Fetal heart rate monitoring

BACKGROUND: Intrapartum cardiotocographic monitoring of fetal heart rate by abdominal external ultrasound transducer without simultaneous maternal heart rate recording has been associated with increased risk of early neonatal death and other asphyxia-related neonatal outcomes. It is unclear, however, whether this increase in risk is independently associated with fetal surveillance method or is attributable to other factors. OBJECTIVES: In a large retrospective cohort of deliveries, the aim of the present study was to compare different fetal surveillance methods and their association with adverse short-term and long-term fetal and neonatal outcomes...

BACKGROUND: In clinical medicine, fetal heart rate (FHR) monitoring using cardiotocography (CTG) is one of the most commonly used methods for assessing fetal acidosis. However, as the visual interpretation of CTG depends on the subjective judgment of the clinician, this has led to high inter-observer and intra-observer variability, making it necessary to introduce automated diagnostic techniques. METHODS: In this study, we propose a computer-aided diagnostic algorithm (Hybrid-FHR) for fetal acidosis to assist physicians in making objective decisions and taking timely interventions...

OBJECTIVE: The study aims to assess how oral misoprostol for cervical ripening affects the time of cesarean delivery (CD) for fetal heart rate (FHR) abnormalities in pre-eclampsia patients. Secondary goals include determining the role of uterine hyperstimulation, comparing misoprostol with Foley catheter, and identifying risk factors for FHR abnormalities associated with CD. METHODS: A previously published randomized clinical trial was subjected to a secondary analysis (NCT01801410)...

Fetal heart rate monitoring during general anesthesia for non-obstetric surgery at viable gestational ages is recommended to evaluate fetal well-being during the intervention. Alteration induced by anesthetic drugs could mimic fetal acute hypoxia, leading to pointless Cesarean sections. We report a case of a pregnant woman in the third trimester undergoing neurosurgical surgery. The continuous heart rate registration showed a non-reassuring pattern, potentially inducing the multidisciplinary team to expedite the delivery...

INTRODUCTION: In clinical practice, fetal heart rate monitoring is performed intermittently using Doppler ultrasound, typically for 30 minutes. In case of a non-reassuring heart rate pattern, monitoring is usually prolonged. Noninvasive fetal electrocardiography may be more suitable for prolonged monitoring due to improved patient comfort and signal quality. This study evaluates the performance and patient experience of four noninvasive electrocardiography devices to assess candidate devices for prolonged noninvasive fetal heart rate monitoring...

PURPOSE: Fetal cardiotocography is the most common method to assess fetal well-being during labor. Nevertheless, its predictive ability for acidemia is limited, both in low-risk and high-risk pregnancies (Nelson et al. in N Engl J Med 334: 613-9, 1996; Rinciples P et al. in Health and Human Development Workshop Report on Electronic Fetal Monitoring : Update on Definitions. no. 2007, 510-515, 2008), especially in high-risk pregnancies, such as those complicated by growth restriction...

Background Cholecystectomy is the second most common non-obstetric indication for surgery during pregnancy; however, there is little recent literature specifically exploring perioperative care approaches, and a paucity of Australian data exists. This study investigates the incidence of laparoscopic cholecystectomy (LC) during pregnancy, peri-operative management, and post-operative outcomes in a single Australian tertiary center. Methods A retrospective analysis of LCs performed on pregnant patients between the ages of 16 and 50 years at a tertiary hospital between 2016 and 2023 was completed...

Assessment of fetal heart rate (fHR) through non-invasive fetal electrocardiogram (fECG) is challenging task. This study compares the performance of five template subtraction (TS) methods on Labor (12 5-min recordings) and Pregnancy datasets (10 20-min recordings). The methods include TS without adaptation, TS using singular value decomposition (TS[Formula: see text]), TS using linear prediction (TS[Formula: see text]), TS using scaling factor (TS[Formula: see text]), and sequential analysis (SA). The influence of the chosen maternal wavelet for the continuous wavelet transform (CWT) detector is also compared...

Advancements in orally bioavailable iron chelators and MRI methods have improved life expectancy and reproductive potential in Thalassemia Major (TM) and Thalassemia Intermedia(TI). Pregnancy is associated with adverse maternal and neonatal outcomes, frequency of which has not been well delineated. This systematic review aimed to provide risk estimates of maternal and fetal outcomes in TM and TI and explore pregnancy's impact on iron homeostasis. Fifteen studies (429 participants,684 pregnancies) were included...

KEY CLINICAL MESSAGE: Considering the laceration of the inner layer of the myometrium as an important and controllable cause of bleeding during childbirth can lead to saving the mother's life. ABSTRACT: Laceration of the inner layer of the myometrium can cause massive bleeding during and after childbirth, which can lead to the death of the mother if it is not diagnosed in time.we presented a rare case of massive intrapartum bleeding following myometrial laceration that diagnosed correctly and the patient survived with in-time treatments...

Autoimmune congenital heart block (ACHB) is a passively acquired immune-mediated disease characterized by the presence of maternal antibodies against components of the Ro/SSA and La/SSB ribonucleoprotein complex that mainly affects the cardiac conducting system. ACHB occurs in 2% of women with positive anti-Ro/SSA and anti-La/SSB antibodies and causes a high risk of intrauterine fetal death, neonatal mortality, and long-term sequelae. In this review, we first describe a case of ACHB to provide preliminary knowledge...

Fetal heart rate (FHR) monitoring, typically using Doppler ultrasound (DUS) signals, is an important technique for assessing fetal health. In this work, we develop a robust DUS-based FHR estimation approach complemented by DUS signal quality assessment (SQA) based on unsupervised representation learning in response to the drawbacks of previous DUS-based FHR estimation and DUS SQA methods. We improve the existing FHR estimation algorithm based on the autocorrelation function (ACF), which is the most widely used method for estimating FHR from DUS signals...

IMPORTANCE: Fetal growth restriction (FGR) is a common pregnancy complication and a significant contributor of fetal and neonatal morbidity and mortality, mainly due to the lack of effective screening, prevention, and management policies. OBJECTIVE: The aim of this study was to review and compare the most recently published influential guidelines on the management of pregnancies complicated by FGR. EVIDENCE ACQUISITION: A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the International Society of Ultrasound in Obstetrics and Gynecology, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynecologists of Canada (SOGC), the Perinatal Society of Australia and New Zealand, the Royal College of Physicians of Ireland, the French College of Gynecologists and Obstetricians (FCGO), and the German Society of Gynecology and Obstetrics on FGR was carried out...

Objective: To investigate the perinatal maternal and fetal adverse outcomes of cesarean section in the different duration of the second stage of labor. Methods: A retrospective cohort study was conducted on the clinical data of 154 pregnant women with singleton head pregnancy who underwent cesarean section at different times of the second stage of labor due to maternal and fetal factors in the First Affiliated Hospital of Nanjing Medical University from January 1, 2019 to December 31, 2021. According to the duration of the second stage of labor, they were divided into <2 h group (54 cases), 2-<3 h group (61 cases), and ≥3 h group (39 cases)...

Intrapartum foetal hypoxia is related to long-term morbidity and mortality of the foetus and the mother. Foetal surveillance is extremely important to minimize the adverse outcomes arising from foetal hypoxia during labour. Several methods have been used in current clinical practice to monitor foetal well-being. For instance, biophysical technologies including cardiotocography, ST-analysis adjunct to cardiotocography, and Doppler ultrasound are used for intrapartum foetal monitoring. However, these technologies result in a high false-positive rate and increased obstetric interventions during labour...

OBJECTIVE: To investigate the clinical manifestations and laboratory indicators of anti-Sjögren's-syndrome-related antigen A (SSA) antibody associated fetal cardiac disease. METHODS: Pregnant women hospitalized at Peking University People's Hospital from January 2013 to July 2023 were included. Eleven patients with anti-SSA antibody positive were eventually diagnosed with fetal cardiac di-sease. And patients with anti-SSA antibody positive without fetal cardiac disease were selected as controls...

Monitoring the fetal heart rate (FHR) is common practice in obstetric care to assess the risk of fetal compromise. Unfortunately, human interpretation of FHR recordings is subject to inter-observer variability with high false positive rates. To improve the performance of fetal compromise detection, deep learning methods have been proposed to automatically interpret FHR recordings. However, existing deep learning methods typically analyse a fixed-length segment of the FHR recording after removing signal gaps, where the influence of this segment selection process has not been comprehensively assessed...

Fetal electrocardiogram (fECG) or photoplethysmogram (fPPG) devices are being developed for fetal heart rate (FHR) monitoring. However, deep tissue sensing is challenged by low fetal signal-to-noise ratio (SNR). Data quality is easily degraded by motion, or interference from maternal tissues and data losses can happen due to communication faults. In this paper, we propose to combine fECG and fPPG measurements in order to increase robustness against such dynamic challenges and increase FHR estimation accuracy...

Fetal heart rate monitoring is a crucial element in determining the health of the fetus during pregnancy. In this paper, we evaluate the fetal heart rate (FHR) and maternal heart rate (MHR) between our non-invasive fetal monitoring system, Femom, developed by a Biorithm and the Huntleigh computerized cardiotocography (cCTG) together with the Sonicaid FetalCare3 software by comparing the accuracy, sensitivity, and reliability through using Bland-Altman analysis, Positive Percent Agreement (PPA) and Intraclass Correlation Coefficient (ICC) respectively...

Non-invasive fetal electrocardiography (NI-fECG) is a promising technique for continuous fetal heart rate (fHR) monitoring. However, the weak amplitude of the fetal electrocardiogram (fECG), and the presence of the dominant maternal ECG (mECG), makes it highly challenging to detect the fetal QRS (fQRS) complex, which is needed to obtain the fHR. This paper proposes a new method for automated fQRS detection from single-channel NI-fECG signals, without cancelling out the mECG. The proposed method leverages the different spectral behaviour exhibited by mECG and fECG signals...