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Fetal Heart Tracing

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1. Vibroacoustic stimulation for fetal assessment in labour in the presence of a nonreassuring fetal heart rate trace. Full Text available with Trip Pro

Vibroacoustic stimulation for fetal assessment in labour in the presence of a nonreassuring fetal heart rate trace. Fetal vibroacoustic stimulation (VAS) is a simple, non-invasive technique where a device is placed on the maternal abdomen over the region of the fetal head and sound is emitted at a predetermined level for several seconds. It is hypothesised that the resultant startle reflex in the fetus and subsequent fetal heart rate (FHR) acceleration or transient tachycardia following VAS (...) provide reassurance of fetal well-being. This technique has been proposed as a tool to assess fetal well-being in the presence of a nonreassuring cardiotocographic (CTG) trace during the first and second stages of labour.To evaluate the clinical effectiveness and safety of VAS in the assessment of fetal well-being during labour, compared with mock or no stimulation for women with a singleton pregnancy exhibiting a nonreassuring FHR pattern.We searched the Cochrane Pregnancy and Childbirth Group's

2013 Cochrane

2. Intrapartum Fetal Heart Rate Tracing Among Small-for-Gestational Age Compared With Appropriate-for-Gestational-Age Neonates. Full Text available with Trip Pro

Intrapartum Fetal Heart Rate Tracing Among Small-for-Gestational Age Compared With Appropriate-for-Gestational-Age Neonates. To compare fetal heart rate (FHR) patterns during the last hour of labor between small-for-gestational-age (SGA; birth weight less than the 10th percentile for gestational age) and appropriate-for-gestational-age (AGA; birth weight at the 10-90th percentile) neonates at 36 weeks of gestation or greater. We also compared the rate of cesarean delivery and composite neonatal (...) morbidity among SGA and AGA newborns.This is a secondary analysis of a randomized trial of intrapartum fetal electrocardiographic ST-segment analysis. We excluded women with chorioamnionitis, insufficient duration of FHR tracing in the hour before delivery, and anomalous newborns. Fetal heart rate patterns were categorized by computerized pattern recognition software (PeriCALM Patterns). Composite neonatal morbidity was defined as any of the following: intrapartum fetal death, Apgar score 3 or less at 5

2018 Obstetrics and Gynecology Controlled trial quality: uncertain

3. Uterine, Fetal Cerebral Doppler and Oligohydramnios to Predict Abnormal Heart Rate Tracings in Postterm Pregnancies

Uterine, Fetal Cerebral Doppler and Oligohydramnios to Predict Abnormal Heart Rate Tracings in Postterm Pregnancies Uterine, Fetal Cerebral Doppler and Oligohydramnios to Predict Abnormal Heart Rate Tracings in Postterm Pregnancies - 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. Uterine, Fetal Cerebral Doppler and Oligohydramnios to Predict Abnormal Heart Rate Tracings in Postterm Pregnancies The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details

2018 Clinical Trials

4. Risk factors for nonreassuring fetal heart rate tracings after artificial rupture of membranes in spontaneous labor. (Abstract)

Risk factors for nonreassuring fetal heart rate tracings after artificial rupture of membranes in spontaneous labor. We aimed to characterize factors associated with nonreassuring fetal heart (FHR) tracings after artificial rupture of membranes (AROM), during the active phase of labor.Delivery charts of patients who presented in spontaneous labor, at term, between 2015 and 2016 were reviewed. We identified cases in which AROM was performed during the active stage of labor. We compared (...) deliveries with a normal FHR and those who developed nonreassuring FHR. Nonreassuring FHR was defined as fetal tracing that necessitated intrauterine resuscitation, which included: oxytocin withheld, amnioinfusion, or immediate instrumental or cesarean birth.Of 664 deliveries, nonreassuring FHR occurred in 141 (21.2%) and normal FHR in 523 (78.7%). Both groups were notable for similar maternal characteristics and a similar gestational age. Epidural block was significantly more common in the nonreassuring

2018 Birth

5. Fetal Heart Tracing

Studies (from Trip Database) Ontology: Heart Rate, Fetal (C0018811) Definition (NCI) The number of fetal cardiac beats per minute. Definition (MSH) The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute. Concepts Finding ( T033 ) MSH SnomedCT 249043002 English Fetal Heart Rate , Fetal Heart Rates , Heart Rates, Fetal , Rate, Fetal Heart , Rates, Fetal Heart , heart sounds fetal heart rate ___ bpm , fetal heart rate , fetal heart rate (physical finding) , Heart (...) Rate, Fetal , foetal heart rate , heart rate fetal , fetal heart rates , Foetal heart rate , Fetal heart rate , FHR - Fetal heart rate , Fetal heart rate (observable entity) Italian Battito cardiaco fetale , Frequenza cardiaca fetale Swedish Hjärtfrekvens hos foster Japanese タイジシンパクスウ , 胎児心拍数 , 心拍数-胎児 Czech srdeční frekvence fetální , Srdeční frekvence plodu Finnish Sikiön syketiheys French Fréquence cardiaque du foetus , RCF (Rythme Cardiaque Foetal) , Rythme cardiaque du foetus , Fréquence

2018 FP Notebook

6. Flowchart: Intrapartum fetal surveillance , Mode of fetal heart rate monitoring

Flowchart: Intrapartum fetal surveillance , Mode of fetal heart rate monitoring Department of Health Queensland Clinical Guidelines State of Queensland (Queensland Health) 2015 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Mode of fetal heart rate monitoring Abbreviations: APH Antepartum Haemorrhage; BMI Body Mass Index; CTG Cardiotocograph; FBS Fetal blood sample; FGR 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; < Less than; = Equal to; o C Degrees Celsius Intrapartum • IOL with Prostaglandin • Abnormal auscultation or CTG • Oxytocin induction/augmentation • Post PV Prostaglandins at onset of contractions • Regional analgesia/paracervical block (obtain baseline trace prior to insertion) • Abnormal

2015 Queensland Health

7. Size and Shape of the Four-Chamber View of the Fetal Heart in Fetuses with an Estimated Fetal Weight Less than the Tenth Centile. (Abstract)

Size and Shape of the Four-Chamber View of the Fetal Heart in Fetuses with an Estimated Fetal Weight Less than the Tenth Centile. Fetuses with an estimated fetal weight (EFW) <10th centile have an increased risk for adverse perinatal and long-term outcomes as well as increased rates of cardiac dysfunction which often alters cardiac size and shape of the 4-chamber view and the individual ventricles. As a result, a simple method has emerged to screen for potential cardiac dysfunction in fetuses (...) measured from their corresponding epicardial borders. This allowed the 4CV area and global sphericity index (4CV length/4CV width) to be computed. In addition, tracing along the endocardial borders with speckle tracking software enabled measurements of the right and left ventricular chamber areas and the RV /LV area ratios to be computed. Doppler waveform pulsatility indices from the umbilical (UAPI) and middle cerebral arteries (MCAPI) were analyzed, and the cerebroplacental ratio (CPR) computed

2019 American Journal of Obstetrics and Gynecology

8. Fetal hemodynamics and cardiac streaming assessed by 4D flow cardiovascular magnetic resonance in fetal sheep. Full Text available with Trip Pro

-sensitive cardiovascular magnetic resonance imaging ("4D flow" CMR) and a specialized animal preparation (catheters to monitor fetal heart rate, anesthesia to immobilize mother and fetus) to examine fetal sheep cardiac hemodynamics in utero.Ten pregnant Merino sheep underwent surgery to implant arterial catheters in the target fetuses. Anesthetized ewes underwent 4D flow CMR with acquisition at 3 T for fetal whole-heart coverage with 1.2-1.5 mm spatial resolution and 45-62 ms temporal resolution. Flow (...) Fetal hemodynamics and cardiac streaming assessed by 4D flow cardiovascular magnetic resonance in fetal sheep. To date it has not been possible to obtain a comprehensive 3D assessment of fetal hemodynamics because of the technical challenges inherent in imaging small cardiac structures, movement of the fetus during data acquisition, and the difficulty of fusing data from multiple cardiac cycles when a cardiac gating signal is absent. Here we propose the combination of volumetric velocity

2019 Journal of Cardiovascular Magnetic Resonance

9. Fetal Heart Monitor Tracing in a Pregnancy Complicated by a Ruptured Fetal Vessel on the Placenta: A Case Report. (Abstract)

Fetal Heart Monitor Tracing in a Pregnancy Complicated by a Ruptured Fetal Vessel on the Placenta: A Case Report. This report describes the fetal heart rate (FHR) tracing in a pregnancy complicated by antenatal spontaneous rupture of fetal vessels on the placental surface that resulted in a live birth.36-year-old woman, G2P1001, was being followed with weekly antenatal testing for gestational diabetes type A2 on insulin with possible intrauterine growth restriction. She presented for an office (...) visit at 37.5 weeks' gestation with a complaint of decreased fetal movement. The FHR pattern demonstrated minimal baseline variability with an occasional spontaneous deceleration not associated with a contraction, an absence of recurrent decelerations, and no accelerations. The antenatal evaluation is discussed, and portions of the FHR tracing and the placental findings at delivery are provided.The FHR pattern did not fit with what is usually depicted with uteroplacental insufficiency or umbilical

2016 Journal of Reproductive Medicine

10. Standard External Doppler Fetal Heart Tracings versus External Fetal Electrocardiogram in Very Preterm Gestation: A Pilot Study Full Text available with Trip Pro

Standard External Doppler Fetal Heart Tracings versus External Fetal Electrocardiogram in Very Preterm Gestation: A Pilot Study Introduction Very preterm babies can be difficult to monitor using standard external Doppler fetal heart tracings (eFHR). External fetal electrocardiogram (fECG) is a potential alternative. Methods This was a prospective observational pilot study of hospitalized patients at 24 to 28 weeks' gestation. A total of 30 women were traced for up to 2 hours using eFHR followed (...) by up to 2 hours using fECG. The percentage of time the fetal heart rate was traced during the 2-hour window for each modality was calculated. Differences of ≥ 60, ≥ 80, and ≥ 90% total time traced were compared between modalities using McNemar's test. Differences were also assessed for each method between nonobese (body mass index [BMI] < 30 kg/m2) and obese (BMI ≥ 30 kg/m2) women using chi-square and Fisher's exact tests. Results Superior performance was found with eFHR at ≥ 60% (93.3 vs. 46.7%, p

2016 AJP Reports

11. The 5-tier system of assessing fetal heart rate tracings is superior to the 3-tier system in identifying fetal acidemia (Abstract)

The 5-tier system of assessing fetal heart rate tracings is superior to the 3-tier system in identifying fetal acidemia Electronic fetal heart rate monitoring was developed to identify fetuses at risk of acidemia for intervention before adverse outcomes. Our objective was to compare the 3-tier system with a 5-tier system in evaluation of fetal acidemia.Retrospective case-control study of patients with a fetal arterial pH <7 matched to the next birth that resulted in a pH >7.2. Tracings were (...) categorized into 3- and 5-tier systems by a single reviewer. Sensitivities and specificities were calculated for each.Twenty-four cases and 24 controls were identified. The sensitivity for an orange or red tracing was higher than for category III, with more of these in the pH <7 group compared with controls (P ≤ .001). There were significantly more green, blue, and yellow tracings in the normal pH group compared with the pH <7 group (P = .033, P = .008, P = .023), respectively.The 5-tier system had

2012 EvidenceUpdates

12. A Comprehensive Feature Analysis of the Fetal Heart Rate Signal for the Intelligent Assessment of Fetal State Full Text available with Trip Pro

A Comprehensive Feature Analysis of the Fetal Heart Rate Signal for the Intelligent Assessment of Fetal State Continuous monitoring of the fetal heart rate (FHR) signal has been widely used to allow obstetricians to obtain detailed physiological information about newborns. However, visual interpretation of FHR traces causes inter-observer and intra-observer variability. Therefore, this study proposed a novel computerized analysis software of the FHR signal (CAS-FHR), aimed at providing medical (...) decision support. First, to the best of our knowledge, the software extracted the most comprehensive features (47) from different domains, including morphological, time, and frequency and nonlinear domains. Then, for the intelligent assessment of fetal state, three representative machine learning algorithms (decision tree (DT), support vector machine (SVM), and adaptive boosting (AdaBoost)) were chosen to execute the classification stage. To improve the performance, feature selection/dimensionality

2018 Journal of clinical medicine

13. Oxygen for Intrauterine Resuscitation of Category II Fetal Heart Tracings

University School of Medicine Information provided by (Responsible Party): Washington University School of Medicine Study Details Study Description Go to Brief Summary: Maternal oxygen administration for concerning fetal heart rate tracing (FHT) patterns is common practice on Labor and Delivery units in the United States. Despite the broad use of oxygen, it is unclear if this practice is beneficial for the fetus. The purpose of this study is to compare oxygen to room air in patients with Category II (...) Oxygen for Intrauterine Resuscitation of Category II Fetal Heart Tracings Oxygen for Intrauterine Resuscitation of Category II Fetal Heart Tracings - 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. Oxygen

2016 Clinical Trials

14. Comparison of diurnal variations, gestational age and gender related differences in fetal heart rate (FHR) parameters between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) fetuses in the home environment. Full Text available with Trip Pro

, success rate of the fetal abdominal ECG in the AGA fetuses was 75.7% compared to 48.6% in the SGA group. Based on randomly selected episodes of heart rate traces where recording quality exceeded 80% we were able to show a marginal difference between day and night-time recordings in AGA vs. SGA fetuses beyond 32 weeks of gestation. A selection bias in terms of covering different representation periods of fetal behavioural states cannot be excluded. In contrast to previous studies, we neither controlled (...) Comparison of diurnal variations, gestational age and gender related differences in fetal heart rate (FHR) parameters between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) fetuses in the home environment. To assess the influence of gender, time of the day and gestational age on fetal heart rate (FHR) parameters between appropriate-for-gestational-age (AGA) and small-for-gestational age (SGA) fetuses using a portable fetal ECG monitor employed in the home setting.We

2018 PLoS ONE

15. Intra- And Interobserver Agreement Among Obstetric Experts in Court Regarding the Review of Abnormal Fetal Heart-Rate Tracings and Obstetrical Management. (Abstract)

Intra- And Interobserver Agreement Among Obstetric Experts in Court Regarding the Review of Abnormal Fetal Heart-Rate Tracings and Obstetrical Management. The objective of the study was to evaluate the intra- and interobserver agreement among obstetric experts in court regarding the retrospective review of abnormal fetal heart rate tracings and obstetrical management of patients with abnormal fetal heart rate during labor.A total of 22 French obstetric experts in court reviewed 30 cases of term (...) deliveries of singleton pregnancies diagnosed with at least 1 hour of abnormal fetal heart rate, including 10 cases with adverse neonatal outcome. The experts reviewed all cases twice within a 3-month interval, with the first review being blinded to neonatal outcome. For each case reviewed, the experts were provided with the obstetric data and copies of the complete fetal heart rate recording and the partogram. The experts were asked to classify the abnormal fetal heart rate tracing and to express

2015 American Journal of Obstetrics and Gynecology

16. Fetal Health Surveillance: Intrapartum Consensus Guideline Full Text available with Trip Pro

) the maternal-fetal condition is stable and (2) if oxytocin is being administered, the infusion rate is stable (III-B). 21 Electronic fetal monitoring is best interpreted with a continuous tracing of the uterine activity and fetal heart rate. If a continuous tracing is not possible, or there is uncertainty of interpretation due to the quality of the tracing, use of an intrauterine pressure catheter and/or fetal spiral electrode could be considered, if available (III-B). Classification of Intrapartum Fetal (...) be administered for confirmed maternal hypoxia or hypovolemia, and NOT routinely used as a resuscitative measure for atypical or abnormal fetal heart tracings (1-A). 30 An intravenous bolus should be used only in the event of maternal hypovolemia and/or hypotension (III-C). Digital Fetal Scalp Stimulation 31 Digital fetal scalp stimulation is recommended as an indirect assessment of acid-base status in response to atypical or abnormal electronic fetal monitoring tracings (II-B). 32 The absence

2020 Society of Obstetricians and Gynaecologists of Canada

17. IMproving the practice of intrapartum electronic fetal heart rate MOnitoring with cardiotocography for safer childbirth (the IMMO programme): protocol for a qualitative study. Full Text available with Trip Pro

IMproving the practice of intrapartum electronic fetal heart rate MOnitoring with cardiotocography for safer childbirth (the IMMO programme): protocol for a qualitative study. Suboptimal electronic fetal heart rate monitoring (EFM) in labour using cardiotocography (CTG) has been identified as one of the most common causes of avoidable harm in maternity care. Training staff is a frequently proposed solution to reduce harm. However, current approaches to training are heterogeneous in content (...) and format, making it difficult to assess effectiveness. Technological solutions, such as digital decision support, have not yet demonstrated improved outcomes. Effective improvement strategies require in-depth understanding of the technical and social mechanisms underpinning the EFM process. The aim of this study is to advance current knowledge of the types of errors, hazards and failure modes in the process of classifying, interpreting and responding to CTG traces. This study is part of a broader

2019 BMJ open

18. Sex differences in fetal heart rate and variability assessed by antenatal computerized cardiotocography. Full Text available with Trip Pro

Sex differences in fetal heart rate and variability assessed by antenatal computerized cardiotocography. The aim of the current study is to explore the effect of fetal sex on the fetal heart rate and variability.This is a retrospective cross-sectional study. We analyzed fetal heart rate (FHR) traces of pregnant women that were recorded antenatally using a commercially available computerized cardiotocograph (cCTG; Oxford system). Fetal sex was ascertained after birth. Baseline FHR and short-term (...) heart rate variation (STV) were compared between male and female fetuses. Expected mean values for baseline FHR and STV were computed and multiples of the mean (MOMean) of males and females were compared.Information on 9259 cases is reported in this study. Baseline FHR of female fetuses was significantly higher (P < 0.001) and STV lower (P < 0.001) than that of male fetuses. This difference remained even after the effects of gestational age and diurnal variation were eliminated by computation

2018 Acta Obstetricia et Gynecologica Scandinavica

19. Fetal heart rate short term variation during labor in relation to scalp blood lactate concentration. Full Text available with Trip Pro

Fetal heart rate short term variation during labor in relation to scalp blood lactate concentration. Fetal heart rate short term variation (STV) decreases with severe chronic hypoxia in the antenatal period. However, only limited research has been done on STV during labor. We have tested a novel algorithm for a valid baseline estimation and calculated STV. To explore the value of STV during labor, we compared STV with fetal scalp blood (FBS) lactate concentration, an early marker in the hypoxic (...) process.Software was developed which estimates baseline frequency using a novel algorithm and thereby calculates STV according to Dawes and Redman in up to four 30-minute blocks prior to each FBS. Cardiotocography traces from 1070 women in labor who had had FBS performed on 2134 occasions were analyzed.In acidemic cases (lactate >4.8 mmol/L; Lactate Pro™), median STV 30 minutes prior to FBS was 7.10 milliseconds compared with 6.09 milliseconds in the preacidemic (4.2-4.8 mmol/L) and 5.23 milliseconds

2018 Acta Obstetricia et Gynecologica Scandinavica

20. Validation of a computerized algorithm to quantify fetal heart rate deceleration area. Full Text available with Trip Pro

Validation of a computerized algorithm to quantify fetal heart rate deceleration area. Reliability in visual cardiotocography interpretation is unsatisfying, which has led to the development of computerized cardiotocography. Computerized analysis is well established for antenatal fetal surveillance but has yet not performed sufficiently during labor. We aimed to investigate the capacity of a new computerized algorithm compared with visual assessment in identifying intrapartum fetal heart rate (...) baseline and decelerations.In all, 312 intrapartum cardiotocography tracings with variable decelerations were analyzed by the computerized algorithm and visually examined by two observers, blinded to each other and the computer analysis. The width, depth and area of each deceleration was measured. Four cases (>100 variable decelerations) were subjected to in-depth detailed analysis. The outcome measures were bias in seconds (width), beats per minute (depth), and beats (area) between computer

2018 Acta Obstetricia et Gynecologica Scandinavica

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