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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. (PubMed)

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 (...) 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

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2019 BMC Pregnancy and Childbirth

2. 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

3. 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

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

and their associated costs were prevented. 3 Testing for fetal HPA genotype in the at‐risk mother Paternal HPA testing is recommended. For example, if the father is heterozygous for the corresponding HPA against which the mother has an antibody, there are two possible approaches outlined below. 3.1 Invasive testing An amniocentesis at around 16 weeks of gestation for fetal HPA status can be considered. However, there is a procedure‐related 0.5–1.0% risk of miscarriage and possibility of stimulating anti‐HPA (...) of labour at 38 weeks of gestation with avoidance of rotational or ventouse delivery, or fetal scalp blood sampling in labour is a reasonable alternative. The evidence to help guide advice regarding mode of birth is weak. Elective caesarean section at 36–38 weeks of gestation for all women with anti‐HPA‐1a, together with HPA‐1a‐negative platelet donors for the neonate if petechiae are present and/or the platelet count is less than 35 × 10 9 /l has also been suggested, in order to reduce trauma, reduce

2019 Royal College of Obstetricians and Gynaecologists

6. 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

7. Intrapartum fetal surveillance

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 (...) cardiotocography 13 3.6.1 Special Considerations 14 4 Cardiotocograph 15 Features in labour 15 Normal CTG 16 Fetal compromise 17 Management of reversible causes of abnormal CTG 18 5 Intrapartum fetal blood sampling 19 Interpretation of fetal blood sampling results 20 5.1.1 *Special considerations for fetal scalp lactate measurements 20 6 Paired umbilical cord blood gas or lactate analysis 21 Normal cord blood values 22 7 Other methods of fetal monitoring 22 References 23 Appendix A: Interpretation of CTG 25

2019 Queensland Health

8. 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 (...) Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements Clinical Practice Guideline for the Care of Women with Decreased Fetal Movements Developed in partnership with: Endorsed by: 10 August 2017 Produced by: This clinical guideline was produced by a multidisciplinary working group led by the Mater Research Institute, The University of Queensland, Brisbane, Australia, under the auspices of the Stillbirth and Neonatal Death Alliance (SANDA) of the Perinatal Society

2017 Clinical Practice Guidelines Portal

9. 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

10. Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease Diagnosis and Treatment of Fetal Cardiac Disease | 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 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share (...) 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

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2014 American Heart Association

11. 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

12. Absence of accelerations during labor is of little value in interpretation of fetal heart rate patterns. (PubMed)

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

13. 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 (...) Nonreassuring Fetal Status Nonreassuring Fetal Status 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 Nonreassuring Fetal Status

2018 FP Notebook

14. Fetal Awareness: Review of Research and Recommendations for Practice

displays a range of spontaneous move- ments, which are not actually reflexes, as they arise from random muscle actions rather than as reactions to a sensory stimulus. However, when sensory nerves have reached the skin, me- chanical stimulation of the body can produce reflex movements. This confirms that these nerve fibres are carrying information about touch and have connected to the spinal cord and acti- vated nerve fibres controlling motor actions. The fetal spinal cord and brainstem develop well (...) the release of hormones and neurotransmitters dependent on activity in areas of the midbrain. These findings confirm that signals about tissue damage are transmitted from the spinal cord and brainstem to the midbrain from at least 18 weeks. Fetal Awareness 5Box 1. A discussion of the nature of pain The word ‘pain’ is used in different ways. The most frequent use, especially with respect to subjects that cannot communicate verbally, is in describing the behavioural response to nox- ious stimulation

2010 Royal College of Obstetricians and Gynaecologists

15. Intrapartum fetal surveillance

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 (...) cardiotocography 13 3.6.1 Special Considerations 14 4 Cardiotocograph 15 Features in labour 15 Normal CTG 16 Fetal compromise 17 Management of reversible causes of abnormal CTG 18 5 Intrapartum fetal blood sampling 19 Interpretation of fetal blood sampling results 20 5.1.1 *Special considerations for fetal scalp lactate measurements 20 6 Paired umbilical cord blood gas or lactate analysis 21 Normal cord blood values 22 7 Other methods of fetal monitoring 22 References 23 Appendix A: Interpretation of CTG 25

2010 Clinical Practice Guidelines Portal

16. Clinical practice guideline for the management of women who report decreased fetal movements

is recorded at one minute and five minutes after birth. Cardiotocography (CTG) The electronic monitoring of the fetal heart rate and of uterine contractions. 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 on a continuous paper print-out (trace). Congenital malformation A physical malformation, chromosomal (...) . Fetal heart rate and activity patterns in growth-retarded fetuses: changes after vibratory acoustic stimulation. Am J Obstet Gynecol 1988;158:265-71. 20. Ribbert LS, Nicolaides KH, Visser GH. Prediction of fetal acidaemia in intrauterine growth retardation: comparison of quantified fetal activity with biophysical profile score. Br J Obstet Gynaecol 1993;100:653-6. 21. Sival DA, Visser GH, Prechtl HF. The effect of intrauterine growth retardation on the quality of general movements in the human fetus

2010 Clinical Practice Guidelines Portal

17. 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

18. 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

19. 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

20. 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

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