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Fetal Scalp pH

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1. Fetal Scalp Lactate Testing During Intrapartum Pregnancy with Abnormal Fetal Heart Rate: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

encephalopathy, death from congenital abnormalities, Apgar score at five minutes, admission to NICU, umbilical cord pH or base deficit values, metabolic acidemia, number of additional tests performed per fetus to evaluate fetal well-being, mode of birth, and operative birth for non-reassuring fetal status.The three guidelines each recommended the use of fetal scalp blood sampling for women in labour when there is an abnormal or non-reassuring cardiotocography result. Two of these guidelines made (...) with abnormal fetal heart rate was identified. The authors of the systematic review concluded that the available evidence (which had low to unclear risk of bias) indicated that fetal scalp lactate testing was more likely to be successful with fewer scalp incisions and the results were available in less time than with pH estimation. The results of the meta-analysis suggested that lactate and pH tests did not significantly differ from each other for a large number of neonatal outcomes including neonatal

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

2. Fetal Scalp pH

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 (...) , 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

2018 FP Notebook

3. Infant outcome at four years of age after intrapartum sampling of scalp blood lactate for fetal assessment. A cohort study. Full Text available with Trip Pro

Infant outcome at four years of age after intrapartum sampling of scalp blood lactate for fetal assessment. A cohort study. To correlate the value of lactate in fetal scalp blood at delivery and the outcomes of the offspring at four years of age.Cases where scalp blood lactate was taken within sixty minutes before delivery were identified from the randomized trial "Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress". Data were grouped according (...) , although the findings were only significant for fine motor dysfunction (p = 0.036). Elevated lactate values were significantly associated with increased risk for a poorer capacity of attention and understanding of instructions (OR 1.37, 95% CI 1.07-1.74), and for fine motor dysfunction (OR 1.22, 95% CI 1.00-1.49) at the age of four.Higher levels of lactate in fetal scalp blood seems to be associated with increased risk of an aberrant developmental outcome at four years of age in some areas.

2018 PLoS ONE

4. 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 (...) auscultation protocols improved the performance of intermittent auscultation for detecting severe acidemia (pH < 7.0) from 27 to 70% (p = 0.032). The negative predictive value of intermittent auscultation augmented with the fetal scalp stimulation test ranged from 88 to 99% for mild (pH < 7.2) to severe fetal acidemia.The fetal scalp stimulation test, conducted with a handheld Doppler, is feasible and accurate in a limited resource setting. It is a low-cost solution that merits further evaluation to reduce

2019 BMC Pregnancy and Childbirth

5. Accuracy of intrapartum fetal blood gas analysis by scalp sampling: A retrospective cohort study. Full Text available with Trip Pro

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

2017 Medicine

6. Fetal Scalp Stimulation

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 (...) 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

2018 FP Notebook

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

Sampling 33 Where facilities and expertise exist, fetal scalp blood sampling for assessment of fetal acid-base status (using lactate or pH) is recommended in women at gestations >34 weeks when delivery is not imminent and when a atypical/abnormal electronic fetal monitoring tracings are identified and not resolved with intrauterine resuscitation measures (III-C); b digital fetal scalp stimulation does not result in an acceleratory fetal heart rate response (III-C). 34 Fetal scalp lactate blood sampling (...) , the method of intrapartum fetal health surveillance monitoring should be determined by the ongoing maternal and fetal risk factors (III-C). Epidural Analgesia 15 Intermittent auscultation may continue to be used to monitor the fetus when epidural analgesia is initiated and used during labour in low-risk, term pregnancies in spontaneous labour provided that a protocol is in place for frequent intermittent auscultation assessment (III-C). 16 Electronic fetal monitoring is recommended for combined spinal

2020 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

by pH. Amniotic fluid The fluid that surrounds the fetus within the amniotic sac. Antenatal The period of the pregnancy prior to the onset of labour. Antepartum Before the onset of labour. Apgar score A system to assess the status of the baby after birth. The Apgar score is recorded at 1 minute and 5 minutes after birth and is based on the following five variables: heart rate, respiratory effort, muscle tone, reflex irritability and colour, with a maximum score of 10. Body mass index (BMI (...) ) 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

2019 Centre of Research Excellence in Stillbirth

9. Preterm fetal monitoring

with MgSO4. B Fetal monitoring, techniques Fetal blood sampling for pH may be used from gestational week 34+0 D Fetal heart rate monitorering by scalp electrode may be used from gestational week 32+0 - 34+0 D STAN may be used from gestational week 36+0 D Summary of evidence Grade Preterm fetal monitoring, recommended monitoring modalities The incidense of abnormal CTG is higher during preterm delivery than during term delivery. 2a-3 Continous preterm CTG during labour may be able to predict neonatal (...) from the scalp is not recommended before week 34+0. 5 Application of a fetal scalp electrode is not recommended prior to week 32-34 for the same reasons as listed above. 5 STAN should not be used before week 36+0, as the electrophysical properties of the heart may not have developed in the preterm fetus. 5 Characteristics of the normal CTG in the preterm fetus dependent of gestational age (GA) and compared to the normal term CTG. GA Baseline Variability Accelerations Decelerations 24-26 150-160

2019 Nordic Federation of Societies of Obstetrics and Gynecology

10. Intrapartum fetal surveillance

for fetal scalp lactate measurements · Use of scalp lactate rather than pH measurement provides an easier and more affordable adjunct to CEFM for some units 2 · Is as effective as scalp pH in predicting fetal outcomes · Has a strong negative predictive value for fetal acidemia at birth 39 · Requires local decision making to set absolute parameters for interpretation of lactate values as results may vary between machines 2,40 · Requires due diligence with regard to calibration of machine (...) Fetal Growth Restriction; GDM Gestational Diabetes; IOL Induction of labour; MoM Multiples of Median; PaPP-A Pregnancy associated plasma protein-A; PROM Premature Rupture of Membranes; PTL Preterm labour; PV Per Vaginal; T Temperature; = greater than or equal to; Greater than; 4.8 Abnormal: urgent birth · pH 5.0 No Queensland Clinical Guidelines: Intrapartum Fetal Surveillance Guideline No: MN15.15-V4-R20 Confirmatory CTG Normal? Yes Normal CTG · Baseline FHR 110-160 bpm · Baseline variability 6-25

2019 Queensland Health

11. Fetal Scalp pH

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 (...) , 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

2015 FP Notebook

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

. Absence of an acceleration is a POSITIVE test and reason for intervention. Outcome Measures Go to Primary Outcome Measures : Feasibility as measured by completion of all 3 study objectives [ Time Frame: Day 1 ] Predicted fetal acidosis from cord blood pH (at thresholds of cord blood pH<7.0, 7.1, and 7.2) [ Time Frame: Day 1 ] The primary outcome is the sensitivity and specificity of the Doppler device to predict fetal acidosis based on the fetal scalp stimulation test. Secondary Outcome Measures (...) 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

2016 Clinical Trials

13. Clinical evaluation of Statstrip<sup>®</sup> Lactate for use in fetal scalp blood sampling. Full Text available with Trip Pro

Clinical evaluation of Statstrip® Lactate for use in fetal scalp blood sampling. Point-of-care testing of fetal scalp blood lactate is used as an alternative to pH analysis in fetal scalp blood sampling (FBS) during labor. Lactate measurements are not standardized and values vary with each device used. The aim of this study was to evaluate StatStrip® Lactate (SSL) in the clinical setting in comparison with lactate (RLL) and pH (RLpH) using RapidLab® .We obtained 323 FBS samples from (...) evaluated prospectively regarding intervention rates and neonatal outcome, we recommend using SSL in addition to pH in FBS.© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

2016 Acta Obstetricia et Gynecologica Scandinavica

14. Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909]. Full Text available with Trip Pro

and long term risks, could have been avoided without compromising the baby's health. Previously, fetal scalp blood sampling for pH estimation was performed in the context of an abnormal cardiotocograph, to improve the identification of babies in need of expedited delivery. This test has largely been replaced by lactate measurement, although its validity is yet to be established through a randomised controlled trial. This study aims to test the hypothesis that the performance of fetal scalp blood (...) Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909]. The rate of caesarean sections around the world is rising each year, reaching epidemic proportions. Although many caesarean sections are performed for concerns about fetal welfare on the basis of abnormal cardiotocography, the majority of babies are shown to be well at birth, meaning that the operation, with its inherent short

2015 BMC pregnancy and childbirth Controlled trial quality: predicted high

15. Evaluation of the 'SensPoint' Lactate Meter in the Estimation of Foetal Scalp Blood and Umbilical Cord Blood Lactate

and Umbilical Cord Blood Lactate Study Start Date : October 2015 Estimated Primary Completion Date : March 2016 Resource links provided by the National Library of Medicine available for: Groups and Cohorts Go to Outcome Measures Go to Primary Outcome Measures : Comparison of lactate level in blood obtained from the fetal scalp measured using a Senspoint handheld lactate meter and the current gold standard. [ Time Frame: Within 5 minutes of obtaining blood sample ] Foetal blood sampling will be undertaken (...) Evaluation of the 'SensPoint' Lactate Meter in the Estimation of Foetal Scalp Blood and Umbilical Cord Blood Lactate Evaluation of the 'SensPoint' Lactate Meter in the Estimation of Foetal Scalp Blood and Umbilical Cord Blood Lactate - 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

2015 Clinical Trials

16. 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

17. Cadiotocography Combined With ST-analysis Versus Cardiotocography Combined With Scalp-pH

and caesarean section. Interpretation of CTG can be improved by analyzing the acidity of a blood sample taken from the skin of the fetal scalp. Such a scalp pH analysis shows indirectly the fetus gets enough oxygen. Scalp pH measurement requires expertise and requires repeated measurements if the abnormal heart rate pattern persists. This method is the normal routine at the maternity ward at Hvidovre Hospital / Roskilde County Hospital. The problem seems to be partially alleviated by using a newly developed (...) of Newborn Device: Neoventa S 21 ST-ANalysis of fetal heart Procedure: CTG + FBS Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 1025 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Cardiotocography Combined With ST-analysis Versus Cardiotocography Combined With Scalp-pH in Deliveries With Abnormal CTG - A Randomised Trial

2012 Clinical Trials

18. Fetal Scalp Stimulation

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 (...) 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

2015 FP Notebook

19. Scalp Sampling for Fetal Surveillance

Scalp Sampling for Fetal Surveillance Scalp Sampling for Fetal Surveillance - 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. Scalp Sampling for Fetal Surveillance (FBS) The safety and scientific validity (...) Information provided by (Responsible Party): Maria Jonsson, Uppsala University Hospital Study Details Study Description Go to Brief Summary: The purpose of this study is to compare lactate and total acid-base status in fetal scalp blood with lactate and total acid-base status in maternal blood and amniotic fluids to provide information on how lactate and base deficit correlates with scalp samples. Furthermore, the investigators want to study whether angiogenic factors in fluids above may be a possible

2012 Clinical Trials

20. 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

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