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Fetal Heart Tracing

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61. Variability in antenatal prognostication of diaphragmatic hernia across the North American Fetal Therapy Network. (Abstract)

Variability in antenatal prognostication of diaphragmatic hernia across the North American Fetal Therapy Network. To evaluate variability in antenatal sonographic prognostication of congenital diaphragmatic hernia (CDH) within the North American Fetal Therapy Network (NAFTNet).NAFTNet centres were invited to complete a questionnaire and participate in videoconference calls, during which participants were observed while measuring lung area using the anteroposterior (AP), longest and trace method (...) measurement was consistent, including an axial section of the chest with clear lung borders and a 4-chamber cardiac view. Lung area measurement methods varied across NAFTNet, with most centers using longest (4/9 FETO vs. 13/29 non-FETO) or trace (3/9 FETO vs. 11/29 non-FETO). Centres differed in expected reference ranges for o/e LHR determination and whether the lowest, highest or average o/e LHR was used.Variability in antenatal sonographic prognostication of CDH was identified across NAFTNet, indicating

2019 Prenatal diagnosis

62. Risk factors for Cesarean delivery in pregnancies with a small-for-gestational-age fetus undergoing induction of labor. (Abstract)

risk factors associated with cesarean delivery in pregnancies complicated by SGA and undergoing induction of labor. The secondary outcome was to identify risk factors associated with non-reassuring fetal heart tracing (NRFHT). Univariate and multivariable analyses were used to determine which clinical characteristics, available at the time of admission, were most associated with cesarean delivery during labor induction. The predictive value of the final model was assessed with the area under (...) Risk factors for Cesarean delivery in pregnancies with a small-for-gestational-age fetus undergoing induction of labor. To identify risk factors for cesarean delivery in small-for-gestational age (SGA) fetuses undergoing induction of labor.This was a retrospective cohort study of non-anomalous, singleton gestations delivered in a single tertiary referral center who met criteria for SGA, defined as an estimated fetal weight (EFW) less than 10th percentile. Our primary outcome was to identify

2019 Ultrasound in Obstetrics and Gynecology

63. Evolution of the Fetal Atrioventricular Interval from 6 to 40 Weeks of Gestation. (Abstract)

the first trimester to 40 weeks gestational age, and to explore functional and electrophysiological events that potentially impact its evolution. We prospectively examined healthy pregnancies by fetal echocardiography from 6 to 40 weeks' gestational age. The atrioventricular interval, heart rate, isovolumic contraction time, and A-wave duration were measured from simultaneous ventricular inflow-outflow Doppler tracings. Regression analysis was used to examine relations with gestational age, and linear (...) Evolution of the Fetal Atrioventricular Interval from 6 to 40 Weeks of Gestation. Doppler-based methods of estimating the atrioventricular interval are commonly used as a surrogate for the electrical PR in fetuses at risk of conduction abnormalities; however, to date, normal values for the fetal atrioventricular interval and an understanding of the evolution of its components in the late first trimester are lacking. We sought to investigate changes in the fetal atrioventricular interval from

2019 American Journal of Cardiology

64. Feasibility of Non-invasive Fetal Electrocardiographic Interval Measurement in the Outpatient Clinical Setting. (Abstract)

Feasibility of Non-invasive Fetal Electrocardiographic Interval Measurement in the Outpatient Clinical Setting. Non-invasive fetal electrocardiography (ECG) is a promising method for evaluating fetal cardiac electrical activity. Despite advances in fetal ECG technology, its ability to provide reliable, interpretable results in a typical outpatient fetal cardiology setting remains unclear. We sought to determine the feasibility of measuring standard ECG intervals in an outpatient fetal (...) 25-31 and 32-37 weeks. Of the six fetuses with abnormal rhythms on fetal echocardiogram, fetal ECG tracing was interpretable in five and matched the rhythm noted on fetal echocardiogram. Abdominal fetal ECG acquisition is feasible for arrhythmia detection and ECG interval calculation in a routine clinical setting.

2019 Pediatric Cardiology

65. Fetal echocardiographic assessment of the cardiovascular impact of prolonged support in the EXTrauterine Environment for Neonatal Development (EXTEND) system. Full Text available with Trip Pro

studied fetal sheep supported for a minimum of 3 weeks on EXTEND. Hemodynamic parameters of heart rate, mean arterial pressure, Doppler echocardiography derived cardiac output, pulsatility indices of middle cerebral artery, umbilical artery, and ductus venosus, and cardiac function as gauged by speckle tracking derived global longitudinal strain and strain rate of right and left ventricles, were all measured weekly and compared.Of 10 fetal sheep, 7 survived for 3 weeks and were studied. Median (...) gestational age at cannulation was 107 days (range 95-109). Parameters of heart rate, blood pressure, the quantities and relative ratios of right and left cardiac output all remained stable within the anticipated physiological range throughout. Vascular tracings and pulsatility indices appeared similar to normal as seen in the natural in-utero state, with middle cerebral pulsatility indices higher than umbilical arterial. Umbilical arterial tracings maintained abundant diastolic flow despite absence

2019 Ultrasound in Obstetrics and Gynecology

66. Pulse Pressure and Post-epidural Fetal Heart Rate Changes

used on Labor and Delivery at MetroHealth Medical Center Experimental: Volume Replacement IV Preload Patients in this arm will receive 1500mL of Lactated Ringer's solution Drug: Lactated Ringer's 1500 cc of IV Fluid (crystalloid) used for preload prior to epidural administration in the treatment arm. Control arm receives 500 cc. Other Name: Ringer's Lactate Outcome Measures Go to Primary Outcome Measures : Incidence of New-onset Category II or III Fetal Heart Rate Tracings [ Time Frame: First 60 (...) minutes following epidural placement ] Each fetal heart rate tracing was evaluated in 15 min increments from the completion of epidural placement and initial dose administration. ACOG Category I, II, and III was assigned to each 15 min increment. Secondary Outcome Measures : New Onset Hypotension (>20% Decrease in Systolic and/or Diastolic Blood Pressure) [ Time Frame: First 60 minutes following epidural placement ] Interventions to Correct Maternal Hypotension or Fetal Heart Rate Abnormalities

2015 Clinical Trials

67. The Monica Fetal Heart Monitor

the amount of time that the fetal heart tones are traced in babies just at or beyond viability using a traditional device compared to the Monica device. Condition or disease Intervention/treatment Fetal Heart Tracing Other: Fetal Heart Rate Monitor Detailed Description: If a patient is admitted to the antepartum service and is between 24 - 28 weeks gestation, the investigators will approach the patient and inform her about the study. If the patient agrees to the study then the baby's heart tracings (...) the amount of time that the fetal heart tones are traced in babies just at or beyond viability using a traditional device compared to the Monica device [ Time Frame: How long can hetal heart tracings be capture continuously ] This study is to compare the amount of time that the fetal heart tones are traced in babies just at or beyond viability using a traditional device compared to the Monica device. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate

2015 Clinical Trials

68. Preterm Cesarean Delivery for Nonreassuring Fetal Heart Rate: Neonatal and Neurologic Morbidity. (Abstract)

Preterm Cesarean Delivery for Nonreassuring Fetal Heart Rate: Neonatal and Neurologic Morbidity. To compare the rates of neonatal morbidity and cerebral palsy among preterm neonates (less than 37 weeks of gestation) delivered by cesarean for a nonreassuring fetal heart rate (FHR) tracing compared with those who did not.This was a secondary analysis of a multicenter randomized trial of MgSO4 for the prevention of cerebral palsy. Newborns of women delivered by cesarean delivery for nonreassuring (...) %, adjusted OR 2.3, 95% CI 1.2-4.5) and moderate-to-severe cerebral palsy at 2 years of corrected age (6.0 compared with 2.2%, adjusted OR 3.2, 95% CI 1.4-7.1) was significantly higher in children born through cesarean delivery for nonreassuring FHR.Nonreassuring fetal tracing deemed so serious as to require cesarean delivery is associated with an increased risk of cerebral palsy in preterm neonates.II.

2015 Obstetrics and Gynecology Controlled trial quality: predicted high

69. Distention of the Immature Left Ventricle Triggers Development of Endocardial Fibroelastosis: An Animal Model of Endocardial Fibroelastosis Introducing Morphopathological Features of Evolving Fetal Hypoplastic Left Heart Syndrome Full Text available with Trip Pro

Distention of the Immature Left Ventricle Triggers Development of Endocardial Fibroelastosis: An Animal Model of Endocardial Fibroelastosis Introducing Morphopathological Features of Evolving Fetal Hypoplastic Left Heart Syndrome Endocardial fibroelastosis (EFE), characterized by a diffuse endocardial thickening through collagen and elastin fibers, develops in the human fetal heart restricting growth of the left ventricle (LV). Recent advances in fetal imaging indicate that EFE development (...) is directly associated with a distended, poorly contractile LV in evolving hypoplastic left heart syndrome (HLHS). In this study, we developed an animal model of EFE by introducing this human fetal LV morphopathology to an immature rat heart.A neonatal donor heart, in which aortic regurgitation (AR) was created, was heterotopically transplanted into a recipient adult rat. AR successfully induced the LV morphology of evolving HLHS in the transplanted donor hearts, which resulted in the development

2015 BioMed research international

70. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association Full Text available with Trip Pro

of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. Methods and Results: To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long (...) , the potential for coronary artery complications was not appreciated. KD is now the most common cause of acquired heart disease in children in developed countries. In the absence of pathognomonic tests, the diagnosis continues to rest on the identification of principal clinical findings and the exclusion of other clinically similar entities with known causes. Timely initiation of treatment with intravenous immunoglobulin (IVIG) has reduced the incidence of coronary artery aneurysms defined from absolute

2017 American Heart Association

71. Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

and subspecialty spectrum in pediatric cardiology. Clinical Scenarios: Fetal Echocardiography and Fetal Cardiac Monitoring Fetal tele-echocardiography increases prenatal detection of critical congenital heart disease (CCHD). Sharma et al reported that adequate screening for fetal heart disease is feasible and that community acceptance for telemedicine-assisted fetal cardiac screening and counseling is not adversely affected by a lack of direct personal contact with a specialist. Prenatal detection of CCHD (...) . By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association , MD, FAHA, Chair , MD , MD , MD , MD , MD , MD, FAHA , JD , MD, FAHA , MD , MD , and MD, FAHA MD, FAHA, Vice ChairOn behalf of the American Heart Association Congenital Cardiac Disease Committee of the Council on Cardiovascular Disease in the Young and Council on Quality Care

2017 American Heart Association

72. Umbilical Artery Thrombosis with Associated Acute and Severe Fetal Growth Restriction and Transient Severe Protein S Deficiency: Report of a Case with Prenatal Ultrasound Diagnosis Allowing for Timely Intervention and Good Outcome Full Text available with Trip Pro

with a single umbilical artery. The estimated fetal weight measurements at 26 weeks, 29 weeks, and 31 weeks were at the 27th percentile, the 26th percentile, and less than the 5th percentile, respectively. At 33 weeks, amniotic fluid index became abnormal at 2.3 cm and fetal heart tracing revealed spontaneous prolonged decelerations, and a cesarean delivery was performed. Placental pathology showed thrombosis of one of the umbilical arteries. At birth, a transient protein S deficiency was detected (activity (...) Umbilical Artery Thrombosis with Associated Acute and Severe Fetal Growth Restriction and Transient Severe Protein S Deficiency: Report of a Case with Prenatal Ultrasound Diagnosis Allowing for Timely Intervention and Good Outcome Thrombosis of one of the umbilical arteries can be associated with adverse pregnancy outcomes such as stillbirth and severe intrauterine growth restriction (IUGR).A 21-year-old gravida 1 patient, with a history of 3-vessel cord at 20 weeks, presented at 29 weeks

2018 Case reports in obstetrics and gynecology

73. Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis. Full Text available with Trip Pro

of non-reassuring fetal heart tracing (9.8% vs. 1.9%, P < 0.001) and of caesarean delivery (9.1% vs. 5.0%, P = 0.013) was higher in women with EFW. Overestimation was associated with an increased risk for delivery by caesarean section (odds ratio 2.80; 95% confidence interval 1.2-6.5, P = 0.017). After adjustment, EFW remained associated with increased non-reassuring fetal heart tracing (odds ratio 4.73; 95% confidence interval 2.3-9.6) and caesarean delivery (odds ratio 1.86; 95% confidence interval (...) Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis. The aim of the study was to investigate the accuracy of ultrasound-derived estimated fetal weight (EFW) and to determine its impact on management and outcome of delivery.In this single-center cohort analysis, women with a singleton term pregnancy in the beginning stages of labor were included. Women with immediately antepartum EFW (N = 492) were compared

2018 BMC Pregnancy and Childbirth

74. Comparison of Intrathecal Versus Epidural Fentanyl on Fetal Bradycardia in Labor Combined Spinal Epidural Analgesia

any differences in risk exist between fentanyl and bupivacaine when used as a part of the CSE procedure. Some authors have reported cases of parturients who developed uterine hyperactivity and fetal bradycardia after subarachnoid administration of fentanyl during labor. (D'Angelo & Eisenach, 1997) (Friedlander JD, 1997). It has been suggested that uterine hypertonus, leading to non-reassuring fetal heart rate tracings, might be an etiologic factor in these situations. (Landau, 2002). We propose (...) preservative-free 0.25% bupivacaine and epidural fentanyl 100 mcg. After the procedure, we will monitor the fetal heart rate and tocometry tracings for 20 min. Thereafter, an epidural infusion with a solution containing 0.125% bupivacaine and 2mcg/mL of fentanyl will be started. We will record demographic variables (age, and BMI), obstetric variables (parity, gestational age, cervical dilation, oxytocin infusion) and anesthetic variables (level of insertion of epidural catheter). Primary outcomes: Fetal

2018 Clinical Trials

75. Delayed Appearance of a Traumatic Fetal Intracranial Hemorrhage Full Text available with Trip Pro

hyperechogenic lesion and subdural fluid collection. The neonate, following an uneventful birth at 39 weeks, had seizures and abnormal muscle tone. MRI was consistent with in utero intracranial hemorrhage.Serial fetal imaging following maternal trauma, particularly when accompanied by abnormal fetal heart rate tracings, should be considered when fetal injury is a concern, even in the setting of a normal initial ultrasound. (...) Delayed Appearance of a Traumatic Fetal Intracranial Hemorrhage Fetal intracranial injury is a potentially devastating sequelae of maternal trauma, but there is little guidance regarding fetal evaluation in this setting.A 23-year-old woman at 27-week gestation was admitted after a high-speed motor vehicle accident. The initial obstetrical ultrasound was unremarkable, but persistently minimal fetal heart rate variability was observed. Ultrasound on day 3 after the accident showed an intracranial

2018 Case reports in obstetrics and gynecology

76. A randomised comparison of bolus phenylephrine and ephedrine for the management of spinal hypotension in patients with severe preeclampsia and fetal compromise. (Abstract)

for a non-reassuring fetal heart tracing were randomised to receive either bolus ephedrine (7.5-15mg) or phenylephrine (50-100µg), to treat spinal hypotension. The primary outcome was umbilical arterial base excess. Secondary outcomes were umbilical arterial and venous pH and lactate concentration, venous base excess, and Apgar scores.Among 133 women, 64 who required vasopressor treatment were randomised into groups of 32 with similar patient characteristics. Pre-delivery blood pressure changes were (...) A randomised comparison of bolus phenylephrine and ephedrine for the management of spinal hypotension in patients with severe preeclampsia and fetal compromise. Studies in healthy patients undergoing elective caesarean delivery show that, compared with phenylephrine, ephedrine used to treat spinal hypotension is associated with increased fetal acidosis. This has not been investigated prospectively in women with severe preeclampsia.Patients with preeclampsia requiring caesarean delivery

2018 International journal of obstetric anesthesia Controlled trial quality: uncertain

77. Maternal Oxygen Administration for Fetal Distress II

will be obtained. Placenta glutathione (GSH) [ Time Frame: within 30 to 60 seconds of placenta delivery ] Immediately after placenta delivery (within 30-60 seconds of delivery), placenta tissue sample will be obtained. Other Outcome Measures: Rate of cesarean delivery [ Time Frame: at 1 minute after birth ] Rate of assisted vaginal delivery [ Time Frame: at 1 minute after birth ] Rate of abnormal fetal heart tracing [ Time Frame: at 1 minute after birth ] Rate of serious neonatal morbidity or death [ Time (...) , the effect of supplemental maternal oxygen therapy on fetal acid base status has been debated for more than seven decades. The investigators found the use of 2 L/min maternal oxygen during the second stage of labor did not adversely affect either the umbilical artery pH value or the fetal heart rate (FHR) pattern distribution. Condition or disease Intervention/treatment Phase Oxygen Inhalation Therapy Second Stage of Labour Fetal Distress Device: High flow facemask Device: Sham facemask oxygen

2018 Clinical Trials

78. Oxygen vs Room Air for Intrauterine Fetal Resuscitation.

Oxygen vs Room Air for Intrauterine Fetal Resuscitation. Oxygen vs Room Air for Intrauterine Fetal Resuscitation. – Less Is More Search for: Simpler & Better Medicine Menu / Summary: For women in labor at term (> 37 weeks gestational age) who develop category II fetal heart rate tracings requiring intrauterine resuscitation, use of “room air” for the mother may be associated with the same subsequent level of umbilical artery as use of oxygen 10 LPM by face mask for the mother, without any

2019 Less Is More Blog

79. Correlation of arterial fetal base deficit and lactate changes with severity of variable heart rate decelerations in the near-term ovine fetus. (Abstract)

Correlation of arterial fetal base deficit and lactate changes with severity of variable heart rate decelerations in the near-term ovine fetus. Recent guidelines classify variable decelerations without detail as to degree of depth. We hypothesized that variable deceleration severity is highly correlated with fetal base deficit accumulation.Seven near-term fetal sheep underwent a series of graded umbilical cord occlusions resulting in mild (30 bpm decrease), moderate (60 bpm decrease), or severe (...) variable decelerations may result in significant base deficit increases, dependent on frequency. Modified guideline differentiation of mild/moderate vs severe variable decelerations may aid in the interpretation of fetal heart rate tracings and optimization of clinical management paradigms.Copyright © 2013 Mosby, Inc. All rights reserved.

2012 American Journal of Obstetrics and Gynecology

80. Misidentification of maternal heart rate as fetal on cardiotocography (CTG) during the second stage of labor: the role of the fetal ECG. (Abstract)

Misidentification of maternal heart rate as fetal on cardiotocography (CTG) during the second stage of labor: the role of the fetal ECG. To identify the incidence of fetal heart rate (FHR) accelerations in the second stage of labor and the role of fetal electrocardiograph (ECG) in avoiding misidentification of maternal heart rate (MHR) as FHR.Retrospective observational study.University hospital labor ward, London, UK.Cardiotocograph (CTG) tracings of 100 fetuses monitored using external (...) transducers and internal scalp electrodes.CTG traces that fulfilled inclusion criteria were selected from an electronic FHR monitoring database.Rate of accelerations during external and internal monitoring as well as decelerations for a period of 60 minutes prior to delivery were determined. The role of fetal ECG in differentiating between MHR and FHR trace was explored.Decelerations occurred in 89% of CTG traces during the second stage of labor. Accelerations indicating possible recording of FHR or MHR

2012 Acta Obstetricia et Gynecologica Scandinavica

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