, including the American College of Nurse-Midwives Intrapartum Care Data Set and a locally validated measure of maternal well-being...
August 20, 2016: Journal of Midwifery & Women's Health
Ashish Kc, Johan Wrammert, Robert B Clark, Uwe Ewald, Mats Målqvist
BACKGROUND: Newborns are at the greatest risk for dying during the intrapartum period, including labor and delivery, and the first day of life. Fetal heart rate monitoring (FHRM) and partogram use to track labor progress are evidence-based techniques that can help to identify maternal and fetal risk factors so that these can be addressed early. The objective of this study was to assess health worker adherence to protocols for FHRM and partogram use during the intrapartum period, and to assess the association between adherence and intrapartum stillbirth in a tertiary hospital of Nepal...
2016: BMC Pregnancy and Childbirth
H Lemoine, V Ehlinger, M Groussolles, C Arnaud, C Vayssière
OBJECTIVE: Assessing inter- and intra- observer agreement in the reading of fetal heart rate (FHR) between two different paper speeds (1 and 2cm/min) using FIGO classification. MATERIAL AND METHODS: Single-centre experimental study consisting in reading 60minutes FHR tracings by six readers (3 midwives and 3 obstetricians) during 1cm and 2cm/min sessions within a period of three weeks. The reading guideline was based on FIGO classification. Inter- and intra-observer agreement was assessed thanks to Kappa coefficient (K) and percentage of agreement (PA) using the classification of FHR tracings drawn up by readers...
August 2, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Shuang Liu, Uri Elkayam, Tasneem Z Naqvi
Cardiovascular disease (CVD) remains the leading cause of maternal mortality, and clinical diagnosis of CVD in women during pregnancy is challenging. Pregnant women with known heart disease require careful multidisciplinary management by obstetric and medical teams to assess for maternal and fetal risk. Echocardiography is a safe and effective diagnostic tool indicated in pregnant women with cardiac symptoms or women with known cardiac disease for appropriate selection of women who require close monitoring of cardiac condition and valvular function...
September 2016: Current Cardiology Reports
Khalid Abd Aziz Mohamad Khader, Ahmed Samy Saad, Mohammed Abdelshafy
OBJECTIVE: This study was carried out to determine the maternal (including thromboembolic and hemorrhagic complications) and fetal outcomes (including miscarriage, stillbirth, baby death, and live birth) in women with mechanical heart valves managed with therapeutic doses of unfractionated heparin (UFH) versus enoxaparin during pregnancy. METHODS: This is a prospective comparative, nonrandomized study. Pregnant women with mechanical heart valves presenting to high-risk pregnancy unit of Benha University Hospital, Egypt were treated with UFH 15,000 U/12 h versus enoxaparin (Clexane) 1 mg/kg SC/12 h during pregnancy and the results were analyzed...
October 2016: Journal of Obstetrics and Gynaecology of India
Hans Wolf, Birgit Arabin, Christoph C Lees, Dick Oepkes, Federico Prefumo, Baskaran Thilaganathan, Tullia Todros, Gerard H A Visser, Caterina M Bilardo, Jan B Derks, Anke Diemert, Johannes J Duvekot, Enrico Ferrazzi, Tiziana Frusca, Kurt Hecher, Neil Marlow, Pasquale Martinelli, Eva Ostermayer, Aris T Papageorghiou, Hubertina C J Scheepers, Dietmar Schlembach, K T M Schneider, Adriana Valcamonico, Aleid van Wassenaer-Leemhuis, Wessel Ganzevoort
OBJECTIVES: To explore if in early fetal growth restriction (FGR) the longitudinal pattern of short-term fetal heart rate (FHR) variation (STV) can be used for identifying imminent fetal distress and if abnormalities of FHR registration associate with two-year infant outcome. METHODS: The original TRUFFLE study assessed if in early FGR the use of ductus venosus Doppler pulsatility index (DVPI), in combination with a safety-net of very low STV and / or recurrent decelerations, could improve two-year infant survival without neurological impairment in comparison to computerised cardiotocography (cCTG) with STV calculation only...
August 3, 2016: Ultrasound in Obstetrics & Gynecology
Hernâni Gonçalves, Paula Pinto, Manuela Silva, Diogo Ayres-de-Campos, João Bernardes
PURPOSE: Evaluation of maternal heart rate (MHR) variability provides useful information on the maternal-fetal clinical state. Electrocardiography (ECG) is the most accurate method to monitor MHR but it may not always be available, and pulse oximetry using photoplethysmography (PPG) can be an alternative. In this study we compared ECG and PPG signals, obtained with conventional fetal monitors, to evaluate signal loss, MHR variability indices, and the ability of the latter to predict fetal acidemia and operative delivery...
2016: SpringerPlus
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