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Heart Rate Monitoring (heart + rate_monitoring)
Selected AbstractsThe 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] Tocolysis and delayed delivery versus emergency delivery in cases of non-reassuring fetal status during laborJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2007Leonel Briozzo Abstract Aim:, To determine whether fetal intrauterine resuscitation using tocolysis and delayed delivery is better for the fetus than emergency delivery when fetal hypoxia is suspected because of a non-reassuring fetal heart-rate (FHR) pattern using conventional heart rate monitoring. Methods:, This was a prospective and randomized study, conducted between 2001 and 2004 at Pereira Rossell Hospital, Montevideo, Uruguay. The population consisted of 390 fetuses, in which intrauterine distress was diagnosed using electronic FHR monitoring. Of these, 197 were randomly assigned to the emergency delivery group and 193 to the fetal intrauterine resuscitation group. The inclusion criteria were: term singleton pregnancy, in labor, cephalic presentation, and no placental accidents. Results:, The time between randomization and birth was 16.9 ± 7.6 min (mean ± SD) for the emergency delivery group, and 34.5 ± 11.7 min (mean ± SD) for the resuscitation group. The relative risk (RR) of acidosis in the umbilical artery (pH < 7.1) in the emergency delivery group was 1.47 (0.95,2.27). The RR of base deficit ,12 mEq/L in the emergency delivery group was higher than in the resuscitation group (RR = 1.48 [1.0,2.2], P = 0.04). When considering the need for admission to the neonatal care unit, the relative risk was higher in the emergency delivery group than in the resuscitation group (RR = 2.14 [1.23·3.74], P = 0.005). No maternal adverse effects were reported. Conclusion:, Tocolysis and delayed delivery renders better immediate neonatal results than emergency delivery when fetal distress is suspected because of a non-reassuring fetal heart pattern. In addition, it may decrease the need for emergency delivery without increasing maternal and fetal adverse side-effects. [source] Fetal heart rate monitoring from maternal body surface potentials using independent component analysisANIMAL SCIENCE JOURNAL, Issue 5 2004Wenxi CHEN ABSTRACT The fetal heart rate is indispensable for monitoring the health of unborn cattle fetuses. To monitor the fetal heart rate, a method employing independent component analysis (ICA) to extract the fetal electrocardiogram (fECG) from potentials measured on the maternal body surface and composed of a mixture of the maternal ECG (mECG), fECG, baseline drift and noise is described. A mixing of the raw data was simplified using a linear time-invariant model. To separate the fECG from the mECG, baseline drift, and noise, an ICA strategy was applied, using a hyperbolic tangent as the contrast function and treating mutual information with the minimization principle to find the optimum demixing matrix to derive the fECG from the measured signals. After the feasibility of this method was shown on simulated signals obtained by randomly mixing pure fECG, pure mECG, low frequency sinusoidal drift and noise, real signals from three cloned pregnant Holstein cows with 157, 177 and 224-day gestation periods were used to verify the separation method. The results show that the fECG, mECG, low-frequency sinusoidal drift and noise can be clearly segregated in simulations, and that the fECG, mECG, baseline drift and noise can be successfully derived from real signals. The ICA approach has great potential in effectively detecting the fECG from maternal body surface potentials. [source] Vaginal birth after Caesarean section: A survey of practice in Australia and New ZealandAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2003Jodie Dodd Abstract Aims: Women with a single prior Caesarean section (CS) in a subsequent pregnancy will be offered either a planned elective repeat CS or vaginal birth after Caesarean (VBAC). Recent reports of VBAC have highlighted risks of increased morbidity, including uterine rupture, and adverse infant outcome. A survey of practice was sent to fellows and members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists to determine current care for women in a subsequent pregnancy with a single prior CS, and to assess variations by length and type of obstetric practice. Methods: Questions asked about the safety of VBAC, induction of labour with a uterine scar, and requirements to conduct VBAC and elective repeat CS. Results: A total of 1641 surveys were distributed, with 1091 (67%) returned, 844 from practicing obstetricians (51% of college membership). Almost all respondents (96%) agreed or strongly agreed that VBAC should be presented as an option to the woman, varying from 90% where the indication for primary CS was breech, 88% for fetal distress, and 55% for failure to progress. Forty percent of respondents agreed or strongly agreed that VBAC was the safest option for the woman, and associated with fewer risks than CS. In contrast, 44% of respondents disagreed or strongly disagreed that VBAC was the safest option for the infant, and opinions varied as to whether risks of VBAC outweighed those of CS for the infant. Almost two-thirds of practitioners would offer induction of labour to a woman with a prior CS in a subsequent pregnancy, one-third indicating a willingness to use vaginal prostaglandins, and 77% syntocinon. Most respondents preferred to conduct VBAC in a level two or three hospital (86%); required the availability within 30 min of an anaesthetist (81%), a neonatologist (84%), and operating theatre (97%); recommended continuous electronic fetal heart rate monitoring (86%); intravenous access (90%); and routine group and hold (79%) during labour. For an elective repeat CS, most practitioners request routine blood for group and hold (78%), a neonatologist in theatre (77%), the use of an in-dwelling urinary catheter (96%), and the use of intraoperative antibiotics (82%). Conclusions: Most obstetricians indicated VBAC to be the safest option for the woman, but were less certain about benefits and risks for the infant. The consensus of practice is to present VBAC as an option and induce labour if needed. Vaginal birth after Caesarean is preferred in a level two or three hospital, with an anaesthetist, neonatologist and operating theatre available within 30 min. The use of continuous electronic fetal heart rate monitoring and intravenous access are recommended. In planned CS, a neonatologist in theatre is preferred, and an in-dwelling urinary catheter and intraoperative antibiotics will be used. [source] Expectant management of early onset, severe pre-eclampsia: perinatal outcomeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2000D. R. Hall Consultant Objective To evaluate the perinatal outcome of expectant management of early onset, severe pre-eclampsia. Design Prospective case series extending over a five-year period. Setting Tertiary referral centre. Population All women (n= 340) presenting with early onset, severe pre-eclampsia, where both mother and the fetus were otherwise stable. Methods Frequent clinical and biochemical monitoring of maternal status with careful blood pressure control. Fetal surveillance included six-hourly heart rate monitoring, weekly Doppler and ultrasound evaluation of the fetus every two weeks. All examinations were carried out in a high care obstetric ward. Main outcome measures Prolongation of gestation, perinatal mortality rate, neonatal survival and major complications. Results A mean of 11 days were gained by expectant management. The perinatal mortality rate was 24/1000 (, 1000 g/7 days) with a neonatal survival rate of 94%. Multivariate analysis showed only gestational age at delivery to be significantly associated with neonatal outcome. Chief contributors to neonatal mortality and morbidity were pulmonary complications and sepsis. Three pregnancies (0.8%) were terminated prior to viability and only two (0.5%) intrauterine deaths occurred, both due to placental abruption. Most women (81.5%) were delivered by caesarean section with fetal distress the most common reason for delivery. Neonatal intensive care was necessary in 40.7% of cases, with these babies staying a median of six days in intensive care. Conclusion Expectant management of early onset, severe pre-eclampsia and careful neonatal care led to high perinatal and neonatal survival rates. It also allowed the judicious use of neonatal intensive care facilities. Neonatal sepsis remains a cause for concern. [source] | ||||||||||