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Fetal Scalp pH

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1. Fetal Scalp Lactate Testing During Intrapartum Pregnancy with Abnormal Fetal Heart Rate: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

with abnormal fetal heart rate was identified. The authors of the systematic review concluded that the available evidence (which had low to unclear risk of bias) indicated that fetal scalp lactate testing was more likely to be successful with fewer scalp incisions and the results were available in less time than with pH estimation. The results of the meta-analysis suggested that lactate and pH tests did not significantly differ from each other for a large number of neonatal outcomes including neonatal (...) encephalopathy, death from congenital abnormalities, Apgar score at five minutes, admission to NICU, umbilical cord pH or base deficit values, metabolic acidemia, number of additional tests performed per fetus to evaluate fetal well-being, mode of birth, and operative birth for non-reassuring fetal status.The three guidelines each recommended the use of fetal scalp blood sampling for women in labour when there is an abnormal or non-reassuring cardiotocography result. Two of these guidelines made

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Fetal Scalp pH

Fetal Scalp pH Fetal Scalp pH Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp pH Fetal Scalp pH Aka: Fetal Scalp pH (...) , Fetal Scalp Blood Sampling II. Indications Assess degree of III. Scalp Stimulation Test Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) IV. Fetal Scalp Blood Sample Analysis Normal pH: 7.25-7.35 (mean 7.33) pCO2: 40-50 mmHg pO2: 20-30 mmHg Base: <10 Non-reassuring findings (see interpretation below) pH <7.20 < -12 mmol/liter pH: <7.25 pCO2: 45-55 mmHg pO2: <20 mmHg Base: >10 pH: <7.25 pCO2: >50 mmHg pO2: Varies Base: <10 V

2018 FP Notebook

3. Using fetal scalp stimulation with Doppler ultrasonography to enhance intermittent auscultation in low-resource settings: a diagnostic trial from Tanzania. (Full text)

auscultation protocols improved the performance of intermittent auscultation for detecting severe acidemia (pH < 7.0) from 27 to 70% (p = 0.032). The negative predictive value of intermittent auscultation augmented with the fetal scalp stimulation test ranged from 88 to 99% for mild (pH < 7.2) to severe fetal acidemia.The fetal scalp stimulation test, conducted with a handheld Doppler, is feasible and accurate in a limited resource setting. It is a low-cost solution that merits further evaluation to reduce (...) Using fetal scalp stimulation with Doppler ultrasonography to enhance intermittent auscultation in low-resource settings: a diagnostic trial from Tanzania. Hypoxia during labor contributes to 2.2 million intrapartum and early neonatal deaths each year. An additional 0.6-1.0 million cases of life-long disability occur because of fetal hypoxia during labor. It is known that fetal heart rate changes in labor correspond to hypoxia and neurologic compromise, but a reliable, low-cost method

2019 BMC Pregnancy and Childbirth PubMed

4. Infant outcome at four years of age after intrapartum sampling of scalp blood lactate for fetal assessment. A cohort study. (Full text)

Infant outcome at four years of age after intrapartum sampling of scalp blood lactate for fetal assessment. A cohort study. To correlate the value of lactate in fetal scalp blood at delivery and the outcomes of the offspring at four years of age.Cases where scalp blood lactate was taken within sixty minutes before delivery were identified from the randomized trial "Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress". Data were grouped according (...) , although the findings were only significant for fine motor dysfunction (p = 0.036). Elevated lactate values were significantly associated with increased risk for a poorer capacity of attention and understanding of instructions (OR 1.37, 95% CI 1.07-1.74), and for fine motor dysfunction (OR 1.22, 95% CI 1.00-1.49) at the age of four.Higher levels of lactate in fetal scalp blood seems to be associated with increased risk of an aberrant developmental outcome at four years of age in some areas.

2018 PLoS ONE PubMed

5. Accuracy of intrapartum fetal blood gas analysis by scalp sampling: A retrospective cohort study. (Full text)

Accuracy of intrapartum fetal blood gas analysis by scalp sampling: A retrospective cohort study. Fetal blood gas analysis (FBGA) using scalp blood is commonly used to identify serious fetal distress. However, there is a lack of data regarding its accuracy and reliability. The aim of this study was to determine the positive predictive value (PPV) and negative predictive value (NPV) of FBGA for predicting postpartum acidosis in case of nonreassuring fetal heart rate tracings (NRFHRT (...) to determine the influence of cardiotocography variations and the time delay between FBGA and delivery on the accuracy of FBGA. We analyzed 343 deliveries with NRFHRT. In 32 (9%) of these cases, fetal acidosis was confirmed by a postpartum umbilical cord blood pH value ≤ 7.15. In 308/343 (90%) cases, FBGA identified NRFHRT as false positive (as confirmed by nonacidotic postpartum pH values) and thus avoided unnecessary interventions such as operative delivery. The overall test accuracy of FBGA was 91

2017 Medicine PubMed

6. Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings.

. Absence of an acceleration is a POSITIVE test and reason for intervention. Outcome Measures Go to Primary Outcome Measures : Feasibility as measured by completion of all 3 study objectives [ Time Frame: Day 1 ] Predicted fetal acidosis from cord blood pH (at thresholds of cord blood pH<7.0, 7.1, and 7.2) [ Time Frame: Day 1 ] The primary outcome is the sensitivity and specificity of the Doppler device to predict fetal acidosis based on the fetal scalp stimulation test. Secondary Outcome Measures (...) Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings. Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100

2016 Clinical Trials

7. Clinical evaluation of Statstrip<sup>®</sup> Lactate for use in fetal scalp blood sampling. (PubMed)

Clinical evaluation of Statstrip® Lactate for use in fetal scalp blood sampling. Point-of-care testing of fetal scalp blood lactate is used as an alternative to pH analysis in fetal scalp blood sampling (FBS) during labor. Lactate measurements are not standardized and values vary with each device used. The aim of this study was to evaluate StatStrip® Lactate (SSL) in the clinical setting in comparison with lactate (RLL) and pH (RLpH) using RapidLab® .We obtained 323 FBS samples from (...) evaluated prospectively regarding intervention rates and neonatal outcome, we recommend using SSL in addition to pH in FBS.© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

2016 Acta Obstetricia et Gynecologica Scandinavica

8. Fetal Scalp Stimulation

Stimulation Aka: Fetal Scalp Stimulation , Scalp Stimulation Test , Fetal Acoustic Stimulation II. Indications Assess degree of III. Technique Stimulate infant with one of two techniques Fetal Scalp Stimulation Fetal Acoustic Stimulation Observe response to stimulation IV. Interpretation: Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) V. References Images: Related links to external sites (from Bing) These images are a random sampling (...) Fetal Scalp Stimulation Fetal Scalp Stimulation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp Stimulation Fetal Scalp

2018 FP Notebook

9. Fetal electrocardiogram (ECG) for fetal monitoring during labour. (Full text)

quality evidence). There were, however, on average fewer fetal scalp samples taken during labour (average RR 0.61, 95% CI 0.41 to 0.91; four trials, 9671 babies; high quality evidence) although the findings were heterogeneous and there were no data from the largest trial (from the USA). There were marginally fewer operative vaginal births (RR 0.92, 95% CI 0.86 to 0.99; six trials, 26,446 women); but no obvious difference in the number of babies with low Apgar scores at five minutes or babies requiring (...) neonatal intubation, or babies requiring admission to the special care unit (RR 0.96, 95% CI 0.89 to 1.04, six trials, 26,410 babies; high quality evidence). There was little evidence that monitoring by PR interval analysis conveyed any benefit of any sort.The modest benefits of fewer fetal scalp samplings during labour (in settings in which this procedure is performed) and fewer instrumental vaginal births have to be considered against the disadvantages of needing to use an internal scalp electrode

2015 Cochrane PubMed

10. Intrapartum fetal surveillance

for fetal scalp lactate measurements · Use of scalp lactate rather than pH measurement provides an easier and more affordable adjunct to CEFM for some units 2 · Is as effective as scalp pH in predicting fetal outcomes · Has a strong negative predictive value for fetal acidemia at birth 39 · Requires local decision making to set absolute parameters for interpretation of lactate values as results may vary between machines 2,40 · Requires due diligence with regard to calibration of machine (...) Fetal Growth Restriction; GDM Gestational Diabetes; IOL Induction of labour; MoM Multiples of Median; PaPP-A Pregnancy associated plasma protein-A; PROM Premature Rupture of Membranes; PTL Preterm labour; PV Per Vaginal; T Temperature; = greater than or equal to; Greater than; 4.8 Abnormal: urgent birth · pH 5.0 No Queensland Clinical Guidelines: Intrapartum Fetal Surveillance Guideline No: MN15.15-V4-R20 Confirmatory CTG Normal? Yes Normal CTG · Baseline FHR 110-160 bpm · Baseline variability 6-25

2019 Queensland Health

11. Preterm fetal monitoring

with MgSO4. B Fetal monitoring, techniques Fetal blood sampling for pH may be used from gestational week 34+0 D Fetal heart rate monitorering by scalp electrode may be used from gestational week 32+0 - 34+0 D STAN may be used from gestational week 36+0 D Summary of evidence Grade Preterm fetal monitoring, recommended monitoring modalities The incidense of abnormal CTG is higher during preterm delivery than during term delivery. 2a-3 Continous preterm CTG during labour may be able to predict neonatal (...) from the scalp is not recommended before week 34+0. 5 Application of a fetal scalp electrode is not recommended prior to week 32-34 for the same reasons as listed above. 5 STAN should not be used before week 36+0, as the electrophysical properties of the heart may not have developed in the preterm fetus. 5 Characteristics of the normal CTG in the preterm fetus dependent of gestational age (GA) and compared to the normal term CTG. GA Baseline Variability Accelerations Decelerations 24-26 150-160

2019 Nordic Federation of Societies of Obstetrics and Gynecology

12. Fetal Scalp pH

Fetal Scalp pH Fetal Scalp pH Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp pH Fetal Scalp pH Aka: Fetal Scalp pH (...) , Fetal Scalp Blood Sampling II. Indications Assess degree of III. Scalp Stimulation Test Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) IV. Fetal Scalp Blood Sample Analysis Normal pH: 7.25-7.35 (mean 7.33) pCO2: 40-50 mmHg pO2: 20-30 mmHg Base: <10 Non-reassuring findings (see interpretation below) pH <7.20 < -12 mmol/liter pH: <7.25 pCO2: 45-55 mmHg pO2: <20 mmHg Base: >10 pH: <7.25 pCO2: >50 mmHg pO2: Varies Base: <10 V

2015 FP Notebook

13. Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements

. Cardiotocography (CTG) The electronic monitoring of the fetal heart rate (cardio) and of uterine contractions (toco). The fetal heart rate is recorded by means of either an external ultrasonic abdominal transducer or a fetal scalp electrode. Uterine contractions are recorded by means of an abdominal pressure transducer. The recordings are graphically represented over time. Congenital anomaly A structural malformation, chromosomal abnormality, genetic syndrome or metabolic disorder which is present from birth (...) Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements Developed in partnership with: Endorsed by: 10 August 2017 Produced by: This clinical guideline was produced by a multidisciplinary working group led by the Mater Research Institute, The University of Queensland, Brisbane, Australia, under the auspices of the Stillbirth and Neonatal Death Alliance (SANDA) of the Perinatal Society

2017 Clinical Practice Guidelines Portal

14. Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909]. (Full text)

and long term risks, could have been avoided without compromising the baby's health. Previously, fetal scalp blood sampling for pH estimation was performed in the context of an abnormal cardiotocograph, to improve the identification of babies in need of expedited delivery. This test has largely been replaced by lactate measurement, although its validity is yet to be established through a randomised controlled trial. This study aims to test the hypothesis that the performance of fetal scalp blood (...) Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909]. The rate of caesarean sections around the world is rising each year, reaching epidemic proportions. Although many caesarean sections are performed for concerns about fetal welfare on the basis of abnormal cardiotocography, the majority of babies are shown to be well at birth, meaning that the operation, with its inherent short

2015 BMC pregnancy and childbirth PubMed

15. Evaluation of the discrepancy between pH and lactate in combined fetal scalp blood sampling. (PubMed)

Evaluation of the discrepancy between pH and lactate in combined fetal scalp blood sampling. To evaluate the rate of discrepancy between pH and lactate values in fetal blood sampling (FBS). To evaluate differences in obstetric management in response to combined tests (pH and lactate) and single tests (pH or lactate).Descriptive study.Uppsala University Hospital, Sweden.Labors monitored by FBS during one year (n=241).Discrepancy in the combined tests was defined as a test having one abnormal (...) and one normal value. Abnormal pH was defined as 7.24 or lower and abnormal lactate as 4.2 or higher. The results were categorized according to whether the test was normal or abnormal and according to whether it was a combined or single analysis.Discrepancy between pH and lactate values in combined tests. Frequency of operative delivery for fetal distress (ODFD). Time interval from the last FBS to ODFD.In the combined tests with abnormality, a discrepancy between pH and lactate values occurred in 55

2011 Acta Obstetricia et Gynecologica Scandinavica

16. Cadiotocography Combined With ST-analysis Versus Cardiotocography Combined With Scalp-pH

and caesarean section. Interpretation of CTG can be improved by analyzing the acidity of a blood sample taken from the skin of the fetal scalp. Such a scalp pH analysis shows indirectly the fetus gets enough oxygen. Scalp pH measurement requires expertise and requires repeated measurements if the abnormal heart rate pattern persists. This method is the normal routine at the maternity ward at Hvidovre Hospital / Roskilde County Hospital. The problem seems to be partially alleviated by using a newly developed (...) of Newborn Device: Neoventa S 21 ST-ANalysis of fetal heart Procedure: CTG + FBS Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 1025 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Cardiotocography Combined With ST-analysis Versus Cardiotocography Combined With Scalp-pH in Deliveries With Abnormal CTG - A Randomised Trial

2012 Clinical Trials

17. Diagnosis and Treatment of Fetal Cardiac Disease (Full text)

Diagnosis and Treatment of Fetal Cardiac Disease Diagnosis and Treatment of Fetal Cardiac Disease | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share (...) on Jump to Free Access article Diagnosis and Treatment of Fetal Cardiac Disease A Scientific Statement From the American Heart Association , MD , MD , MD , MD , MD , MD , MD , MD , MD , MD , DO , MD , MD , RN , MD, DSc, FAHA , MD, FAHA , MD , and MD MDon behalf of the American Heart Association Adults With Congenital Heart Disease Joint Committee of the Council on Cardiovascular Disease in the Young and Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Council

2014 American Heart Association PubMed

18. Scalp Sampling for Fetal Surveillance

Scalp Sampling for Fetal Surveillance Scalp Sampling for Fetal Surveillance - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Scalp Sampling for Fetal Surveillance (FBS) The safety and scientific validity (...) Information provided by (Responsible Party): Maria Jonsson, Uppsala University Hospital Study Details Study Description Go to Brief Summary: The purpose of this study is to compare lactate and total acid-base status in fetal scalp blood with lactate and total acid-base status in maternal blood and amniotic fluids to provide information on how lactate and base deficit correlates with scalp samples. Furthermore, the investigators want to study whether angiogenic factors in fluids above may be a possible

2012 Clinical Trials

19. Fetal Scalp Stimulation

Stimulation Aka: Fetal Scalp Stimulation , Scalp Stimulation Test , Fetal Acoustic Stimulation II. Indications Assess degree of III. Technique Stimulate infant with one of two techniques Fetal Scalp Stimulation Fetal Acoustic Stimulation Observe response to stimulation IV. Interpretation: Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) V. References Images: Related links to external sites (from Bing) These images are a random sampling (...) Fetal Scalp Stimulation Fetal Scalp Stimulation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp Stimulation Fetal Scalp

2015 FP Notebook

20. Spontaneous Fetal EEG Recording During Labor

is to validate the feasibility of acquiring the new modality of human fetal bioelectrical activity, EEG, derived from the routinely used scalp FHR monitor. The investigators expect that in some newborns acidemia will be detected based on cord blood pH. In these babies, the investigators will trace back the EEG recordings to further validate whether the EEG - FHR patterns were predictive of this outcome. In fetal sheep model of human labour the investigators were able to see the onset of acidemia <55 min (...) ahead of severe drop of pH to <7.00. This corresponded to an average pH of 7.20. The investigators hypothesize that they will be able to acquire fetal EEG during labour such that the normal behavioural sleep states will be observed and their disruption, followed by emergence of the pathognomonic EEG-FHR pattern will be seen with incipient acidemia. At-risk pregnant women routinely admitted for intrapartum monitoring will be asked to consent when the Fetal Scalp Monitor (FSM) is placed

2017 Clinical Trials

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