Home About us Contact
|
Home About us Contact | ||
|
|
||
Electronic Fetal Monitoring (electronic + fetal_monitoring)
Selected AbstractsOn NICHD Workshops I (1997) and II (2008) on Electronic Fetal MonitoringJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2009Carol J. Harvey No abstract is available for this article. [source] The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal Monitoring: Update on Definitions, Interpretation, and Research GuidelinesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 5 2008George A. Macones MD ABSTRACT In April 2008, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine partnered to sponsor a 2-day workshop to revisit nomenclature, interpretation, and research recommendations for intrapartum electronic fetal heart rate monitoring. Participants included obstetric experts and representatives from relevant stakeholder groups and organizations. This article provides a summary of the discussions at the workshop. This includes a discussion of terminology and nomenclature for the description of fetal heart tracings and uterine contractions for use in clinical practice and research. A three-tier system for fetal heart rate tracing interpretation is also described. Lastly, prioritized topics for future research are provided. [source] Comparing Auscultation to Electronic Fetal MonitoringNURSING FOR WOMENS HEALTH, Issue 3 2000Nancy Fischbeck Feinstein RNC Editor's Note: The following article has been excerpted from "Fetal Heartz ate Auscultation", one of the newest monographs in the AWHONN Symposia Series. [source] Advancing Patient Safety through Process ImprovementsJOURNAL FOR HEALTHCARE QUALITY, Issue 5 2009Linda Elgart Abstract: The department of Women's and Children's Services at the Hospital of Saint Raphael (HSR) in New Haven, CT, has initiated several different and successful approaches to reducing patient risk within the department. The department purchased a computerized fetal monitoring and documentation program that has improved the ability to provide high-level antepartal care for mothers and fetuses with automatic patient data management and continuous fetal heart rate surveillance. A Risk Reduction Grant offered through the hospital malpractice insurance program provided the financial assistance for all medical providers to become certified in electronic fetal monitoring. The certification is now a required educational standard for nurses, certified nurse midwives, and for physicians who work in the labor and delivery unit. Infant and pediatric security is incorporated into policy and practice measures that include hospital-wide drills for the prevention of infant abduction. The Obstetrics and Gynecology (OB/GYN) Quality Improvement Committee supports systematic reviews of identified clinical risks and works to find viable solutions to these problems. The hospital has supported specialized obstetrical care through the Maternal Fetal Medicine Unit (MFMU), Newborn Intensive Care Unit (NICU), the Inpatient Pediatric Unit, and the labor and delivery unit. In addition, HSR has initiated an enhanced medical informed consent that is available online for providers and a patient education tool that includes a computer room at the hospital for patient use. [source] Team Midwifery Care in a Tertiary Level Obstetric Service: A Randomized Controlled TrialBIRTH, Issue 3 2000Mary Anne Biró RN Background:In 1996 a new model of maternity care characterized by continuity of midwifery care from early pregnancy through to the postpartum period was implemented for women attending Monash Medical Centre, a tertiary level obstetric service, in Melbourne, Australia. The objective of this study was to compare the new model of care with standard maternity care.Methods:In a randomized controlled trial, 1000 women who booked at the antenatal clinic and met the eligibility criteria were randomly allocated to receive continuity of midwifery care (team care) from a group of seven midwives in collaboration with obstetric staff, or care from a variety of midwives and obstetric staff (standard care). The primary outcome measures were procedures in labor, maternal outcomes, neonatal outcomes, and length of hospital stay.Results:Women assigned to the team care group experienced less augmentation of labor, less electronic fetal monitoring, less use of narcotic and epidural analgesia, and fewer episiotomies but more unsutured tears. Team care women stayed in hospital 7 hours less than women in standard care. More babies of standard care mothers were admitted to the special care nurseries for more than 5 days because of preterm birth, and more babies of team care mothers were admitted to the nurseries for more than 5 days with intrauterine growth retardation. No differences occurred in perinatal mortality between the two groups.Conclusions:Continuity of midwifery care was associated with a reduction in medical procedures in labor and a shorter length of stay without compromising maternal and perinatal safety. Continuity of midwifery care is realistically achievable in a tertiary obstetric referral service. [source] Declining Trends in Cesarean Deliveries, Ohio 1989,1996: An Analysis by IndicationsBIRTH, Issue 1 2000Siran M. Koroukian PhD Background:Similar to trends observed nationwide, the rates of cesarean deliveries declined in Ohio during the late 1980s and the early 1990s. This study examined the trends in cesarean deliveries in Ohio from 1989 through 1996, in the presence or absence of indications, and in relation to the use of obstetric procedures. Methods:Birth certificate data for all singleton, liveborn infants in Ohio (n =1,204,859) were used to analyze temporal trends in cesarean sections. Results:The rates of primary and repeat cesarean deliveries declined, respectively, from 15.7 to 12.4 percent and from 83 to 63.3 percent during the 8-year study period. Significant declines in repeat cesarean deliveries were observed both in the presence and absence of documented medical conditions that could present a potential indication for the procedure. The rates of repeat cesareans remained comparable among women with and without documented indications for cesarean section (64% and 61%, respectively). In addition, 45 and 30 percent of repeat cesareans in 1989 and 1996, respectively, were performed in the absence of any documented indications, or on an elective basis. The declines in cesarean delivery rates during the 8-year study period occurred simultaneously with an increase in the use of electronic fetal monitoring, induction, and stimulation of labor. Conclusions:The findings suggest that a sizable proportion of repeat cesarean deliveries in 1996 may be unnecessary, even though a marked decline in the procedure has occurred between 1989 and 1996. [source] Do maternity care provider groups have different attitudes towards birth?BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2004Birgit Reime Objective To compare family physicians', obstetricians' and midwives' self-reported practices, attitudes and beliefs about central issues in childbirth. Design Mail-out questionnaire. Setting/Population All registered midwives in the province, and a sample of family physicians and obstetricians in a maternity care teaching hospital. Response rates: 91% (n= 50), 69% (n= 97) and 89% (n= 34), respectively. Methods A postal survey. Main outcome measures Twenty-three five-point Likert scale items (strongly agree to strongly disagree) addressing attitudes toward routine electronic fetal monitoring, induction of labour, epidural analgesia, episiotomy, doulas, vaginal birth after caesarean section (VBACs), birth centres, provision educational material, birth plans and caesarean section. Results Cluster analysis identified three distinct clusters based on similar response to the questions. The ,MW' cluster consisted of 100% of midwives and 26% of the family physicians. The ,OB' cluster was composed of 79% of the obstetricians and 16% of the family physicians. The ,FP' cluster was composed of 58% the family physicians and 21% the obstetricians. Members of the ,OB' cluster more strongly believed that women had the right to request a caesarean section without maternal/fetal indications (P < 0.001), that epidurals early in labour were not associated with development of fetal malpositions (P < 0.001) and that increasing caesarean rates were a sign of improvement in obstetrics (P < 0.001). The ,OB' cluster members were more likely to say they would induce women as soon as possible after 41 3/7 weeks of gestation (P < 0.001) and were least likely to encourage the use of birth plans (P < 0.001). The ,MW' cluster's views were the opposite of the ,OBs' while the ,FP' cluster's views fell between the ,MW' and ,OB' clusters. Conclusions In our environment, obstetricians were the most attached to technology and interventions including caesarean section and inductions, midwives the least, while family physicians fell in the middle. While generalisations can be problematic, obstetricians and midwives generally follow a defined and different approach to maternity care. Family physicians are heterogeneous, sometimes practising more like midwives and sometimes more like obstetricians. [source] | ||||||||||