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Fetal Heart Tracing

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181. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

of VTE, mechanical heart valves, and atrial fibrillation. In addition, patients with bare metal or drug-eluting coronary stents require antiplatelet therapy with aspirin and thienopyridine derivatives (eg, clopidogrel) for varying durations. These patients may present for elective or urgent surgical procedures. Perioperative management involves balancing the risks of surgical bleeding and thromboembolism. Minor procedures may not require interruption of antithrombotic or antiplatelet therapy. However (...) . In other patients, bridging anticoagulation with UFH or LMWH is required until the time of surgery (and reinitiated in the immediate postoperative period). It may also be necessary to postpone elective surgeries in patients where a suitable “bridge” has not been identified and antithrombotic therapy is critical; premature discontinuation of dual antiplatelet therapy in patients with coronary stents has been associated with stent thrombosis, myocardial infarction, and death ( and ). Evidence-based

2018 American Society of Regional Anesthesia and Pain Medicine

182. CRACKCast E180 – Labor & Delivery

, the strength of the contractions correlates poorly with the tracing. The tracings are position and placement sensitive. Fetal heart rate tracings have several components that can be assessed—baseline heart rate, variability, accelerations, decelerations, and diagnostic patterns. Ultrasonography the gestational age, biophysical profile, amniotic fluid index, and a survey of fetal and placental anatomy may be obtained. What are the indications for foetal monitoring during labour? -> Labouring woman 4 (...) information, limited assistance with intrapartum decision making External electronic fetal monitoring uses tracings of the fetal heart rate and uterine activity. helps confirm true labor and may help diagnose fetal distress. In combination with clinical data, this can portend fetal distress due to hypoxia and provide a window for intervention. Uterine activity is measured transabdominally by a pressure transducer, creating a recording of the contraction frequency. Because the measurements are indirect

2018 CandiEM

183. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

)/factitious disorder by proxy (FDP) Hereditary fructose intolerance Child neglect or abuse Urea cycle defects Self-induced vomiting Amino and organic acidemias Cyclic vomiting syndrome Fatty acid oxidation disorders Rumination syndrome Metabolic acidosis Congenital adrenal hyperplasia/adrenal crisis Toxic Renal Lead poisoning Obstructive uropathy Other toxins Renal insuf?ciency Cardiac Heart failure Vascular ring Autonomic dysfunction ESPGHAN ¼ European Society for Pediatric Gastroenterology, Hepatology (...) indications for the performance of pH-MII in the evaluation of GERD. 1. Differentiate patients with NERD, hypersensitive esopha- gus and functional heartburn in patients with normal endoscopy. The recently published Rome IV criteria for esophageal disorders included new classi?cations for adults with typical GERD symptoms including chest pain and heart burn. In patients with persistent typical symptoms despite acid suppression, pH-MII can clarify the diagnosis of NERD (pathologic re?ux regardless

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

184. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report

. For patients with AF and stable coronary artery disease (eg, no acute coronary syndrome within the previous year) and who choose oral anticoagulation, we suggest OAC with either an NOAC or adjusted- dose VKA therapy alone (target international normalized ratio [INR] range, 2.0-3.0) rather than the combination of OAC and aspirin (Weak recommendation, low quality evidence). 32. In patients with AF in whom catheter ablation of AF or implantation of cardiac electronic implantable devices is planned, we suggest (...) and signpost the patient to appropriate educational resources. Introduction Atrial ?brillation (AF) is the most common sustained cardiac arrhythmia, with an increasing prevalence and incidencewithage.Inadultsaged>40years,thereisa1 in 4 lifetime risk of developing AF, with incident AF commonly related to various associated cardiovascular and noncardiovascular risk factors. AF without associated valvular heart disease (so-called “nonvalvular AF”) is associated with a ?vefold increase in stroke risk

2018 American College of Chest Physicians

185. Dinutuximab beta Apeiron - neuroblastoma

processing ECG Electrocardiogram ECHO Echocardiogram EEG Electroencephalogram EFS event-free survival ELISA Enzyme-linked immunosorbent assay EM(E)A European Medicines Agency EOT End of treatment EPC End of Production Cells Assessment Report - Dinutuximab beta Apeiron EMA/263814/2017 Page 5/129 ESI-TOF-MS Electrospray ionisation time-of-flight mass spectrometry FAS Full analysis set FCS Fetal calf serum Fc?R FC gamma receptor FDA Food and Drug Administration G0 Glycan without core fucose and no galactose (...) 150 kDa corresponding to the expected size of an intact IgG1, but smaller faint bands were also visible at about 100 kDa, 70kDa and 26kDa on the gels. The identity of these bands has been clarified as product-related variants of ch14.18/CHO, with only traces of HCP. Bands at 50kDa appear to contain heavy chain and two light chains, with the band at 25 kDa appearing to be mainly free light chain with low levels of HCP. Since these are all at levels well below the main band (by densitometry

2017 European Medicines Agency - EPARs

187. Improving the health of the public by 2040

and medical interventions. However, despite overall improvements in health, major inequalities in health outcomes, reflecting social and economic inequalities, persist.1. Introduction 12 • Vaccination. • Motor vehicle safety. • Safer workplaces. • Control of infectious diseases. • Decline in deaths from coronary heart disease and stroke. • Safer and healthier foods. • Healthier mothers and babies. • Family planning. • Fluoridation of drinking water. • Recognition of tobacco use as a health hazard. Box 1 (...) and in the last 50 years has increased by a further 10 years for a man and 8 for a woman. 3,4 Improvements in living conditions and large reductions in infant and child mortality were major contributors to this increase in the first half of the 20th century. Over the last 50 years, improvement has been greatest at older ages. The number of people dying from coronary heart disease, for example, in Great Britain more than halved between 1961 and 2009. 5 While improved treatments have had an important role

2017 Academy of Medical Sciences

188. Trumenba - meningococcal group b vaccine (recombinant, adsorbed)

in the final packaging process may contain trace levels of animal tallow derivatives. As tallow is processed under rigorous conditions, it is considered compliant with the TSE note for guidance. The information provided does not give rise to any concerns on adventitious agents. The absence of adventitious agents has been sufficiently demonstrated. 2.2.4. Discussion on chemical, pharmaceutical and biological aspects The quality documentation submitted in support of Trumenba was considered of good quality

2017 European Medicines Agency - EPARs

189. Preterm labour and birth

blood cell count and measurement of fetal heart rate using cardiotocography) to diagnose intrauterine infection in women with P-PROM. 1.5.2 Do not use any one of the following in isolation to confirm or exclude intrauterine infection in women with P-PROM: a single test of C-reactive protein white blood cell count measurement of fetal heart rate using cardiotocography. 1.5.3 If the results of the clinical assessment or any of the tests are not consistent with each other, continue to observe the woman (...) reducing the dose of magnesium sulfate. 1.11 Fetal monitoring Monitoring options: cardiotocogr Monitoring options: cardiotocograph aphy and intermittent auscultation y and intermittent auscultation 1.11.1 Discuss with women in suspected, diagnosed or established preterm labour (and their family members or carers as appropriate): the purpose of fetal monitoring and what it involves the clinical decisions it informs at different gestational ages if appropriate, the option not to monitor the fetal heart

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

190. Management of bleeding in the late preterm period

abruption is defined as placental separation, either partial or complete, prior to delivery. Classically, women with placental abruption present with abdominal pain and bleeding, and approximately 60% will also have a nonreassuring fetal heart rate tracing. x 32 Hurd, W.W., Miodovnik, M., Hertzberg, V., and Lavin, J.P. Selective management of abruptio placentae: A prospective study. Obstet Gynecol . 1983 ; 61 : 467–473 | | | Numerous risk factors for placental abruption have been described (...) : 911–915 | | | | | If the diagnosis is unclear, bleeding is minimal, and the maternal and fetal status remain stable, delivery may be delayed with close surveillance and ongoing fetal testing. However, as with other women presenting with active hemorrhage from any etiology in the late preterm period, delivery is indicated in the setting of abruption with significant vaginal bleeding, abnormal laboratory results including acute anemia or coagulopathy, abnormality of the fetal heart tracing

2017 Society for Maternal-Fetal Medicine

191. Hepatitis C in pregnancy: screening, treatment, and management Full Text available with Trip Pro

categories: velpatasvir, dacla- tasvir, ombitasvir/paritaprevir/ritonavir/dasabuvir, ledipasvir, and elbasvir/grazoprevir. Again, the limited animal data that exist have not shown a risk to the fetus. 47-51 Another DAA therapy without an assigned FDA pregnancy category is simeprevir, which has shown fetal toxicity in animal studies. 52 Due to the lack of human studies, no DAA therapy has yet been approved to treat HCV infection in pregnancy. 1 Given the availability of ribavirin-free DAA regimens (...) compared with no internal monitoring. In contrast, a retrospective study with 724 women found no association. 60 One of these studies alsofoundthatepisiotomywassigni?cantlyassociatedwith an increased risk of vertical transmission. 59 Based on the availableevidence,werecommendthatobstetriccareproviders avoid internal fetal monitoring, prolonged rupture of membranes, andepisiotomyinmanaginglaborinHCV-positivewomen(GRADE 1B), unless it is unavoidable in the course of management (ie, when unable to trace

2017 Society for Maternal-Fetal Medicine

193. Analgesia and Anesthesia for the Breastfeeding Mother

. Of the anticholinergic agents, atropine is found in trace amountsinbreastmilk.Glycopyrrolateisnotexpected tobefoundinbreastmilkandispoorlyabsorbedthrough the gastrointestinal tract. 5 Antiemetics are used commonly in the perioperative period, and most of these medications are considered safe during breastfeeding. Ondansetron, dexamethasone, and metoclopramide may be preferred because of their lack of sedating side effects. 3 (IV) Prochlorperazine, promethazine, and scopolamine are likely safe, but may lead (...) 4 hours around the clocksincehercesareandelivery6daysbefore. 38 (III) Remifentanil. Although there are no published data on remifentanil, this esterase-metabolized opioid has abriefhalf-lifeevenininfants(<10minutes)andhas been documented to produce no fetal sedation even in utero. Although its duration of action is limited, it could be used safely and indeed may be ideal in breastfeeding mothers for short painful procedures. Sufentanil. Sufentanil transfer into milk has not been published

2017 Academy of Breastfeeding Medicine

194. Interventions Targeting Sensory Challenges in Children with Autism Spectrum Disorder - An Update

and Developmental Delay. J Can Acad Child Adolesc Psychiatry. 2011 Aug;20(3):214-6. PMID: 21804851.X-1 745. Mason MC. Head for bed. Nurs Stand. 2011 Jan 26-Feb 1;25(21):20. PMID: 21329128.X-1 746. Mathewson KJ, Drmic IE, Jetha MK, et al. Behavioral and cardiac responses to emotional stroop in adults with autism spectrum disorders: influence of medication. Autism Res. 2011 Apr;4(2):98-108. doi: 10.1002/aur.176. PMID: 21360828.X-1 747. Matisz CE, McDougall JJ, Sharkey KA, et al. Helminth parasites

2017 Effective Health Care Program (AHRQ)

195. First Trimester Vaginal Bleeding

) of the pregnancy should generally be avoided in the first trimester due to concerns about potential bioeffects in the developing embryo [57-59]. Documentation of embryonic cardiac activity is best done with M- mode US as the heart rate can be measured. Video clips can also be used to document embryonic cardiac activity. Once a normal IUP has been excluded, Doppler US may be useful when other diagnoses such as RPOC are suspected. Doppler US is not generally needed to make a diagnosis of GTD, but may be helpful (...) heart rate by 8 weeks at US. Radiology. 2005;236(2):643-646. 25. Bromley B, Harlow BL, Laboda LA, Benacerraf BR. Small sac size in the first trimester: a predictor of poor fetal outcome. Radiology. 1991;178(2):375-377. ACR Appropriateness Criteria ® 9 First Trimester Vaginal Bleeding 26. Horrow MM. Enlarged amniotic cavity: a new sonographic sign of early embryonic death. AJR Am J Roentgenol. 1992;158(2):359-362. 27. McKenna KM, Feldstein VA, Goldstein RB, Filly RA. The empty amnion: a sign of early

2017 American College of Radiology

196. HTA of smoking cessation interventions

for the National Clinical Programme for Acute Coronary Syndrome, HSE Dr Paul Kavanagh Specialist in Public Health Medicine, HSE Dr Marcus Kennedy Interventional Pulmonologist, Consultant Respiratory and General Physician, Cork University Hospital Prof Deirdre Madden Professor, Faculty of Law, University College Cork Ms Patricia McQuillan Practice Nurse Development Co-ordinator, Asthma and COPD Clinical Programme, HSE Dr Patrick Moran Senior HTA Analyst, HIQA (Project Lead) Health Technology Assessment (HTA (...) . Smoking during pregnancy is harmful. It is associated with an increased risk of congenital anomalies, preterm birth, intrauterine fetal growth restriction, placental abruption, stillbirth, sudden infant death syndrome, respiratory infection, adverse cognitive and behavioural outcomes in infancy, and the development of chronic disease in adulthood. Evidence shows that smokers with mental health disorders smoke more heavily, are more nicotine dependent, and have smoked for longer than smokers who do

2017 Health Information and Quality Authority

197. Joint NASPGHAN and ESPGHAN guidelines on Gastro-oesophageal Reflux Disease in Children

Renal Lead poisoning Obstructive uropathy Other toxins Renal insuf?ciency Cardiac Heart failure Vascular ring Autonomic dysfunction ESPGHAN ¼ European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; GERD ¼ gastroesophageal re?ux disease; NASPGHAN ¼ North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Adapted from the ESPGHAN/NASPGHAN 2009 GERD guidelines. JPGN Volume 66, Number 3, March 2018 Pediatric Gastroesophageal Reflux Clinical Practice (...) for esophageal disorders included new classi?cations for adults with typical GERD symptoms including chest pain and heart burn. In patients with persistent typical symptoms despite acid suppression, pH-MII can clarify the diagnosis of NERD (pathologic re?ux regardless of symptom correlation), hyper- sensitive esophagus (positive symptom correlation with either acid or nonacid re?ux events but no pathologic re?ux), and functional heartburn (negative symptom correlation and no pathologic re?ux; see ‘‘Summary

2018 British Society of Paediatric Gastroenterology Hepatology and Nutrition

198. Intrapartum care for healthy women and babies

, she will need to be transferred to obstetric-led care. [2017] [2017] 1.4.9 Offer continuous cardiotocography if any of the risk factors listed in recommendation 1.4.3 are identified on initial assessment, and explain to the woman why this is being offered. (See also section 1.10 on fetal monitoring.) [2017] [2017] 1.4.10 Offer cardiotocography if intermittent auscultation indicates possible fetal heart rate abnormalities, and explain to the woman why this is being offered. If the trace is normal (...) tr ansferred (% of total transferred from each ansferred from each setting) setting) F From home rom home (n=3,529) (n=3,529) F From a freestanding rom a freestanding midwifery unit (n=2,457) midwifery unit (n=2,457) F From an alongside rom an alongside midwifery unit midwifery unit (n=4,401) (n=4,401) Delay during first or second stage of labour 1,144 (32.4%) 912 (37.1%) 1,548 (35.2%) Abnormal fetal heart rate 246 (7.0%) 259 (10.5%) 477 (10.8%) Request for regional analgesia 180 (5.1%) 163 (6.6

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

199. Standards for obstetrical ultrasound assessments

/ absence of yolk sac or embryo ? ? Fetal number: ? ? if multiple – chorionicity and amnionicity ? ? Location of gestational sac ? ? Cardiac activity: ? ? Presence / absence ? ? Fetal Heart Rate (FHR) ? ? Crown rump length (CRL) ? ? Maternal pelvic anatomy (adnexa, ovaries, cervix) ? ? Head circumference (HC) ? ? Biparietal diameter (BPD) ? ? Choroid plexus filled ventricles ? ? Stomach ? ? Symmetrical lung fields ? ? Presence of 4 limbs, each with 3 segments ? ? Abdominal wall cord insertion ? ? NT (...) measurement in mm to 1 decimal point ? ? FMF# of person performing the NT measurement ? ? Standard comments established by the BC Prenatal Genetic Screening Program (PGSP)? Appendix 5 4.0 Minimum Required Content, cont’d8 Perinatal Services BC 4.3 2nd Trimester Ultrasound Report (14wks 1d – 26wks 6d) Must include the items listed in “ALL OB Ultrasound Reports” in addition to the following: ? ? Cardiac activity: ? ? Presence / absence ? ? Fetal Heart Rate (FHR) ? ? Cardiac axis ? ? Fetal number

2016 CPG Infobase

200. Heart Full Text available with Trip Pro

of the right atrium is an oval-shaped depression known as the , which is a remnant of an opening in the fetal heart known as the . Most of the internal surface of the right atrium is smooth, the depression of the fossa ovalis is medial, and the anterior surface has prominent ridges of , which are also present in the . The right atrium is connected to the right ventricle by the . The walls of the right ventricle are lined with , ridges of cardiac muscle covered by endocardium. In addition to these muscular (...) ) or . In the worst case this may cause cardiac arrest, a sudden and utter loss of output from the heart. , , uncontrolled , smoking and high can all increase the risk of developing atherosclerosis and coronary artery disease. Heart failure Main article: is defined as a condition in which the heart is unable to pump enough blood to meet the demands of the body. Patients with heart failure may experience breathlessness especially when lying flat, as well as ankle swelling, known as . Heart failure is the end

2012 Wikipedia

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