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Intrapartum compromise

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https://www.readbyqxmd.com/read/28369712/computerized-data-driven-interpretation-of-the-intrapartum-cardiotocogram-a-cohort-study
#1
Antoniya Georgieva, Christopher W G Redman, Aris T Papageorghiou
Continuous intrapartum fetal monitoring remains a significant clinical challenge. We propose utilising cohorts of routinely collected data. We aim to combine non-classical (data-driven) and classical cardiotocography (CTG) features with clinical features into a system (OxSys), which generates automated alarms for the fetus at risk of intrapartum hypoxia. We hypothesise that OxSys can outperform clinical diagnosis of 'fetal distress', when optimised and tested over large retrospective datasets MATERIAL AND METHODS: We studied a cohort of 22,790 labouring women (≥36 weeks gestation)...
March 28, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28341515/computerised-interpretation-of-fetal-heart-rate-during-labour-infant-a-randomised-controlled-trial
#2
(no author information available yet)
BACKGROUND: Continuous electronic fetal heart-rate monitoring is widely used during labour, and computerised interpretation could increase its usefulness. We aimed to establish whether the addition of decision-support software to assist in the interpretation of cardiotocographs affected the number of poor neonatal outcomes. METHODS: In this unmasked randomised controlled trial, we recruited women in labour aged 16 years or older having continuous electronic fetal monitoring, with a singleton or twin pregnancy, and at 35 weeks' gestation or more at 24 maternity units in the UK and Ireland...
March 21, 2017: Lancet
https://www.readbyqxmd.com/read/28288537/exit-procedure-for-fetal-mediastinal-teratoma-with-large-pericardial-effusion-a-case-report-with-review-of-literature
#3
Arpit Agarwal, Eliot Rosenkranz, Salih Yasin, Sethuraman Swaminathan
BACKGROUND: Large mediastinal teratomas in the fetus are rare and can present with direct compression of intrathoracic structures as well as pericardial and pleural effusions. Mediastinal fetal teratoma may be detected as a mass in the chest during a routine prenatal ultrasound. Because of the pressure on mediastinal structures it may result in non-immune fetal hydrops (NIFH) and polyhydramnios. The development of hydrops may lead to fetal demise. Timely obstetric and/or surgical intervention is important to improve survival in this patient population...
April 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28279215/quality-of-the-delivery-services-in-health-facilities-in-northern-ethiopia
#4
Girmatsion Fisseha, Yemane Berhane, Alemayehu Worku, Wondwossen Terefe
BACKGROUND: Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. METHODS: A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers...
March 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#5
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28251626/intrapartum-intervention-rates-and-perinatal-outcomes-following-induction-of-labour-compared-to-expectant-management-at-term-from-an-australian-perinatal-centre
#6
COMPARATIVE STUDY
Yi Zhao, Christopher Flatley, Sailesh Kumar
BACKGROUND: Induction of labor (IOL) is a common obstetric intervention, yet its impact on intervention rates and perinatal outcomes is conflicting. AIMS: To evaluate the impact of IOL on intrapartum intervention rates and perinatal outcomes in women with singleton pregnancies at term. MATERIAL AND METHODS: This was a retrospective, cross-sectional study of term singleton deliveries at the Mater Mother's Hospital in Brisbane, Australia in 2007-2013...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28216258/review-systematic-review-of-the-utility-of-the-fetal-cerebroplacental-ratio-measured-at-term-for-the-prediction-of-adverse-perinatal-outcome
#7
REVIEW
Liam Dunn, Helen Sherrell, Sailesh Kumar
AIM: This systematic review evaluates the utility of the fetal cerebroplacental ratio (CPR) when assessed at term (from 37 + 0 weeks gestation) as a predictor of adverse obstetric and perinatal outcomes. DATA SOURCES AND SEARCH STRATEGY: An electronic search of Pubmed and Embase using variations of 'cerebroplacental ratio' and 'cerebroumbilical ratio' was conducted by two independent reviewers. Full text studies written in English that reported on low CPR and its correlation with relevant obstetric and perinatal outcomes were included...
February 12, 2017: Placenta
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#8
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28121831/committee-opinion-no-687-approaches-to-limit-intervention-during-labor-and-birth
#9
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28121830/committee-opinion-no-687-summary-approaches-to-limit-intervention-during-labor-and-birth
#10
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28056853/maternal-asian-ethnicity-and-obstetric-intrapartum-intervention-a-retrospective-cohort-study
#11
Maya Reddy, Euan M Wallace, Joanne C Mockler, Lynne Stewart, Michelle Knight, Ryan Hodges, Sasha Skinner, Miranda Davies-Tuck
BACKGROUND: Maternal ethnicity is a recognized risk factor for stillbirth, such that South Asian women have higher rates than their Caucasian counterparts. However, whether maternal ethnicity is a risk factor for intrapartum outcomes is less clear. The aim of this study is to explore associations between maternal country of birth, operative vaginal delivery and emergency cesarean section, and to identify possible mechanisms underlying any such associations. METHODS: We performed a retrospective cohort study of singleton term births among South Asian, South East/East Asian and Australian/New Zealand born women at an Australian tertiary hospital in 2009-2013...
January 5, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27929532/post-term-surveillance-and-birth-outcomes-in-south-asian-born-compared-with-australian-born-women
#12
C Yim, L Wong, C Cabalag, E M Wallace, M Davies-Tuck
OBJECTIVE: To determine if apparently healthy post-term South Asian-born (SA) women were more likely to have abnormal post-term fetal surveillance than Australian- and New Zealand-born (AUS/NZ) women, whether those abnormalities were associated with increased rates of obstetric intervention and adverse perinatal outcomes, and whether SA women and their babies were at higher risk of adverse outcomes in the post-term period irrespective of their post-term surveillance outcomes. STUDY DESIGN: Post-term surveillance and perinatal outcomes of 145 SA and 272 AUS/NZ nulliparous women with a singleton post-term pregnancy were compared in a retrospective multicentre cohort analysis...
December 8, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27871474/the-relationship-between-maternal-placental-growth-factor-levels-and-intrapartum-fetal-compromise
#13
Larissa N Bligh, Ristan M Greer, Sailesh Kumar
INTRODUCTION: Whilst some cases of intrapartum fetal compromise are the result of unpredictable catastrophic events, the majority arise from an unrecognised reduction in feto-placental reserve in otherwise healthy pregnancies. There is currently no reliable technique prior to labour that identifies the at-risk fetus. We aimed to investigate the relationship between maternal levels of serum placental growth factor (PlGF) and intrapartum fetal compromise in term pregnancies prior to labour...
December 2016: Placenta
https://www.readbyqxmd.com/read/27806661/intrapartum-intervention-rates-and-perinatal-outcomes-following-induction-of-labour-after-41%C3%A2-%C3%A2-0-weeks-compared-to-expectant-management
#14
Elaine Yuzhen Teo, Sailesh Kumar
OBJECTIVE: There is limited evidence regarding the incidence of intrapartum fetal compromise in women who are induced compared to those managed expectantly. The aim of this study was to investigate intrapartum and perinatal outcomes in women who were induced at >41 + 0 weeks compared to an expectantly managed cohort. METHODS: This was a retrospective cohort study of singleton, non-anomalous pregnancies delivering between 41 + 0 to 43 + 0 weeks at the Mater Mothers' Hospital, Brisbane...
November 24, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27762166/birth-weight-centiles-risk-of-intrapartum-compromise-and-adverse-perinatal-outcomes-in-term-infants
#15
Danielle Dowdall, Christopher Flatley, Sailesh Kumar
OBJECTIVE: The objective of this study is to evaluate the association between birth weight centiles and the risk of intrapartum compromise and adverse neonatal outcomes in term pregnancies. METHODS: Retrospective study of 32 468 term singleton births at a major tertiary maternity hospital in Australia. Data comprised gestation, mode, and indication for delivery and adverse perinatal outcomes. Fetal sex and gestational age-specific birth weight centiles were the main exposure variable...
October 20, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27687377/a-randomized-trial-comparing-prophylactic-phenylephrine-and-ephedrine-infusion-during-spinal-anesthesia-for-emergency-cesarean-delivery-in-cases-of-acute-fetal-compromise
#16
Kajal Jain, Jeetinder Kaur Makkar, Siva Subramani Vp, Shalini Gander, Praveen Kumar
BACKGROUND: Previous evidence showed that use of phenylephrine was associated with higher umbilical artery pH (UA pH) than ephedrine after elective cesarean delivery (CD). However, the best choice of vasopressor and its effect on funic gases in cases of acute fetal compromise require additional studies. METHODS: Ninety parturients showing acute fetal compromise during intrapartum period and taken up for CD (category II) under spinal anesthesia were randomized to receive prophylactic infusion of ephedrine 2...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27651599/caesarean-section-for-foetal-distress-and-correlation-with-perinatal-outcome
#17
Richa Gangwar, Sarita Chaudhary
BACKGROUND: The main documented indication of intrapartum caesarean section is foetal distress (MacKenzie and Cooke in BMJ 323(7318):930, 2001). Foetal distress indicates foetal hypoxia and acidosis during intrauterine life. PURPOSE: To correlate the diagnosis of foetal distress and perinatal outcome. METHODS: This was a prospective observational study of women who underwent caesarean section for foetal distress as detected by cardiotocography and not responding to intrauterine resuscitation...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27646638/ep16-10-prelabour-fetal-cardiac-output-and-risk-of-intrapartum-fetal-compromise
#18
A A Alsolai, L Bligh, S Kumar
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27645918/ep16-06-the-relationship-between-the-cerebroumbilical-ratio-and-cardiac-output-in-fetuses-that-develop-intrapartum-compromise-at-term
#19
A A Alsolai, L Bligh, S Kumar
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27606061/can-surveys-of-women-accurately-track-indicators-of-maternal-and-newborn-care-a-validity-and-reliability-study-in-kenya
#20
Katharine J McCarthy, Ann K Blanc, Charlotte E Warren, James Kimani, Brian Mdawida, Charity Ndwidga
BACKGROUND: Tracking progress on maternal and newborn survival requires accurate information on the coverage of essential interventions. Despite widespread use, most indicators measuring maternal and newborn intervention coverage have not been validated. This study assessed the ability of women delivering in two Kenyan hospitals to recall critical elements of care received during the intrapartum and immediate postnatal period at two time points: hospital discharge and 13-15 months following delivery...
December 2016: Journal of Global Health
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