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Fetal Scalp Stimulation

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1. Using fetal scalp stimulation with Doppler ultrasonography to enhance intermittent auscultation in low-resource settings: a diagnostic trial from Tanzania. Full Text available with Trip Pro

for detecting these changes is not available. In this study we sought to compare the ability of a handheld Doppler device to detect accelerations as part of the fetal scalp stimulation test and to compare the diagnostic performance of routine intermittent auscultation with auscultation that is augmented with fetal scalp stimulation.This non-randomized, pre- and post-diagnostic trial was conducted with 568 maternal-fetus pairs at Kilimanjaro Christian Medical Center in Moshi, Tanzania. The first objective (...) Using fetal scalp stimulation with Doppler ultrasonography to enhance intermittent auscultation in low-resource settings: a diagnostic trial from Tanzania. Hypoxia during labor contributes to 2.2 million intrapartum and early neonatal deaths each year. An additional 0.6-1.0 million cases of life-long disability occur because of fetal hypoxia during labor. It is known that fetal heart rate changes in labor correspond to hypoxia and neurologic compromise, but a reliable, low-cost method

2019 BMC Pregnancy and Childbirth

2. Fetal Scalp Stimulation

Fetal Scalp Stimulation Fetal Scalp Stimulation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp Stimulation Fetal Scalp (...) Stimulation Aka: Fetal Scalp Stimulation , Scalp Stimulation Test , Fetal Acoustic Stimulation II. Indications Assess degree of III. Technique Stimulate infant with one of two techniques Fetal Scalp Stimulation Fetal Acoustic Stimulation Observe response to stimulation IV. Interpretation: Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) V. References Images: Related links to external sites (from Bing) These images are a random sampling

2018 FP Notebook

3. Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings.

Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings. Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings. - 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. Introducing Fetal Scalp Stimulation as an Adjunct to Intermittent Auscultation in Low-Resource Settings. 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. Read our for details. ClinicalTrials.gov Identifier: NCT02862925 Recruitment Status : Completed First Posted : August 11, 2016 Last Update Posted

2016 Clinical Trials

4. Fetal Scalp pH

, Fetal Scalp Blood Sampling II. Indications Assess degree of III. Scalp Stimulation Test Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) IV. Fetal Scalp Blood Sample Analysis Normal pH: 7.25-7.35 (mean 7.33) pCO2: 40-50 mmHg pO2: 20-30 mmHg Base: <10 Non-reassuring findings (see interpretation below) pH <7.20 < -12 mmol/liter pH: <7.25 pCO2: 45-55 mmHg pO2: <20 mmHg Base: >10 pH: <7.25 pCO2: >50 mmHg pO2: Varies Base: <10 V (...) Fetal Scalp pH Fetal Scalp pH Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp pH Fetal Scalp pH Aka: Fetal Scalp pH

2018 FP Notebook

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

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 (...) of an acceleration with digital fetal scalp stimulation does not necessarily indicate fetal compromise. When acceleration does not occur: • Fetal scalp blood sampling should be considered when available (II-B). • If fetal scalp blood sampling is not possible, consider ongoing vigilant evaluation of the fetal health surveillance tracing if other elements of the fetal health surveillance and the clinical situation are normal or prompt delivery depending on the overall clinical situation (III-C). Fetal Scalp Blood

2020 Society of Obstetricians and Gynaecologists of Canada

6. Prenatal Management of Pregnancies at Risk of Fetal Neonatal Alloimmune Thrombocytopenia (FNAIT)

, and as a consequence, reduced use of invasive fetal testing and fetal blood sampling (FBS). There is very little high quality evidence on which to base management of this condition, but advances in treatment report very good outcomes. Severe FNAIT is very rare, adverse consequences for the fetus are potentially disastrous and the treatments are costly. This document considers the latest evidence in relation to treatment options in the prenatal management of pregnancies at risk of FNAIT; specifically, the role (...) ‐throughput, low‐cost HPA‐1a genotyping is now available. For women identified as HPA‐1a‐negative, the HPA status of the fetus can be determined from fetal DNA in maternal plasma and if the fetus is HPA‐1a negative, no further follow‐up is necessary. However, this has not yet been developed as a routine laboratory test. Scheffer et al. reported 100% sensitivity and 100% specificity for this test in 34 pregnancies in the Netherlands. Alternatively, the father's HPA‐1a genotype can be tested and if negative

2019 Royal College of Obstetricians and Gynaecologists

7. Fetal Health Surveillance: Intrapartum Consensus Guideline

). Recommendation 6: Digital Fetal Scalp Stimulation 1. Digital fetal scalp stimulation is recommended in response to atypical electronic fetal heart tracings (II-B). 2. In the absence of a positive acceleratory response with digital fetal scalp stimulation, • Fetal scalp blood sampling is recommended when available (II-B). • If fetal scalp blood sampling is not available, consideration should be given to prompt delivery, depending upon the overall clinical situation (III-C). Recommendation 7: Fetal Scalp Blood (...) Sampling 1. Where facilities and expertise exist, fetal scalp blood sampling for assessment of fetal acid–base status is recommended in women with “atypical/abnormal” fetal heart tracings at gestations > 34 weeks when delivery is not imminent, or if digital fetal scalp stimulation does not result in an acceleratory fetal heart rate response (III-C). Recommendation 8: Umbilical Cord Blood Gases 1. Ideally, cord blood sampling of both umbilical arterial and umbilical venous blood is recommended for ALL

2018 Society of Obstetricians and Gynaecologists of Canada

8. Clinical practice guideline for the care of women with decreased fetal movements for women with a singleton pregnancy from 28 weeks’ gestation

) A person's weight in kilograms divided by the square of height in meters. Cardiotocography (CTG) The electronic monitoring of the fetal heart rate (cardio) and of uterine contractions (toco). The fetal heart rate is recorded by means of either an external ultrasonic abdominal transducer or a fetal scalp electrode. Uterine contractions are recorded by means of an abdominal pressure transducer. The recordings are graphically represented over time. Congenital anomaly Structural or functional anomalies (e.g (...) their growth potential during pregnancy (which can be assessed by serial ultrasound scans). FGR babies are frequently but not always SGA. 1 World Health Organization, 2019. Congenital anomalies. World Health Organization, accessed 24 July 2019 (https://www.who.int/topics/congenital_anomalies/en/) v Term Definition Fetal to maternal haemorrhage (FMH) The passage of blood across the placental interface from the fetus to mother. FMH may be diagnosed using flow cytometry or the Kleihauer Betke test which

2019 Centre of Research Excellence in Stillbirth

9. Intrapartum fetal surveillance

trough of fluctuation in one minute segments of the CTG trace · Represents an adequately oxygenated fetal central nervous system Accelerations 2 · Transient increases in the FHR of 15 bpm or more above the baseline rate, lasting 15 seconds or more, at the baseline · Are a fetal response to stimulation · Commonly occur as a result of fetal movement · May be of lesser amplitude and shorter duration in a premature fetus than a mature fetus · Significance of no accelerations on an otherwise normal (...) after use Page 5 of 30 Abbreviations BMI Body mass index bpm Beats per minute CEFM Continuous electronic fetal monitoring CS Caesarean section CTG Cardiotocograph FBS Fetal blood sample/sampling FGR Fetal growth restriction FHR Fetal heart rate FSE Fetal scalp electrode GTN Glyceryl trinitrate Hb Haemoglobin IA Intermittent auscultation IFS Intrapartum fetal surveillance IV Intravenous MoM Multiples of Median PaPP–A Pregnancy associated plasma protein–A RANZCOG Royal Australian and New Zealand

2019 Queensland Health

10. Fetal Scalp Stimulation

Fetal Scalp Stimulation Fetal Scalp Stimulation Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp Stimulation Fetal Scalp (...) Stimulation Aka: Fetal Scalp Stimulation , Scalp Stimulation Test , Fetal Acoustic Stimulation II. Indications Assess degree of III. Technique Stimulate infant with one of two techniques Fetal Scalp Stimulation Fetal Acoustic Stimulation Observe response to stimulation IV. Interpretation: Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) V. References Images: Related links to external sites (from Bing) These images are a random sampling

2015 FP Notebook

11. Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements

. Cardiotocography (CTG) The electronic monitoring of the fetal heart rate (cardio) and of uterine contractions (toco). The fetal heart rate is recorded by means of either an external ultrasonic abdominal transducer or a fetal scalp electrode. Uterine contractions are recorded by means of an abdominal pressure transducer. The recordings are graphically represented over time. Congenital anomaly A structural malformation, chromosomal abnormality, genetic syndrome or metabolic disorder which is present from birth (...) death See “Stillbirth” Fetal to maternal haemorrhage (FMH) The passage of blood across the placental interface from the fetus to mother. FMH may be diagnosed using flow cytometry or the Kleihauer test which detects fetal red blood cells separately to the mother’s red blood cells. FMH may be acute or chronic and may be asymptomatic. Although the volume of significant FMH is not defined and is gestational age dependent, it is associated with fetal mortality and morbidity. Fetal growth restriction (FGR

2017 Clinical Practice Guidelines Portal

12. Repetitive transcranial magnetic stimulation for treatment-resistant major depression

the utility of the treatment), ? implanted medical devices (cochlear implant, medication pump, pacemaker, intra-cardiac lines, etc.), ? during pregnancy (in this case the magnetic nerve root stimulation is of critical importance; the transcranial stimulation is less critical on the basis of the greater distance to the foetus), ? increased intracranial pressure (e.g. after trauma or infection), ? a history of epileptic seizures (only applies for the cortical use; if necessary, a risk/benefit analysis (...) the coil around the subject. The Magstim trolley ensures the transport of the stimulators. The 70mm Double Air Film sham coil allows users to conduct research trials with a true sham condition. By stimulating the peripheral nerves of the face and scalp, the Air Film sham coil looks, sounds, and feels the same as an active coil, both to the subject and operator, but does not deliver active stimulation of deep nerves. Class II HF-rTMS for TRD Error! Use the Home tab to apply Datum to the text that you

2017 EUnetHTA

13. Fetal Scalp pH

, Fetal Scalp Blood Sampling II. Indications Assess degree of III. Scalp Stimulation Test Positive Scalp stimulation response increases 15 beats for 15 seconds Positive Response implies no acidosis (pH > 7.20) IV. Fetal Scalp Blood Sample Analysis Normal pH: 7.25-7.35 (mean 7.33) pCO2: 40-50 mmHg pO2: 20-30 mmHg Base: <10 Non-reassuring findings (see interpretation below) pH <7.20 < -12 mmol/liter pH: <7.25 pCO2: 45-55 mmHg pO2: <20 mmHg Base: >10 pH: <7.25 pCO2: >50 mmHg pO2: Varies Base: <10 V (...) Fetal Scalp pH Fetal Scalp pH Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Fetal Scalp pH Fetal Scalp pH Aka: Fetal Scalp pH

2015 FP Notebook

14. Diagnosis and Treatment of Fetal Cardiac Disease Full Text available with Trip Pro

disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases (...) the goal has become to understand the fetus as a patient, knowing that the fetal circulation is different from the postnatal circulation, that structural disease may progress in utero, and that cardiac function and stability of the cardiovascular system play an important role in fetal wellness. Given the expanded roles of the pediatric cardiologist specializing in fetal medicine and the maternal fetal specialist as collaborative caregivers for fetuses with structural heart disease, arrhythmias

2014 American Heart Association

15. Nonreassuring Fetal Status

Nonreassuring Fetal Status Aka: Nonreassuring Fetal Status , Fetal Distress , Fetal Hypoxia , Birth Asphyxia From Related Chapters II. Causes Uterine Hyperstimulation accident Uteroplacental Insufficiency III. Definition: Nonreassuring Fetal Status (preferred term) suggestive of IV. Evaluation Fetal status Confirm findings with alternative monitoring Consider fetal scalp electrode Response to acoustic or scalp stimulation Consider (pH < 7.20 is abnormal) Maternal status Maternal s Vaginal examination (e.g (...) . Definition (MSH) Deficient oxygenation of FETAL BLOOD. Concepts Disease or Syndrome ( T047 ) MSH SnomedCT 276638004 English In Utero Hypoxia , Fetal Hypoxia , fetal hypoxia (diagnosis) , fetal hypoxia , Fetal Hypoxia [Disease/Finding] , fetus hypoxia , HYPOXIA IN UTERO , Fetal hypoxia , Fetal hypoxia (disorder) , Hypoxia, Fetal Portuguese Hipóxia Fetal Swedish Syrebrist hos foster Czech fétus - hypoxie , fetální hypoxie Finnish Sikiön hypoksia Russian PLODA GIPOKSIIA , GIPOKSIIA PLODA , KISLORODNAIA

2018 FP Notebook

16. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Treatment)

with Doppler US or electrodes on the maternal abdomen or a fetal scalp electrode placed after rupture of membranes, in conjunction with the simultaneous recording of uterine activity with a tocodynamometer. After 32 weeks' gestation, the fetus responds to uterine contractions with tachycardia. The criteria for reactive test results are the following: Heart rate of 120-160 beats/min - Fetal tachycardia may be due to fever, drugs, or fetal arrhythmias or hypoxemia Normal beat-to-beat variability of more than (...) is equivocal and warrants further investigation. Whereas the false-positive rate of a BPP has been measured as high as 75%, fetal death rates can be increased 14 times in the absence of fetal movement and 18 times in the absence of fetal breathing. Scores of 0-4 correlate well with a fetal blood pH of less than 7.20 and, along with oligohydramnios, may be indications for immediate delivery. Test results can be adversely affected by prematurity, maternal drugs, or a sleeping fetus. Vibroacoustic stimulation

2014 eMedicine Pediatrics

17. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Follow-up)

with Doppler US or electrodes on the maternal abdomen or a fetal scalp electrode placed after rupture of membranes, in conjunction with the simultaneous recording of uterine activity with a tocodynamometer. After 32 weeks' gestation, the fetus responds to uterine contractions with tachycardia. The criteria for reactive test results are the following: Heart rate of 120-160 beats/min - Fetal tachycardia may be due to fever, drugs, or fetal arrhythmias or hypoxemia Normal beat-to-beat variability of more than (...) is equivocal and warrants further investigation. Whereas the false-positive rate of a BPP has been measured as high as 75%, fetal death rates can be increased 14 times in the absence of fetal movement and 18 times in the absence of fetal breathing. Scores of 0-4 correlate well with a fetal blood pH of less than 7.20 and, along with oligohydramnios, may be indications for immediate delivery. Test results can be adversely affected by prematurity, maternal drugs, or a sleeping fetus. Vibroacoustic stimulation

2014 eMedicine Pediatrics

18. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Diagnosis)

with Doppler US or electrodes on the maternal abdomen or a fetal scalp electrode placed after rupture of membranes, in conjunction with the simultaneous recording of uterine activity with a tocodynamometer. After 32 weeks' gestation, the fetus responds to uterine contractions with tachycardia. The criteria for reactive test results are the following: Heart rate of 120-160 beats/min - Fetal tachycardia may be due to fever, drugs, or fetal arrhythmias or hypoxemia Normal beat-to-beat variability of more than (...) is equivocal and warrants further investigation. Whereas the false-positive rate of a BPP has been measured as high as 75%, fetal death rates can be increased 14 times in the absence of fetal movement and 18 times in the absence of fetal breathing. Scores of 0-4 correlate well with a fetal blood pH of less than 7.20 and, along with oligohydramnios, may be indications for immediate delivery. Test results can be adversely affected by prematurity, maternal drugs, or a sleeping fetus. Vibroacoustic stimulation

2014 eMedicine Pediatrics

19. The Fetus as a Patient: Prenatal Diagnosis and Fetal Therapy (Overview)

with Doppler US or electrodes on the maternal abdomen or a fetal scalp electrode placed after rupture of membranes, in conjunction with the simultaneous recording of uterine activity with a tocodynamometer. After 32 weeks' gestation, the fetus responds to uterine contractions with tachycardia. The criteria for reactive test results are the following: Heart rate of 120-160 beats/min - Fetal tachycardia may be due to fever, drugs, or fetal arrhythmias or hypoxemia Normal beat-to-beat variability of more than (...) is equivocal and warrants further investigation. Whereas the false-positive rate of a BPP has been measured as high as 75%, fetal death rates can be increased 14 times in the absence of fetal movement and 18 times in the absence of fetal breathing. Scores of 0-4 correlate well with a fetal blood pH of less than 7.20 and, along with oligohydramnios, may be indications for immediate delivery. Test results can be adversely affected by prematurity, maternal drugs, or a sleeping fetus. Vibroacoustic stimulation

2014 eMedicine Pediatrics

20. Absence of accelerations during labor is of little value in interpretation of fetal heart rate patterns. Full Text available with Trip Pro

Absence of accelerations during labor is of little value in interpretation of fetal heart rate patterns. The aim of this study was to investigate the correlation between increasing time since fetal heart rate (FHR) accelerations, positive (no acceleration) stimulation tests and fetal acidemia.Observational study of FHR recordings from 1070 laboring women with indication for fetal scalp blood sampling (FBS). FHR traces were scrutinized regarding acceleration at FBS and duration since most recent (...) acceleration and increased lactate concentration. The majority of fetuses are not acidemic even when the FHR trace is pathological and stimulation tests are only helpful when accelerations are provoked.© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

2016 Acta Obstetricia et Gynecologica Scandinavica

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