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Fetal Heart Tracing

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41. Tachysystole in Term Labor: Incidence, Risk Factors, Outcomes, and Effect on Fetal Heart Tracings. (Abstract)

Tachysystole in Term Labor: Incidence, Risk Factors, Outcomes, and Effect on Fetal Heart Tracings. Recent recommendations called for obstetricians to abandon the terms of "hyperstimulation" and "hypercontractility" in favor of the more rigidly defined term, "tachysystole" (TS). The aim of the current study is to describe incidence of and risk factors for TS, describe fetal heart rate (FHR) changes associated with TS, and investigate maternal and neonatal outcomes associated with TS.For (...) this retrospective cohort study, we reviewed and analyzed the intrapartum FHR and tocometric characteristics of all patients with a singleton, nonanomalous fetus in term labor in a single hospital system over a 28-month period. Univariate association testing was done using χ(2) and t tests, comparing demographics, pregnancy characteristics, outcomes, and TS events. Multivariable association testing between risk factors and TS events were tested using generalized estimating equations, adjusting for multiple

2013 American Journal of Obstetrics and Gynecology

42. Intrapartum Management of Category II Fetal Heart Rate Tracings- Towards Standardization of Care. (Abstract)

Intrapartum Management of Category II Fetal Heart Rate Tracings- Towards Standardization of Care. There is currently no standard national approach to the management of category II fetal heart rate (FHR) patterns, yet such patterns occur in the majority of fetuses in labor. Under such circumstances, it would be difficult to demonstrate the clinical efficacy of FHR monitoring even if this technique had immense intrinsic value, since there has never been a standard hypothesis to test dealing

2013 American Journal of Obstetrics and Gynecology

43. Intrapartum fetal surveillance – Indications

evidensgrad III, styrke C: Studie Population Studie design Fund Philip Reif: Short-term neonatal outcome in diabetic versus non-diabetic pregnancies complicated by non- reassuring foetal heart rate traces (2) 57 kvinder med gestationel diabetes type 1 eller type 2 diabetes, 114 ikke- diabetiske matchede controller. 7 kvinder havde prægestationel diabetes, 13 kunne klassificeres som White gruppe A/B ud fra målinger af C- peptid og insulin i navlesnorsblod. 27 kvinder havde diætbehandlet GDM, de øvrige (...) Thyreoideasygdomme o Vægtestimat -15% - -22% 6 7 9 14 16 20 22 25 28 31 33 33 352 o Igangsættelse o Igangsættelse, medikamentel o Igangsættelse, mekanisk (Ballonkateter og HSP) o Pressefase over 1 time o Vandafgang mere end 24 timer 38 39 41 43 47 Hvornår skal overvågningen opstartes 49 Intrapartum fetal surveillance – Indications. English summery 51 Referencer 61 Forkortelser CTG: Cadiotocografi FIGO: International Federation of Gynecology and Obstetrics FHR: Fetal Heart Rate FV: Foster vægt BPM: Beats per

2017 Nordic Federation of Societies of Obstetrics and Gynecology

44. 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

2015 FP Notebook

45. Human factors affecting the interpretation of fetal heart rate tracings: an update. Full Text available with Trip Pro

Human factors affecting the interpretation of fetal heart rate tracings: an update. Human factors can have an important impact on cardiotocography (CTG) interpretation and management decisions, and therefore may directly affect obstetrical outcomes.It has been well demonstrated that there is wide observer disagreement over CTG interpretation, particularly in the evaluation of variability, decelerations, and overall tracing classification. The reasons behind this are still incompletely

2012 Current Opinion in Obstetrics and Gynecology

46. Mobile Phone Effects on Umbilical Artery Doppler and Heart Rate Tracing

on the mother's abdomen for 10 minutes, concurrently with repeating the 15 minutes CTG trace. The umbilical artery Doppler was repeated 5 minutes after hanging up to avoid the interference with the Doppler machine. The umbilical artery Doppler ultrasound and the recorded fetal heart rate (FHR) strips before and after the mobile phone use were blindly analyzed with respect to umbilical artery resistance indices (RI) and CTG parameters in terms of number of fetal kicks, absence of beat to beat variability, loss (...) of accelerations and the appearance of spontaneous decelerations. Condition or disease Intervention/treatment Phase Umbilical Artery Doppler Fetal Heart Rate Tracing Radiation: mobile phone Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 190 participants Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Diagnostic Official Title: The Effects of Mobile Phone

2015 Clinical Trials

47. Fetal cardiac axis and congenital heart defects in early gestation. (Abstract)

fetuses with confirmed congenital heart defects. A control group was selected by matching each fetus with a congenital heart defect with two fetuses in the control group with similar crown-rump length (± 5 mm) and date of study (± 2 months). Cardiac axis was measured on the four-chamber view as the angle between the line that traces the long axis of the heart and the line that bisects the thorax in an anteroposterior direction.In the control group, mean cardiac axis was 44.5 ± 7.4°. The cardiac axis (...) Fetal cardiac axis and congenital heart defects in early gestation. To investigate the association between cardiac axis and fetal congenital heart defects to demonstrate the potential clinical applicability of cardiac axis measurement for detection of congenital heart defect in early gestation.This case-control study was undertaken in three tertiary centers with expertise in fetal imaging in early gestation. Fetal cardiac axis was evaluated between 11 0/7 and 14 6/7 weeks of gestation in 197

2015 Obstetrics and Gynecology

48. Investigation of the outcome of pregnancies complicated by increased fetal movements and their relationship to underlying causes - A prospective cohort study. (Abstract)

outcome: birthweight <3rd centile, 2 (3.1%); pH ≤7.10, 1 (1.6%); neonatal intensive care unit admission, 4 (6.3%). Women had IFM for varying lengths of time before presenting: 17.2% had IFM for less than 1 hour and 29.7% reported IFM lasting longer than 24 hours. Four women (6.3%) had abnormalities of the fetal heart rate trace on assessment. Women with IFM had similar modes of birth to women giving birth in participating maternity units. There was no evidence of macroscopic placental or umbilical (...) Investigation of the outcome of pregnancies complicated by increased fetal movements and their relationship to underlying causes - A prospective cohort study. Retrospective studies have reported an association between a single episode of significantly increased fetal movements (IFMs) and stillbirth after 28 weeks' gestation. This prospective study aimed to report the outcome of pregnancies associated with maternal perception of IFMs and determine whether this symptom is associated with adverse

2020 Acta Obstetricia et Gynecologica Scandinavica

49. Evaluation of an external fetal electrocardiogram monitoring system: a randomized controlled trial. (Abstract)

monitoring).We conducted a randomized controlled trial at 4 Utah hospitals. Patients were enrolled at labor admission and randomized in blocks based on body mass index to fetal electrocardiography or standard external monitoring. Two reviewers, blinded to study allocation, reviewed each fetal heart rate tracing. The primary outcome was the percentage of interpretable minutes of fetal heart rate tracing. An interpretable minute was defined as >25% fetal heart rate data present and no more than 25 (...) % continuous missing fetal heart rate data or artifact present. Secondary outcomes included the percentage of interpretable minutes of fetal heart rate tracing obtained while on study device only, the number of device adjustments required intrapartum, clinical outcomes, and patient/provider device satisfaction. We determined that 100 patients per arm (200 total) would be needed to detect a 5% difference in interpretability with 95% power.A total of 218 women were randomized, 108 to fetal

2020 American Journal of Obstetrics and Gynecology

50. Effect of Oxygen vs Room Air on Intrauterine Fetal Resuscitation: A Randomized Noninferiority Clinical Trial Full Text available with Trip Pro

Effect of Oxygen vs Room Air on Intrauterine Fetal Resuscitation: A Randomized Noninferiority Clinical Trial Two-thirds of women in labor receive supplemental oxygen to reverse perceived fetal hypoxemia and prevent acidemia. Oxygen is routinely administered for category II fetal heart tracings, a class of fetal tracing used to designate intermediate risk for acidemia. This liberal use of oxygen may not be beneficial, particularly because neonatal hyperoxygenation is harmful.To test (...) the hypothesis that room air is noninferior to oxygen in improving fetal metabolic status among patients with category II fetal heart tracings.This was a randomized, unblinded noninferiority clinical trial conducted between June 2016 and July 2017 in the labor and delivery ward of a single tertiary care center. Women with singleton pregnancies at 37 weeks' gestational age or more who were admitted for delivery were eligible. Of those who met inclusion criteria, the patients who developed category II tracings

2018 EvidenceUpdates

51. Management of Heart Failure (4th Edition)

(CABG) or percutaneous coronary intervention (PCI)) should be considered in patients with HF and suitable coronary anatomy. Key message 7: Asymptomatic LV Dysfunction ? Identify patients who are at high risk of developing LV dysfunction and treat the underlying disease appropriately. ? ACE-I and ß-blockers (post MI) have been shown to slow down the onset of symptoms and reduce cardiac morbidity. Key message 8:Heart Failure with Preserved LV Function (HFpEF) ? HFpEF is a common cause of HF (...) bypass graft (CABG) or percutaneous coronary intervention (PCI)) should be considered in patients with HF and suitable coronary anatomy. Key message 7: Asymptomatic LV Dysfunction ? Identify patients who are at high risk of developing LV dysfunction and treat the underlying disease appropriately. ? ACE-I and ß-blockers (post MI) have been shown to slow down the onset of symptoms and reduce cardiac morbidity. Key message 8:Heart Failure with Preserved LV Function (HFpEF) ? HFpEF is a common cause

2019 Ministry of Health, Malaysia

52. Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

with Fontan circulation, and this population is expected to double in the next 20 years. In the absence of a subpulmonary ventricle, Fontan circulation is characterized by chronically elevated systemic venous pressures and decreased cardiac output. The addition of this acquired abnormal circulation to innate abnormalities associated with single-ventricle congenital heart disease exposes these patients to a variety of complications. Circulatory failure, ventricular dysfunction, atrioventricular valve (...) are just being recognized. The hallmark of the Fontan circulation is a sustained, abnormally elevated central venous pressure combined with decreased cardiac output, especially during periods of increased demands, resulting in a cascade of physiological consequences. Clinical hazards faced by patients include progressive fatigue, heart failure, arrhythmias, and end-organ complications such as liver disease, in addition to anxiety and concern about their condition and future. Whereas multiple reports

2019 American Heart Association

53. Heart Disease and Stroke Statistics Full Text available with Trip Pro

Cardiac Arrest, Ventricular Arrhythmias, and Inherited Channelopathies e377 18. Subclinical Atherosclerosis e401 19. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris e415 20. Cardiomyopathy and Heart Failure e438 21. Valvular Diseases e455 22. Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism), Chronic Venous Insufficiency, Pulmonary Hypertension e472 23. Peripheral Artery Disease and Aortic Diseases e481 Outcomes 24. Quality of Care e497 25. Medical Procedures (...) States and globally. The Statistical Update also presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease [CHD], heart failure [HF], valvular disease, venous disease, and peripheral arterial disease) and the associated outcomes (including quality of care, procedures, and economic costs). Since 2007, the annual versions of the Statistical Update have

2019 American Heart Association

54. Phase-rectified signal averaging for intrapartum electronic fetal heart rate monitoring is related to acidaemia at birth Full Text available with Trip Pro

Phase-rectified signal averaging for intrapartum electronic fetal heart rate monitoring is related to acidaemia at birth Recent studies suggest that phase-rectified signal averaging (PRSA), measured in antepartum fetal heart rate (FHR) traces, may sensitively indicate fetal status; however, its value has not been assessed during labour. We determined whether PRSA relates to acidaemia in labour, and compare its performance to short-term variation (STV), a related computerised FHR

2014 EvidenceUpdates

55. Heart Failure Full Text available with Trip Pro

. Strong FOR Low Invasive coronary angiography should be considered in patients with heart failure associated with refractory angina, resuscitated cardiac arrest, sustained ventricular arrhythmias, or with evidence of ischaemic heart disease on other investigations, or an intermediate-to-high pretest probability for coronary artery disease, to determine the need for coronary revascularisation. Strong FOR Low Either computed tomography (CT) coronary angiography or cardiac magnetic resonance imaging (CMR (...) receptor neprilysin inhibitor; AV, atrioventricular; BNP, B-type natriuretic peptide; BP, blood pressure; bpm, beats per minute; CABG, coronary artery bypass graft; CMR, cardiac magnetic resonance imaging; CRT, cardiac resynchronisation therapy; CT, computed tomography; ECG, electrocardiogram; DCM, dilated cardiomyopathy; GRADE, Grading of Recommendations Assessment, Development and Evaluation; HFrEF, heart failure with reduced ejection fraction; ICD, implantable cardioverter defibrillator; LGE, late

2018 Cardiac Society of Australia and New Zealand

56. CRACKCast E171 – Pediatric Cardiac Disorders

of Cardiac Disorders in Infants and Children) See Box 170.3 (Key Elements to Elicit in the History of a Child with a Known Cardiac Disorder) Let’s start this sauna-sweat-shop episode with a little anatomy review: Trace the path of the RBC during foetal circulation, and describe the changes that occur following delivery. Oxygen flow: mom’s lungs/body/placenta → umbilical vein → ductus venosus → fetal heart (through IVC) → right atrium → shunted to the left atrium by the patent foramen ovale → left (...) and intravenous immune globulin (IVIG) infusion can prevent the formation of coronary aneurysms. Acute bacterial endocarditis should always be considered in a child with a known congenital heart defect or an acquired cardiac defect who presents with fever of unknown origin, acute neurologic deficits, new-onset microscopic hematuria, myalgias, splenomegaly, petechiae, or other signs of systemic embolization. Oxygen, positive pressure ventilation (noninvasive or invasive), diuretics, and possibly inotropes

2018 CandiEM

57. Complexity analysis of fetal heart rate preceding intrauterine demise Full Text available with Trip Pro

gestational age at the time of IUFD was 35.5 weeks. Three controls were matched to each case for a total of 24 subjects, and 87 FHR tracings were included for analysis. The median gestational age at the first fetal heart rate tracing was similar between groups (median [1st-3rd quartiles] weeks: IUFD cases: 34.7 (34.4-36.2); controls: 35.3 (34.4-36.1); p=.94). The median complexity of the cases' tracings was significantly less than the controls' (12.44 [8.9-16.77] vs. 17.82 [15.21-22.17]; p<.0001 (...) Complexity analysis of fetal heart rate preceding intrauterine demise Visual non-stress test interpretation lacks the optimal specificity and observer-agreement of an ideal screening tool for intrauterine fetal demise (IUFD) syndrome prevention. Computational methods based on traditional heart rate variability have also been of limited value. Complexity analysis probes properties of the dynamics of physiologic signals that are otherwise not accessible and, therefore, might be useful

2016 European journal of obstetrics, gynecology, and reproductive biology

58. The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals Full Text available with Trip Pro

The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid. Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different (...) variability condition. Conclusion The results of the study provide evidence that the presence of a visual aid was useful in helping novices identify FHR signals in simulated maternal-fetal heart rate images. Further, the visual aid was most useful for conditions in which the signal is most difficult to detect (when FHR variability is highest).

2016 AJP Reports

59. Noninvasive Monitoring of Uterine Electrical Activity and Fetal Heart Rate: A New External Monitoring Device

of the contractions, and the amount of discontinuous tracings from the devices. Compare the fetal heart rate tracing obtained via the EUM device vs. external fetal Doppler vs. fetal scalp electrode (simultaneously obtained, 30 minute tracings will be compared) among obese patients and nonobese patients with regards to the amount of discontinuous/unterinterpetable tracing, average fetal heart rate, baseline heart rate, the number accelerations, the number of decelerations, the timing of the accelerations (...) , the timing of decelerations, the maximum fetal heart rate achieved during acceleration, the lowest fetal heart rate achieved during deceleration, and compare the degree of variability in the tracing. Compare tracings of productive vs. non-productive contractions in patients presenting to triage to rule out labor (30 minutes of simultaneously obtained tracings of external tocodynamometer and EUM device will be compared) with regards to the frequency of contractions, the duration of contractions, maximum

2016 Clinical Trials

60. Antenatal foetal heart monitoring. (Abstract)

Antenatal foetal heart monitoring. Antenatal foetal heart rate assessment was introduced into clinical medicine before clear evidence of any benefits had been reported. Ad hoc definitions were used to define normal and abnormal recordings resulting in a high false-positive rate for foetal compromise. The understanding of the foetal states resulted in an improved physiologically based assessment of the antenatal tracings and allowed their classification as (i) reactive - 2 accelerations in 10 (...)  min within a recording period of 120 min, (ii) unreactive - no accelerations seen in 120 min of tracing and (iii) decelerative - the presence of repetitive decelerations on an otherwise unreactive trace. This classification reduces the high rate of false-positive traces associated with recording times of less than 40 min. Traces performed on pregnancies before 32 weeks predict clinical outcome, but need to be interpreted in light of the fact the many foetuses will not show a mature reactive

2016 Best practice & research. Clinical obstetrics & gynaecology

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