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Fetal Scalp Stimulation

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

section so that surgery can be performed while the baby is still receiving oxygen from the placenta fetal magnetoencephalography A technique to measure brain activity in fetus haemodynamic The movement of blood hypoxaemia Decreased blood oxygen vihysterotomy Surgical incision in the uterus, usually to remove the fetus insular cortex Part of the cerebral cortex believed to be responsible for integrating sensory information fMRI (functional magnetic A technique for measuring blood flow in the brain (...) was to review the relevant science and clinical practice relevant to the issue of fetal awareness and, in particular, evidence published since 1997. In so doing, the report was completely rewritten, not only to take account of recent literature but also the evidence presented to the House of Commons Committee. In reviewing the neuroanatomical and physiological evidence in the fetus, it was apparent that connections from the periphery to the cortex are not intact before 24 weeks of gestation and, as most

2010 Royal College of Obstetricians and Gynaecologists

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

. 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 (...) 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

2010 Clinical Practice Guidelines Portal

23. 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

2010 Clinical Practice Guidelines Portal

24. Continued Versus Discontinued Oxytocin Stimulation of Labour

readmission [ Time Frame: 0-168 hours ] Retention of urine [ Time Frame: 0-48 hours ] requiring catheterisation Vaginal explorations [ Time Frame: 0-48 hours ] number Cardiotocogram (CTG) classification [ Time Frame: 0-48 hours ] Parturition will be monitored with continous CTG. Suspicious, pathologic or terminal CTG will be registered. Fetal scalp pH values or Fetal scalp lactate [ Time Frame: 0-48 hours ] Apgar score at 1 and 5 minutes [ Time Frame: 0-48 hours ] Umbilical cord arterial pH [ Time Frame (...) for induction of labour (with or without cervical priming by prostaglandin) Exclusion Criteria: Unable to read and understand the Danish language or to give informed consent Cervical dilatation > 4 cm Non-cephalic presentation Multiple gestation Pathological fetal heart rate pattern (cardiotocogram, CTG) before Syntocinon® initiation Fetal weight estimation > 4500 g (clinical or ultrasonic) Subject declines participation Gestational age less than 37 completed weeks Definition: Stimulation with Syntocinon®

2015 Clinical Trials

25. Optimizing Current and Electrode Montage for Transcranial Direct Current Stimulation in Stroke Patients

stimulation. tDCS currents are applied in increasing strengths and then in different electrode montages. Device: transcranial direct current stimulation brain stimulation using progressively increasing amounts of direct currents and in a variety of electrode montages Other Name: tdcs Outcome Measures Go to Primary Outcome Measures : major response [ Time Frame: Immediately after intervention on the day of tDCS application ] Major response is any of the following: Second degree scalp burn at the site (...) clips or any other electrically sensitive support system; b) non-fixed metal in any part of the body, including a previous metallic injury to eye; c) pregnancy, since the effect of tDCS on the fetus is unknown; d) history of seizure disorder or post-stroke seizure; e) preexisting scalp lesion, bone defect or hemicraniectomy. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using

2015 Clinical Trials

26. 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

2015 FP Notebook

27. Transcranial Stimulation (tDCS) and Prism Adaptation in Spatial Neglect Rehabilitation

Adaptation All participants will undergo prism adaptation, a form of behavioural therapy involving reaching and pointing movements while wearing glasses that induce an optical shift. Device: Anodal tDCS Participants will receive 1mA anodal tDCS over the left primary motor cortex. The active (positive) electrode will be centered on the scalp overlying the primary motor cortex and the reference (negative) electrode will be placed over the contralateral supraorbital ridge. The stimulation will last 20 (...) . Device: Sham tDCS Participants will receive 1mA sham tDCS over the left primary motor cortex. The active (positive) electrode will be centered on the scalp overlying the primary motor cortex and the reference (negative) electrode will be placed over the contralateral supraorbital ridge. The stimulation will last 20 minutes and run concurrent with the duration of the prism adaptation therapy. Placebo Comparator: Prism adaptation + no tDCS Participants will receive no tDCS at all but will undergo a 20

2014 Clinical Trials

28. Transcranial Direct Current Stimulation (tDCS) for Depression in Pregnancy: A Pilot Study

or neurologic illness or history of seizure Currently taking carbamazepine (which may interfere with the effects of anodal tDCS), Major complications and/or a known fetal anomaly in the current pregnancy as determined by the investigator team Planning to leave Toronto prior to delivery in the current pregnancy. Metal implant(s) in cranium Electrical implant(s) in body Currently taking benzodiazepines daily (Intermittent PRN use of low-dose Lorazepam allowed) Non-intact skin on scalp areas where stimulation (...) during that time. Antidepressant medication is effective, but there are high refusal rates of standard pharmacological treatment because of fears about medication exposure. The highly negative impacts of depression in pregnancy on the developing fetus and child illustrate the need for evaluation of timely and innovative treatments. Transcranial direct current stimulation (tDCS) is a non-drug treatment for depression where the dorsolateral prefrontal cortex, a part of the brain that functions

2014 Clinical Trials

29. Transcranial Direct Current Stimulation for Improving Gait Training in Stroke

Date : November 17, 2017 Actual Study Completion Date : November 17, 2017 Arms and Interventions Go to Arm Intervention/treatment Experimental: transcranial direct current stim tDCS will be applied using a Soterix constant current stimulator with 5 x 5 cm (25cm2) carbon rubber electrodes (Covidien 664 REFX 2x2) applied to the scalp with 10-20 conductive paste. The anodal electrode will be placed over the lower extremity representation of primary motor cortex of the lesioned hemisphere [established (...) Transcranial Direct Current Stimulation for Improving Gait Training in Stroke Transcranial Direct Current Stimulation for Improving Gait Training in Stroke - 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

2013 Clinical Trials

30. Twin and triplet pregnancy

: map the fetal positions use nuchal translucency and maternal age to screen for Down's syndrome, Edwards' syndrome and Patau's syndrome when crown–rump length measures from 45.0 mm to 84.0 mm (at approximately 11 +2 weeks to 14 +1 weeks) calculate the chance of Down's syndrome, Edwards' syndrome and Patau's syndrome for each fetus. [2011, amended 2019] [2011, amended 2019] 1.4.6 Refer women with a dichorionic and monochorionic triplet pregnancy who want to have screening for Down's syndrome (...) , measure the deepest vertical pocket (DVP) on either side of the amniotic membrane. [2019] [2019] 1.4.19 Continue monitoring for fetal weight discordance at intervals that do not exceed: 28 days for women with a dichorionic twin pregnancy 14 days for women with a trichorionic triplet pregnancy. [2019] [2019] 1.4.20 Calculate and document estimated fetal weight (EFW) discordance for dichorionic twins using the formula below [2019] [2019]: (EFW larger fetus - EFW smaller fetus) ÷ EFW larger fetus (EFW

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

31. Assisted Vaginal Birth

sampling procedure or application of a fetal scalp electrode. Grade of recommendation: B Operators should be aware that there is a higher risk of subgaleal haemorrhage and scalp trauma with vacuum extraction compared with forceps at preterm gestational ages. Vacuum birth should be avoided below 32 weeks of gestation and should be used with caution between 32 +0 and 36 +0 weeks of gestation. Grade of recommendation: C Operative intervention may be indicated for conditions of the fetus, the mother (...) . Classification for assisted vaginal birth Outlet Fetal scalp visible without separating the labia Fetal skull has reached the perineum Rotation does not exceed 45° Low Fetal skull is at station + 2 cm, but not on the perineum Two subdivisions: Non‐rotational ≤ 45° Rotational > 45° Mid Fetal head is no more than one‐fifth palpable per abdomen Leading point of the skull is at station 0 or + 1 cm Two subdivisions: Non‐rotational ≤ 45° Rotational > 45° 4.3 When should assisted vaginal birth be recommended

2020 Royal College of Obstetricians and Gynaecologists

32. Polycystic ovary syndrome

hypertension scalp hair loss oily skin or excessive sweating acanthosis nigricans family history of PCOS premature adrenarche low birth weight fetal androgen exposure obesity environmental endocrine disruptors Diagnostic investigations serum total and free testosterone serum dehydroepiandrosterone sulfate (DHEAS) serum 17-hydroxyprogesterone serum prolactin serum thyroid-stimulating hormone oral glucose tolerance test fasting lipid panel serum androstenedione pelvic ultrasound basal body temperature (...) monitoring luteal phase progesterone measurement serum LH and follicle-stimulating hormone (FSH) Treatment algorithm ACUTE ONGOING Contributors Authors Director Division of Endocrinology, Diabetes & Metabolism Professor of Medicine Cedars-Sinai Medical Center Los Angeles CA Disclosures MOG is an author of a number of references cited in this topic. Peer reviewers Professor Department of Obstetrics and Gynecology University of California Davis Sacramento CA Disclosures AD declares that he has no competing

2019 BMJ Best Practice

33. Twin delivery

is vertex and estimated fetal weight estimate (both) is > 1500 gr and 25% difference), especially when TV-B > TV-A and TV-B is in non-vertex presentation elective C/S delivery should be considered · Twin pregnancies complicated by IUGR and compromised fetus(es) should be delivered by C/S on the same indications as singletons D Twin delivery Danish Society of Obstetrics and Gynecology 2020 Page 3 of 60 Mode of delivery and criteria for vaginal twin birth at GA > 32+0 MCDA pregnancies, where early TTTS (...) Twin delivery Twin delivery Danish Society of Obstetrics and Gynecology 2020 Page 1 of 60 Twin delivery English summary of recommendations Approved by the Danish Society of Obstetrics and Gynecology 2020 Abbreviations DC Dichorionic DA Diamniotic FHR Fetal heart rate GA Gestational age IUGR Intrauterine Growth Restriction MA Monoamniotic MC Monochorionic Non-vertex Non-cephalic presentation PPH Postpartum hemorrhage sFGR Selective fetal growth restriction SGA Small for Gestational Age sIUGR

2020 Nordic Federation of Societies of Obstetrics and Gynecology

34. Labor Dystocia

will eventually have at least one child, 1 and the majority of these women will undergo labor. “Labor dystocia”— difficult or obstructed labor 2 —encompasses a variety of concepts, ranging from “abnormally” slow dilation of the cervix or descent of the fetus during active labor 3 to entrapment of the fetal shoulders after delivery of the head (“shoulder dystocia,” an obstetric emergency). For the purposes of this systematic review, we assume that “labor dystocia” refers to “abnormal” labor progression during (...) (including nipple stimulation)? ES-4 KQ 8: For women in spontaneous labor undergoing augmentation with oxytocin, what are the relative benefits and harms (in terms of both maternal and neonatal outcomes) of electronic fetal monitoring versus intermittent auscultation? KQ 9: For women in the second stage of labor, is there a benefit from delayed or Valsalva pushing for time to delivery or mode of delivery?ES-5 Figure A. Analytic framework Abbreviations: AEs=adverse effects; KQ=Key Question; NICU=neonatal

2020 Effective Health Care Program (AHRQ)

35. Polycystic ovary syndrome

hypertension scalp hair loss oily skin or excessive sweating acanthosis nigricans family history of PCOS premature adrenarche low birth weight fetal androgen exposure obesity environmental endocrine disruptors Diagnostic investigations serum total and free testosterone serum dehydroepiandrosterone sulfate (DHEAS) serum 17-hydroxyprogesterone serum prolactin serum thyroid-stimulating hormone oral glucose tolerance test fasting lipid panel serum androstenedione pelvic ultrasound basal body temperature (...) monitoring luteal phase progesterone measurement serum LH and follicle-stimulating hormone (FSH) Treatment algorithm ACUTE ONGOING Contributors Authors Director Division of Endocrinology, Diabetes & Metabolism Professor of Medicine Cedars-Sinai Medical Center Los Angeles CA Disclosures MOG is an author of a number of references cited in this topic. Peer reviewers Professor Department of Obstetrics and Gynecology University of California Davis Sacramento CA Disclosures AD declares that he has no competing

2018 BMJ Best Practice

36. Diagnosis and management of epilepsy in adults

ContentsDiagnosis and management of epilepsy in adults Diagnosis and management of epilepsy in adults 5.6 Fetal, neonatal and childhood outcomes 43 5.7 Postpartum advice for mothers 47 5.8 Advice about breastfeeding 48 5.9 Menopause and epilepsy 49 6 Psychiatric comorbidity 50 6.1 Screening 50 6.2 Treatment options 52 7 Sleep 54 7.1 Sleep deprivation and sleep hygiene 54 7.2 Obstructive sleep apnoea and epilepsy 54 7.3 Sudden unexpected death in epilepsy and sleep 54 8 Mortality 55 8.1 Sudden unexpected death

2018 SIGN

37. International evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS)

, diagnosis and management of PCOS, we endorse the Rotterdam diagnostic criteria in adults and recommend tighter criteria requiring both hyperandrogenism and irregular cycles, with ultrasound not indicated in adolescents, due to overlap with normal reproductive physiology. Exclusion of thyroid disease (thyroid stimulating hormone), hyperprolactinemia (prolactin), and non-classic congenital adrenal hyperplasia (17-hydroxy progesterone) is recommended with further evaluation recommended in those

2018 European Society of Human Reproduction and Embryology

38. Care around stillbirth and neonatal death

regional differences exist. In New Zealand, perinatal death consists of fetal death (the death of a fetus of from 20 weeks gestation or weighing at least 400 grams if gestation is unknown 7 ) and early neonatal death (the death of a liveborn baby that occurs before the 7 th day of life 5 ). Perinatal related mortality is fetal and neonatal deaths (up to 28 days) at 20 weeks or beyond, or weighing at least 400g if gestation is unknown. Fetal death includes stillbirth and termination of pregnancy 8 (...) , giving a PMR of 11.2 per 1000 (8.1 and 3.1/1000 for fetal and neonatal death rates respectively) 5 . For Indigenous and other disadvantaged women in both settings (similar to other high income settings), the risk of perinatal death is around double 5,6,9,17 . Using the PSANZ classification system the leading causes of stillbirth are congenital anomaly and spontaneous preterm. However in approximately 20-30% of stillbirths, a cause is never identified. Similarly, for neonatal mortality, the main cause

2019 Centre of Research Excellence in Stillbirth

39. Operative vaginal delivery

sphincter injuries OA – Occiput anterior OP – Occiput posterior Procedure for ventouse/vacuum delivery Indications Foetal • Evident signs of asphyxia (scalp-pH 4.8 mmol/L, significant STAN-event during 2. Stage of labour, persistent bradycardia) • Suspicion of asphyxia Maternal • Failure to progress (dystocia) during 2. Stage of labour, when other treatment measures have been unsuccessful (Oxytocin-stimulation, change of position etc.) • Maternal exhaustion • Attempt to shorten 2. Stage of labour due (...) . • On maternal indication and with reassuring foetal heart rate, under normal circumstances, the baby should be delivered within 20 minutes. The number of pulls should not exceed 3 for descent of the caput and 3 for passing the perineum. • When the procedure is passed on to a more senior doctor the total time frame and/or number of pulls for safe delivery should not be exceeded. • The cup may be reapplied twice if detachment occurs on the condition that no foetal scalp injuries are present. Reconsider

2019 Nordic Federation of Societies of Obstetrics and Gynecology

40. Management of Stroke in Neonates and Children Full Text available with Trip Pro

in the majority of neonates with hemorrhagic stroke, risk factors include postmaturity, emergency cesarean delivery, fetal distress, and male sex. , Mutations in COL4A1 should be considered in neonates with cerebral hemorrhage, porencephaly, glaucoma, or cataracts. , Some hemorrhagic lesions such as periventricular hemorrhagic venous infarction may actually represent hemorrhagic conversion of an arterial or venous infarction. Either acquired or congenital coagulopathy may lead to intracranial hemorrhage

2019 American Heart Association

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