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Fetal Heart Rate Patterns (fetal + heart_rate_pattern)
Selected AbstractsFetal Heart Rate Patterns and Sudden Infant Death SyndromeJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2006Cydney A. Menihan Objective:, To determine differences in electronic fetal monitoring patterns between infants who died of sudden infant death syndrome and controls. Design:, Case-control study (N= 127). Setting:, A tertiary-level women's hospital in Providence, Rhode Island. Participants:, Infants born between 1990 and 1998 who subsequently died of sudden infant death syndrome and controls. Demographic and clinical data included medical maternal charts and fetal monitoring records. Results:, Compared with controls (n= 98), the mothers whose infants subsequently died of sudden infant death syndrome (n= 29) had lower birthweight babies (sudden infant death syndrome 2,840 vs. controls 3,385 g; p < .01), were younger (22 vs. 28 years; p < .01), were more likely to receive Medicaid health insurance (odds ratio 4.6; confidence interval 1.9-11.2), were more likely to be unmarried (odds ratio 5.2; confidence interval 2.1-12.8), had less intention to breastfeed (26% vs. 57%), and were more likely to smoke (odds ratio 4.6; confidence interval 9-11.2). Main outcome measures:, There were no statistical differences in fetal heart rate variability or sleep/wake cycles detected between groups. Conclusion:, Statistical differences were found in demographic characteristics between sudden infant death syndrome mother-infant couples and their controls. However, no differences were detected in the intrapartum electronic fetal monitoring records, specifically in variability and sleep/wake cycles. JOGNN,35, 116,122; 2006. DOI: 10.1111/J.1552-6909.2006.00013.x [source] Fetal heart rate patterns and ECG ST segment changes preceding metabolic acidaemia at birthBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2005Isis Amer-Wåhlin Objectives To compare the rates of abnormal ST segment patterns of the ECG and cardiotocographic (CTG) abnormalities in fetuses with metabolic acidaemia at birth and controls. To evaluate the inter-observer agreement in interpretation of ST analysis and CTG. Design Case,control study. Setting Three University hospitals in southern Sweden. Population Cases and controls were selected from the Swedish randomised controlled trial on intrapartum monitoring, including 4966 fetuses monitored with a scalp electrode. Methods Two obstetricians independently assessed the CTG and ST traces of 41 fetuses with metabolic acidaemia at birth and 101 controls, blinded to group, outcome and all clinical data. They classified each CTG trace and ST analysis as abnormal or not abnormal, and whether there was indication to intervene according to the CTG or to the CTG + ST guidelines. If their classification differed, assessment by a third obstetrician determined the final classification. Main outcome measures Rates of CTG and ST abnormalities and decisions to intervene. Rates of inter-observer agreement. Results CTG was classified as abnormal in 50% and ST in 63% of cases with acidaemia, and in 20% and 34% of controls, respectively. CTG abnormalities were judged to be indication for intervention in 45% and CTG + ST abnormalities in 56% of cases with acidaemia, and in 15% and 8% of controls, respectively. The proportion of agreement between the two initial observers was significantly higher for ST abnormalities (94%) than for CTG abnormalities (73%), and for indication to intervene according to CTG + ST (89%) than according to CTG alone (76%). Conclusions The inter-observer agreement rate was higher for a decision to intervene based on CTG + ST than on CTG alone. [source] Original Article: The development and initiation of the NSW Department of Health interprofessional Fetal welfare Obstetric emergency Neonatal resuscitation Training projectAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010Helen COOKE Background:, The Fetal Welfare Obstetric emergency Neonatal resuscitation Training (FONT) project was initiated on a background of rising notifications of adverse events in NSW maternity units, the significant proportion of which were related to fetal welfare assessment. Aims:, The aim of the study is to describe the development and introduction of the NSW state-wide interprofessional FONT project. Methods:, Following development and risk assessment, FONT was launched in February 2008. The project consists of an online component and two face-to-face training days to be completed each 3 years; the first day for fetal welfare assessment and the second for obstetric and newborn emergencies. Eight, 2-day training sessions were conducted throughout NSW for FONT trainers. Each trainer underwent pre- and post-testing for changes in knowledge of fetal welfare assessment. The 2005,2008 NSW adverse event report numbers were assessed. Results:, From 20 February to 17 April 2008, 240 trainers had been trained in fetal welfare assessment, and by the end of 2008 these trainers had trained 954 clinicians. There were significant improvements in the interpretation and management planning of electronic fetal heart rate patterns following training. Analysis of Severity Assessment Codes 1 and 2 showed no significant trend in the number of notifications for adverse events related to fetal welfare assessment. Conclusions:, In the first 11 months, 25% of the state's maternity practitioners had received training in the first stage of the FONT project. The FONT project has shown short-term improvements in learning and communication skills and in the participants of the project. [source] Commercial Hospital Discharge Packs for Breastfeeding WomenBIRTH, Issue 1 2001J. K. Gupta A substantive amendment to this systematic review was last made on 23 March 1999. Cochrane reviews are regularly checked and updated if necessary. ABSTRACT Background: For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting) or lying down has advantages for women delivering their babies. Objectives: The objective of this review was to assess the benefits and risks of the use of different positions during the second stage of labour (i.e., from full dilatation of the cervix). Search strategy: Relevant trials are identified from the register of trials maintained by the Cochrane Pregnancy and Childbirth Group, and from the Cochrane Controlled Trials Register. Selection criteria: Trials were included which compared various positions assumed by pregnant women during the second stage of labour. Randomised and quasi-randomised trials with appropriate follow-up were included. Data collection and analysis: Trials were independently assessed for inclusion, and data extracted by the two authors. Disagreements would have been resolved by consensus with an editor. Meta-analysis of data is performed using the RevMan software. Main results: Results should be interpreted with caution as the methodological quality of the 18 trials was variable. Use of any upright or lateral position, compared with supine or lithotomy positions, was associated with: 1Reduced duration of second stage of labour (12 trials,mean 5.4 minutes, 95% confidence interval (CI) 3.9,6.9 minutes). This was largely due to a considerable reduction in women allocated to use of the birth cushion. 2A small reduction in assisted deliveries (17 trials,odds ratio (OR) 0.82, 95% CI 0.69,0.98). 3A reduction in episiotomies (11 trials,OR 0.73, 95% CI 0.64,0.84). 4A smaller increase in second degree perineal tears (10 trials,OR 1.30, 95% CI 1.09,1.54). 5Increased estimated risk of blood loss > 500ml (10 trials,OR 1.76, 95% CI 1.34,3.32). 6Reduced reporting of severe pain during second stage of labour (1 trial,OR 0.59, 95% CI 0.41,0.83). 7Fewer abnormal fetal heart rate patterns (1 trial,OR 0.31, 95% CI 0.11,0.91). Reviewers' conclusions: The tentative findings of this review suggest several possible benefits for upright posture, with the possibility of increased risk of blood loss > 500 mL. Women should be encouraged to give birth in the position they find most comfortable. Until such time the benefits and risks of various delivery positions are estimated with greater certainty when methodologically stringent trials data are available, then women should be allowed to make informed choices about the birth positions in which they might wish to assume for delivery of their babies. Citation: Gupta JK, Nikodem VC. Women's position during second stage of labour (Cochrane Review). In: The Cochrane Library, Issue 4, 2000. Oxford: Update Software. [source] | |||||||||||||||||||