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Fetal heart rate

Hyo Kyozuka, Syun Yasuda, Tsuyoshi Hiraiwa, Yasuhisa Nomura, Keiya Fujimori
OBJECTIVE: Histological chorioamnionitis (CAM) is related to neonatal mortality and morbidity. However, identifying intrauterine inflammation before delivery is challenging. The aim of this study was to investigate the changes in fetal heart rate (FHR) short-term variability (STV) during the course of histological CAM. STUDY DESIGN: Changes in STV were measured in 7 chronically instrumented fetal sheep at 111-120 days of gestation. Lipopolysaccharide (LPS) was infused into the amniotic cavity for 2 days following the 4th postoperative day to develop histological CAM...
June 11, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Radek Martinek, Radana Kahankova, Janusz Jezewski, Rene Jaros, Jitka Mohylova, Marcel Fajkus, Jan Nedoma, Petr Janku, Homer Nazeran
Non-adaptive signal processing methods have been successfully applied to extract fetal electrocardiograms (fECGs) from maternal abdominal electrocardiograms (aECGs); and initial tests to evaluate the efficacy of these methods have been carried out by using synthetic data. Nevertheless, performance evaluation of such methods using real data is a much more challenging task and has neither been fully undertaken nor reported in the literature. Therefore, in this investigation, we aimed to compare the effectiveness of two popular non-adaptive methods (the ICA and PCA) to explore the non-invasive (NI) extraction (separation) of fECGs, also known as NI-fECGs from aECGs...
2018: Frontiers in Physiology
Laurence E Shields, Suzanne Wiesner, Catherine Klein, Barbara Pelletreau, Herman L Hedriana
OBJECTIVE:  To determine if a standardized intervention process for Category II fetal heart rates (FHRs) with significant decels (SigDecels) would improve neonatal outcome and to determine the impact on mode of delivery rates. STUDY DESIGN:  Patients with Category II FHRs from six hospitals were prospectively managed using a standardized approach based on the presence of recurrent SigDecels. Maternal and neonatal outcomes were compared between pre- (6 months) and post-(11 months) implementation...
June 12, 2018: American Journal of Perinatology
Zafer Cömert, Adnan Fatih Kocamaz, Velappan Subha
Cardiotocography (CTG) is applied routinely for fetal monitoring during the perinatal period to decrease the rates of neonatal mortality and morbidity as well as unnecessary interventions. The analysis of CTG traces has become an indispensable part of present clinical practices; however, it also has serious drawbacks, such as poor specificity and variability in its interpretation. The automated CTG analysis is seen as the most promising way to overcome these disadvantages. In this study, a novel prognostic model is proposed for predicting fetal hypoxia from CTG traces based on an innovative approach called image-based time-frequency (IBTF) analysis comprised of a combination of short time Fourier transform (STFT) and gray level co-occurrence matrix (GLCM)...
June 6, 2018: Computers in Biology and Medicine
Nina Rolf, Laura Kerschke, Janina Braun, Maria Karina Falkenberg, Kerstin Hammer, Helen Ann Köster, Mareike Möllers, Kathrin Oelmeier de Murcia, Walter Klockenbusch, Ralf Schmitz
PURPOSE: The purpose of our study was to quantify the fetal myocardial function in pregnant women with diabetic diseases (FDM) and in normal controls (FC) using speckle tracking echocardiography (STE). METHODS: In this prospective study, the myocardial strain and dyssynchrony were analyzed using STE in a transversal four-chamber view in 180 fetuses (53 FDM, 127 FC) between 19 and 39 weeks of gestation. The measurements of the global and segmental longitudinal strain of both chambers (2C) and of the single left chamber (1C) were executed offline via QLab 10...
June 12, 2018: Journal of Perinatal Medicine
Spencer G Kuper, Victoria C Jauk, David M George, Rodney K Edwards, Jeff M Szychowski, Sara E Mazzoni, Michelle J Wang, Pamela Files, Alan T Tita, Akila Subramaniam, Lorie M Harper
OBJECTIVE: To assess whether outpatient cervical ripening with a transcervical Foley catheter in parous women undergoing elective induction of labor shortens the total duration of time from admission to the labor ward until delivery. METHODS: We performed an open-label randomized controlled trial at a single academic center in parous women at 39 weeks of gestation or greater with a cervix 3 cm or less dilated, or, if 2-3 cm dilated, less than 80% effaced and reassuring fetal heart rate monitoring (defined as moderate variability with a normal baseline and absence of decelerations)...
June 6, 2018: Obstetrics and Gynecology
Ning Tian, Weiyuan Zhang
This study aimed to identify cardiotocography patterns that discriminate fetal acidemia newborns by comprehensively evaluating the parameters obtained from Holter monitoring during delivery. Between June 1, 2015, and August 1, 2016, a prospective observational study of 85 patients was conducted using fetal Holter monitoring at the Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China. Umbilical cord blood was sampled immediately after delivery and fetal acidemia was defined as umbilical cord arterial blood pH < 7...
2018: BioMed Research International
Lisa Thompson, Cynthia Krening, Dolores Parrett
To address an increase in unexpected poor outcomes in term neonates, our team developed a goal of high reliability and improved fetal safety in the culture of the Labor and Delivery nursing department. We implemented interdisciplinary reviews of fetal heart rate, along with a Category II fetal heart rate management algorithm and a fetal heart rate assessment rapid response alert to call for unscheduled reviews when needed. Enhanced communication between nurses and other clinicians supported an interdisciplinary approach to fetal safety, and we observed an improvement in health outcomes for term neonates...
June 2018: Nursing for Women's Health
Karine Goueslard, Jonathan Cottenet, Adrien Roussot, Christophe Clesse, Paul Sagot, Catherine Quantin
BACKGROUND: Since the 2000s, selective episiotomy has been systematically recommended worldwide. In France, the recommended episiotomy rate in vaginal deliveries is less than 30%. The aims of this study were to describe the evolution of episiotomy rates between 2007 and 2014, especially for vaginal deliveries without instrumental assistance and to assess individual characteristics and birth environment factors associated with episiotomy. METHODS: This population-based study included all hospital discharge abstracts for all deliveries in France from 2007 to 2014...
June 4, 2018: BMC Pregnancy and Childbirth
Martin G Frasch, Silvia Lobmaier, Tamara Stampalija, Paula Desplats, María Eugenia Pallarés, Verónica Pastor, Marcela Brocco, Hau-Tieng Wu, Jay Schulkin, Christophe Herry, Andrew Seely, Gerlinde A S Metz, Yoram Louzoun, Marta Antonelli
Prenatal stress (PS) impacts early postnatal behavioural and cognitive development. This process of 'fetal programming' is mediated by the effects of the prenatal experience on the developing hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). We derive a multi-scale multi-species approach to devising preclinical and clinical studies to identify early non-invasively available pre- and postnatal biomarkers of PS. The multiple scales include brain epigenome, metabolome, microbiome and the ANS activity gauged via an array of advanced non-invasively obtainable properties of fetal heart rate fluctuations...
May 30, 2018: Neuroscience and Biobehavioral Reviews
Thomas Hadberg Lynge, Alexander Gade Jeppesen, Bo Gregers Winkel, Charlotte Glinge, Michael Rahbek Schmidt, Lars Søndergaard, Bjarke Risgaard, Jacob Tfelt-Hansen
BACKGROUND: Congenital heart defects (CHD) are among the leading causes of sudden cardiac death (SCD) in the young. Nationwide incidence of SCD in people with CHD (SCD-CHD) has not been established in the young general population. The aims of this study were to investigate incidence of SCD-CHD and whether incidence of SCD-CHD in infants declined after implementation of nationwide fetal ultrasound screening in Denmark. METHODS: All deaths (n=11 451) among people aged 0 to 35 years in Denmark in 2000 to 2009 (24...
June 2018: Circulation. Arrhythmia and Electrophysiology
Heleen Lameijer, Ymkje J van Slooten, Monique R M Jongbloed, Martijn A Oudijk, Marlies A M Kampman, Arie P van Dijk, Marco C Post, Barbara J Mulder, Krystyna M Sollie, Dirk J van Veldhuisen, Tjark Ebels, Joost P van Melle, Petronella G Pieper
BACKGROUND: We evaluate pregnancy outcome and anticoagulation regimes in women with mechanical and biological prosthetic heart valves (PHV) for congenital heart disease. METHODS: Retrospective multicenter cohort studying pregnancy outcomes in an existing cohort of patients with PHV. RESULTS: 52 women had 102 pregnancies of which 78 pregnancies (46 women) ≥20 weeks duration (59 biological, 19 mechanical PHV). Miscarriages (n = 19, ≤20 weeks) occurred more frequently in women using anticoagulation (P < ...
May 23, 2018: International Journal of Cardiology
H Dupuis, L Ghesquière, Julien De Jonckheere, E Aubry, D Sharma, P Deruelle, L Storme, V Houfflin-Debarge, C Garabedian
OBJECTIVE: The aim of fetal heart rate monitoring during labour is to identify and prevent foetal distress, but its evaluation is not perfect. Fetal scalp blood sampling for pH measurement is one of the second-line methods of monitoring when fetal heart rate is classified as suspicious. This study aims to determine when pH testing should be performed after a prolonged deceleration. STUDY DESIGN: This was an experimental study in a fetal sheep model. A partial umbilical cord occlusion was performed for seven minutes followed by a recuperation period of 30 min...
May 22, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
J E Linde, J M Perlman, K Øymar, J Schulz, J Eilevstjønn, M Thallinger, S Kusulla, H L Kidanto, H L Ersdal
BACKGROUND: Birth asphyxia, defined as 5-minute Apgar score <7 in apneic newborns, is a major cause of newborn mortality. Heart rate (HR) response to ventilation is considered an important indicator of effective resuscitation. OBJECTIVES: To describe the relationship between initial HR in apneic newborns, HR responses to ventilation and 24-h survival or death. METHODS: In a Tanzanian hospital, data on all newborns ≥34 weeks gestational age resuscitated between June 2013-January 2017 were recorded using self-inflating bags containing sensors measuring ventilation parameters and expired CO2 , dry-electrode electrocardiography sensors, and trained observers...
May 23, 2018: Resuscitation
Angie T Ng, Lewei Duan, Theresa Win, Hillard T Spencer, Ming-Sum Lee
OBJECTIVES: The goal of this study is to report the prevalence, aetiology and clinical outcome of pregnant women with heart failure. METHODS: This is a retrospective community-based cohort study that included pregnant women in the Kaiser Permanente Health System between 2003 and 2014. Women with heart failure were identified using International Classification of Disease, Ninth Revision codes. Medical records were manually reviewed to confirm diagnosis and adjudicate outcomes...
May 25, 2018: Heart: Official Journal of the British Cardiac Society
Ke Lu, Malin Holzmann, Fahrad Abtahi, Kaj Lindecrantz, Pelle G Lindqvist, Lennart Nordstrom
INTRODUCTION: Fetal heart rate short term variation (STV) decreases with severe chronic hypoxia in the antenatal period. However, only limited research has been done on STV during labor. We have tested a novel algorithm for a valid baseline estimation and calculated STV. To explore the value of STV during labor we compared STV with fetal scalp blood (FBS) lactate concentration, an early marker in the hypoxic process. MATERIAL AND METHODS: A software was developed which estimates baseline frequency using a novel algorithm and thereby calculate STV according to Dawes and Redman in up to four 30 minute blocks prior to each FBS...
May 25, 2018: Acta Obstetricia et Gynecologica Scandinavica
Niyan Marchon, Gourish Naik, K R Pai
Fetal heart rate (FHR) detection can be monitored using either direct fetal scalp electrode recording (invasive) or by indirect noninvasive technique. Weeks before delivery, the invasive method poses a risk factor to the fetus, while the latter provides accurate fetal ECG (FECG) information which can help diagnose fetal's well-being. Our technique employs variable order linear phase sharp transition (LPST) FIR band-pass filter which shows improved stopband attenuation at higher filter orders. The fetal frequency fiduciary edges form the band edges of the filter characterized by varying amounts of overlap of maternal ECG (MECG) spectrum...
2018: Journal of Healthcare Engineering
L Johnsen, N B Lyckegaard, P Khanal, B Quistorff, K Raun, M O Nielsen
OBJECTIVE: We aimed to test, whether fetal under- or overnutrition differentially program the thyroid axis with lasting effects on energy metabolism, and if early-life postnatal overnutrition modulates implications of prenatal programming. DESIGN: Twin-pregnant sheep ( n  = 36) were either adequately (NORM), under- (LOW; 50% of NORM) or overnourished (HIGH; 150% of energy and 110% of protein requirements) in the last-trimester of gestation. From 3 days-of-age to 6 months-of-age, twin lambs received a conventional (CONV) or an obesogenic, high-carbohydrate high-fat (HCHF) diet...
May 2018: Endocrine Connections
Marlin Touma
Congenital heart defects (CHDs) are the most common cause of childhood morbidity and early mortality. Prenatal detection of the underlying molecular mechanisms of CHDs is crucial for inventing new preventive and therapeutic strategies. Mutant mouse models are powerful tools to discover new mechanisms and environmental stress modifiers that drive cardiac development and their potential alteration in CHDs. However, efforts to establish the causality of these putative contributors have been limited to histological and molecular studies in non-survival animal experiments, in which monitoring the key physiological and hemodynamic parameters is often absent...
May 5, 2018: Journal of Visualized Experiments: JoVE
Diana Escalona-Vargas, Jessica L Coker, Shona Ray-Griffith, Eric R Siegel, Curtis L Lowery, Zachary N Stowe, Hari Eswaran
BACKGROUND AND AIMS: In-utero exposure to opioids including buprenorphine (BUP) has been shown to affect fetal activity, specifically heart-rate variability (FHRV) and fetal movement (FM). Our objective was to extract simultaneous recordings of fetal cardiac, and brain-related activity in BUP-maintained and non-opioid exposed pregnant women using a novel non-invasive biomagnetic technique. DESIGN: A pilot study was conducted, recording and analyzing biomagnetic data from fetuses of BUP-maintained and non-opioid exposed pregnant women...
May 20, 2018: Addiction
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