scholarly journals Prevention of Cerebral Palsy and Fetal Demise with Hypoxia Index, FHR Score and Pathologic Sinusoidal FHR in Fetal Monitoring

2020 ◽  
pp. 1-3
Author(s):  
Kazuo Maeda
Keyword(s):  
Heart Rate ◽  
Cerebral Palsy ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Monitoring ◽  
Infantile Cerebral Palsy ◽  
Fetal Demise ◽  
Fetal Monitor

Although fetal deaths was decreased by intrapartum Fetal Heart Rate (FHR) monitoring, infantile cerebral palsy was not decreased in Dublin trials of Electric Fetal Monitor (EFM), thus, an analysis to reduce cerebral palsy was studied, where cerebral palsy is prevented by setting the threshold of hypoxia index at 24 or less, in the analysis of FHR deceleration.

Effect of Oligohydramnios on Fetal Heart Rate Patterns during Term Labor Induction

2018 ◽  
Vol 36 (07) ◽  
pp. 715-722
Author(s):  
Janine S. Rhoades ◽  
Molly J. Stout ◽  
George A. Macones ◽  
Alison G. Cahill
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Fetal Monitoring ◽  
Secondary Outcome ◽  
Significant Difference ◽  
Electronic Fetal Monitoring ◽  
Consecutive Term

Objective To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term. Study Design Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios. Our secondary outcome was composite neonatal morbidity. Logistic regression was used to control for confounders. Results Of 3,787 patients who underwent IOL, 147 had a diagnosis of oligohydramnios and 3,640 were included in the no oligohydramnios group. There was no significant difference in EFM characteristics between the two groups. There was no difference in composite neonatal morbidity. In patients with oligohydramnios, EFM patterns with baseline tachycardia for 30 minutes or greater were significantly associated with composite neonatal morbidity (31.3 vs. 5.3% adjusted odds ratio 8.63, 95% confidence interval 2.18, 34.1]). Conclusion Term patients undergoing IOL with oligohydramnios had EFM patterns that did not differ from their induced peers.

scholarly journals Non-invasive Fetal Electrocardiography for Intrapartum Cardiotocography

2020 ◽  
Vol 8 ◽  
Author(s):  
Rik Vullings ◽  
Judith O. E. H. van Laar
Keyword(s):  
Heart Rate ◽  
Doppler Ultrasound ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Monitoring ◽  
Irreversible Damage ◽  
Scalp Electrode ◽  
Non Invasive ◽  
Electrophysiological Measurements ◽  
Fetal Electrocardiography

Fetal monitoring is important to diagnose complications that can occur during pregnancy. If detected timely, these complications might be resolved before they lead to irreversible damage. Current fetal monitoring mainly relies on cardiotocography, the simultaneous registration of fetal heart rate and uterine activity. Unfortunately, the technology to obtain the cardiotocogram has limitations. In current clinical practice the fetal heart rate is obtained via either an invasive scalp electrode, that poses risks and can only be applied during labor and after rupture of the fetal membranes, or via non-invasive Doppler ultrasound technology that is inaccurate and suffers from loss of signal, in particular in women with high body mass, during motion, or in preterm pregnancies. In this study, transabdominal electrophysiological measurements are exploited to provide fetal heart rate non-invasively and in a more reliable manner than Doppler ultrasound. The performance of the fetal heart rate detection is determined by comparing the fetal heart rate to that obtained with an invasive scalp electrode during intrapartum monitoring. The performance is gauged by comparing it to performances mentioned in literature on Doppler ultrasound and on two commercially-available devices that are also based on transabdominal fetal electrocardiography.

The Factor Time in Fetal Heart Rate Monitoring and the Detection of Acidosis Using the WAS Score

2014 ◽  
Vol 218 (02) ◽  
pp. 80-86
Author(s):  
V. Roemer ◽  
R. Walden
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Oscillation Amplitude ◽  
Fetal Monitoring ◽  
Significant Loss ◽  
Fetal Heart Rate Monitoring ◽  
Mean Frequency ◽  
Ph Values ◽  
Umbilical Blood

Abstract Background: Using the naked eye evaluation of fetal heart rate (fhr) patterns remains difficult and is not complete. Computer-aided analysis of the fhr offers the opportunity to analyze fhr patterns completely and to detect all changes due to hypoxia and acidosis. It was the goal of this study to analyze the factor time in fetal monitoring and to evaluate the association between the fhr and the actual pH values in arterial umbilical blood. Methods: During a period of 11 years the FHR signals (i. e., the R-R interval of the F-ECG) of 646 fetuses were recorded with a CTG and simultaneously by a computer. The computer files were analyzed thereafter, i. e., the results did not influence our clinical management. To enter the study, all fetuses must have been delivered by the vaginal route – in consequence without a significant loss of fhr signals. During forceps and/or vacuum deliveries recordings were continued. If necessary a new electrode was inserted. In this study recordings of fetuses with chorioamnionitis, tracings of malformed neonates and tracings shorter than 30 min were excluded. Thus 484 recordings were left. We used our own computer programs written in MATLAB (USA). 3 parameters were determined electronically: 1) the mean fetal frequency [fhf, (bpm)], 2) the number of turning points (N/min) in the fhr, which we called ‘microfluctuation’ (micro) and 3) the oscillation amplitude, oamp (bpm). Measurements of the acid-base variables from arterial (UA) and venous (UV) blood were performed using RADIOMETER equipment (ABL500) and trained personnel. However, only the actual pHUA values were used in this study. To detect the influence of hypoxia and acidosis, all 484 cases were separated into 7 groups according to the actual pHUA value: 55 fetuses lying in a small non-acidotic “pH-window” (pHUA=7.290–7.310, mean=7.300±0.008) were used as ‘controls’. Results: In humans fhf, micro and the oamp behave differently during the last 30 min of delivery and with different fetal pHUA values: micro is early (at 0 min) decreased with fetal acidemia and is steadily deceasing (68–40 N/min) during vaginal delivery; the oamp – mainly due to decelerations – is increased from 35 up to 70 bpm during the last 30 min. Hypoxia and acidosis increase the amplitude and duration of decelerations; finally fhf shows only an insignificant reaction to acidemia but is decreased (from 135 to 110 bpm) overall with the course of time. Therefore the 3 characteristics of the fhr might be ranged according to their decreasing sensitivity to acidemia as follows: 1) fetal microfluctuation, 2) oscillation amplitude and 3) mean frequency. The 3 components of the fhr were used to invent and apply a score named the WAS score. This score increases the association between the actual pHUA values and the activity of the fetal heart. The 3 variables of the fhr mentioned above were rated differently; the 3 factors necessary to achieve this were computed electronically using an optimization program. The result is the WAS score: WAS=mean [frq*ff(vj) * micro*fm (vj)/oamp*fa(vj)]j=1,30. Using the last 30 min of delivery the correlation coefficient r of this score with pHUA reaches 0.645, P<< 0.001. The regression is linear in our 484 cases. Conclusions: Microfluctuation is the most sensible variable of the fetal heart followed by the oscillation amplitude and mean frequency. The WAS score offers the best correlation with the actual pH values measured in arterial umbilical blood.

Fetal Heart Rate Pattern in Term or Near-Term Cerebral Palsy: A Nationwide Cohort Study

2021 ◽  
Vol 76 (5) ◽  
pp. 261-263
Author(s):  
Masahiro Nakao ◽  
Asumi Okumura ◽  
Junichi Hasegawa ◽  
Satoshi Toyokawa ◽  
Kiyotake Ichizuka ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cerebral Palsy ◽  
Cohort Study ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Heart Rate Pattern ◽  
Near Term ◽  
Heart Rate Pattern

A Handbook of Pre-natal Paediatrics for Obstetricians and Paediatricians, edited by Gifford F. Batstone, M.B., B.S., Alastair W. Blair, M.B., Ch.B., M.R.C.P.E., D.C.H., and Jack M. Slater, M.B., Ch.B., M.R.C.O.G. Philadelphia: J. B. Lippincott, 1971, 225 pp., $10.00

PEDIATRICS ◽  
1972 ◽  
Vol 50 (5) ◽  
pp. 835-835
Author(s):  
John C. Hobbins
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Monitoring ◽  
Pertinent Information

The British authors have chosen to call this a "handbook." It may be a handbook in size but not in content. It contains more pertinent information relating to the expanding field of perinatology than most of the bulkier texts on my shelf. Although detail and filigree have been sacrificed, the book is far from dry. In the early chapters the reader is given a concise account of fetal monitoring by interpretation of continuous fetal heart rate patterns and information obtained from scalp sampling.

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