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Fetal Heart Tracing

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61. Fetal cardiac axis and congenital heart defects in early gestation. (PubMed)

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 (...) 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

2015 Obstetrics and Gynecology

62. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association | 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 Free Access article Share on Jump to Free Access article Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association , MD, MPH, FAHA, Chair , MD , MD, MPH, FAHA , MD , MD, FAHA , MD, FAHA , MSN, RN, CPNP , MD , MD, FAHA , MD , MD, PhD , MD, PhD , and MD, FAHA MD, FAHA, Co-ChairOn behalf of the American Heart Association Rheumatic

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2017 American Heart Association

63. 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 (...) in turn has been shown to improve postnatal surgical and heart transplantation outcomes. Most commonly, fetal tele-echocardiography is used to refer delivery to a place where a neonatal intervention can be performed. A few centers in North America also use tele-echocardiography for referral for fetal intervention. However, fetal tele-echocardiography is also used across all links of the referral chain, from the primary obstetrician’s office to the quaternary fetal healthcare facility. It is routinely

2017 American Heart Association

64. A new method for monitoring baby’s heart beat during labour probably not justified

guidance say on this issue? The 2014 NICE guideline on intrapartum care recommends that cardiotocography is only used for women with certain risk factors, such as foetal heart rate abnormalities. It states that when in use, practitioners must ensure that the focus of care remains on the woman rather than the cardiotocograph trace, and that care decisions are not made on the basis of cardiotocography findings alone. The guideline makes no recommendation with regard to the use of ST analysis. What (...) with certain risk factors, such as foetal heart rate abnormalities. It states that when in use, practitioners must ensure that the focus of care remains on the woman rather than the cardiotocograph trace, and that care decisions are not made on the basis of cardiotocography findings alone. The guideline makes no recommendation with regard to the use of ST analysis. What are the implications? Because of the rarity of the outcomes being measured, very large trials would be needed to show a difference between

2019 NIHR Dissemination Centre

65. 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

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

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

67. 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 (PubMed)

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

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2018 Case reports in obstetrics and gynecology

68. Delayed Appearance of a Traumatic Fetal Intracranial Hemorrhage (PubMed)

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

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2018 Case reports in obstetrics and gynecology

69. 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

70. Accuracy of immediate antepartum ultrasound estimated fetal weight and its impact on mode of delivery and outcome - a cohort analysis. (PubMed)

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

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2018 BMC Pregnancy and Childbirth

71. Automated analysis of fetal cardiac function using color tissue Doppler imaging in the second half of normal pregnancy. (PubMed)

an automated method to analyze cTDI recordings from a cardiac four-chamber view.This was a cross-sectional study including 201 normal singleton pregnancies between 18 and 42 weeks of gestation. During fetal echocardiography, a four-chamber view of the heart was visualized and cTDI was performed. Regions of interest were positioned at the level of the atrioventricular plane in the left ventricular (LV), right ventricular (RV) and septal walls of the fetal heart, to obtain myocardial velocity traces (...) Automated analysis of fetal cardiac function using color tissue Doppler imaging in the second half of normal pregnancy. Color tissue Doppler imaging (cTDI) is a promising tool for the assessment of fetal cardiac function. However, the analysis of myocardial velocity traces is cumbersome and time-consuming, limiting its application in clinical practice. The aim of this study was to evaluate fetal cardiac function during the second half of pregnancy and to develop reference ranges using

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2018 Ultrasound in Obstetrics and Gynecology

72. Diagnosis and Treatment of Fetal Cardiac Disease

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 (...) and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence

2014 American Heart Association

73. A new method for monitoring baby’s heart beat during labour probably not justified

guidance say on this issue? The 2014 NICE guideline on intrapartum care recommends that cardiotocography is only used for women with certain risk factors, such as foetal heart rate abnormalities. It states that when in use, practitioners must ensure that the focus of care remains on the woman rather than the cardiotocograph trace, and that care decisions are not made on the basis of cardiotocography findings alone. The guideline makes no recommendation with regard to the use of ST analysis. What (...) with certain risk factors, such as foetal heart rate abnormalities. It states that when in use, practitioners must ensure that the focus of care remains on the woman rather than the cardiotocograph trace, and that care decisions are not made on the basis of cardiotocography findings alone. The guideline makes no recommendation with regard to the use of ST analysis. What are the implications? Because of the rarity of the outcomes being measured, very large trials would be needed to show a difference between

2018 NIHR Dissemination Centre

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

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

75. Effectiveness of pulse oximetry versus fetal electrocardiography for the intrapartum evaluation of nonreassuring fetal heart rate. (PubMed)

Effectiveness of pulse oximetry versus fetal electrocardiography for the intrapartum evaluation of nonreassuring fetal heart rate. To compare the effectiveness of pulse oximetry and fetal electrocardiography in the management of labor with nonreassuring fetal heart rate (NRFHR).This randomized experimental study consisted of two arms. In group 1 we used pulse oximetry and in group 2 we used STAN® technology. The participants in each group were 90 pregnant women with a full-term singleton fetus (...) in cephalic presentation and cardiotocographic tracings compatible with NRFHR. We compared the following variables: rate of cesarean delivery, indications for operative delivery due to NRFHR, and repercussions on the newborn's acid-base status.The two groups differed significantly in the mode of delivery, with a cesarean delivery rate of 47.6% in group 1 vs. 30% in group 2 (p=0.032). The groups did not differ in the indications for ending labor due to NRFHR (62% vs. 61%, NS). In terms of neonatal outcomes

2011 European journal of obstetrics, gynecology, and reproductive biology Controlled trial quality: uncertain

76. Association of non-reassuring fetal heart rate and fetal acidosis with placental histopathology. (PubMed)

Association of non-reassuring fetal heart rate and fetal acidosis with placental histopathology. To investigate the association between different placental lesions and non-reassuring fetal heart rate (NRFHR) pattern and fetal acidosis in labor.Placentas from 213 women who underwent cesarean section because of NRFHR with or without fetal acidosis (pH < 7.2) were classified by histopathologic findings: consistent with maternal circulation abnormalities i.e., namely, marginal or retroplacental (...) hemorrhage (M0), maternal underperfusion, vascular (M1) or villous changes (M2), and those consistent with fetal thrombo-occlusive disease due to vascular (F1) or villous (F2) changes. Lesions were also analyzed by maternal (MIR) or fetal (FIR) origin of inflammatory responses.Cord blood pH was normal in 169 neonates (7.29 ± 0.04; control group) and <7.2 in 44 (7.10 ± 0.07; study group). The study group had higher rates of histologic chorioamnionitis; MIR was detected in 34.1% compared to17.8

2011 Placenta

77. Electronic Fetal Monitoring With and Without Pattern Interpretation

rate tracing is recorded on paper or electronically and produces a pattern to allow physicians to visually identify fetuses that are at risk for hypoxia and/or acidemia. This practice allows for prompt intervention via intrauterine resuscitation and expedited delivery if deemed necessary. National and international guidelines published by the International Federation of Gynecology and Obstetrics and American College of Obstetrics and Gynecology describe how fetal heart rate patterns obtained (...) , then their patient information will be collected. Their labor will be managed as in Phase 1 except that EFM will be interpreted and managed as per ACOG/FIGO guidelines using paper on which fetal heart tracings will be recorded. All other aspects of their care will proceed as per standard at Ayder Referral Hospital. Patients who require EFM will be asked to provide basic health and demographic information, along with collection of information on labor and delivery course, post-partum outcome, and neonatal

2017 Clinical Trials

78. Effect of Administering Intravenous Magnesium Sulfate on Fetal Cardiotocography and Neonatal Outcome in Preeclamptic Patients

over 15-20 min. Maintenance dose: 2 gm/hr in 100 mL of IV infusion to be continued for 24 hours after delivery. Other Name: Magnisium sulfate Outcome Measures Go to Primary Outcome Measures : Fetal heart rate tracing [ Time Frame: 20 minutes after MgSO4 administration ] Settings on a CTG machine is standardised to enable a consistent approach of interpretation of traces. Paper speed of 3cm per minute is adopted Eligibility Criteria Go to Information from the National Library of Medicine Choosing (...) settings on machines will be labelled at commencement of tracing. Maternal heart rate will be recorded and noted on CTG. Following birth date, time and mode of delivery will be labelled on CTG. Magnesium Sulphate hepatahydrate administration: Magnesium sulphate will be administered by continuous intravenous infusion according to our hospital protocol as follows: Loading dose: 4-6 gm of magnesium sulphate diluted in 100 mL of IV fluid administered over 15-20 min. Maintenance dose: 2 gm/hr in 100 mL

2017 Clinical Trials

79. Automated analysis of fetal cardiac function using color tissue Doppler imaging. (PubMed)

Automated analysis of fetal cardiac function using color tissue Doppler imaging. To evaluate the feasibility of automated analysis of fetal myocardial velocity recordings obtained by color tissue Doppler imaging (cTDI).This was a prospective cross-sectional observational study of 107 singleton pregnancies ≥ 41 weeks of gestation. Myocardial velocity recordings were obtained by cTDI in a long-axis four-chamber view of the fetal heart. Regions of interest were placed in the septum and the right (...) (RV) and left (LV) ventricular walls at the level of the atrioventricular plane. Peak myocardial velocities and mechanical cardiac time intervals were measured both manually and by an automated algorithm and agreement between the two methods was evaluated.In total, 321 myocardial velocity traces were analyzed using each method. It was possible to analyze all velocity traces obtained from the LV, RV and septal walls with the automated algorithm, and myocardial velocities and cardiac mechanical time

2017 Ultrasound in Obstetrics and Gynecology

80. Accuracy of intrapartum fetal blood gas analysis by scalp sampling: A retrospective cohort study. (PubMed)

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

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2017 Medicine

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