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213 results for

Fetal Scalp pH

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201. Intrapartum fetal stimulation tests: a meta-analysis. (PubMed)

Intrapartum fetal stimulation tests: a meta-analysis. To assess the performance of stimulation tests for the prediction of intrapartum fetal acidemia.We conducted a MEDLINE (Internet Grateful Med) literature review from 1966 to 2000 using the terms "fetal scalp pH," "fetal scalp stimulation," and "fetal acoustic stimulation."Articles were included if sensitivity, specificity, and predictive values for intrapartum fetal acidemia could be calculated. Reactivity was a fetal heart rate (FHR (...) acidemia in the setting of a nonreassuring FHR pattern. Our data reveal the degree of confidence around the estimate of the likelihood ratio of a stimulation test. The very low negative likelihood ratios warrant the use of these tests when a nonreassuring intrapartum FHR pattern appears. Because these tests are less than perfect, caution is advised; careful continued monitoring with repeat testing during the course of labor should be performed as long as suspicious FHR patterns persist. Fetal scalp pH

2002 Obstetrics and Gynecology

202. Pediatric follow-up of a randomized controlled trial of intrapartum fetal monitoring techniques. (PubMed)

to obtain fetal scalp pH. There were no significant differences among the three groups of offspring with respect to neonatal mortality or morbidity, Apgar scores, cord blood gas values, or Brazelton examinations at ages 2 to 3 days. Assessment of the infants at 9 months revealed no significant differences in their growth and development as assessed by physical examination. Bayley Scales of Infant Development, and Milani-Comparetti tests. The frequency of delivery by cesarean section was significantly (...) Pediatric follow-up of a randomized controlled trial of intrapartum fetal monitoring techniques. A controlled prospective study was conducted to evaluate possible effects of the use of three intrapartum fetal monitoring techniques on the offspring of high-risk mothers in labor after at least 34 weeks' gestation. Six hundred and ninety women were randomly assigned to one of the three monitoring groups: auscultation alone, electronic monitoring alone, and electronic monitoring with option

1980 The Journal of pediatrics Controlled trial quality: uncertain

203. The effects of internal electronic fetal heart rate monitoring on maternal and infant infections in high-risk pregnancies. (PubMed)

The effects of internal electronic fetal heart rate monitoring on maternal and infant infections in high-risk pregnancies. A controlled prospective study of the effects of fetal monitoring on mothers and infants was conducted at Denver General Hospital, Denver, Colorado. A total of 690 high-risk patients in labor were randomly assigned to one of three groups; auscultation alone, electronic fetal monitoring and electronic fetal monitoring with the option to obtain a scalp pH sample. Maternal (...) and neonatal infectious morbidity after vaginal or cesarean delivery was unchanged with internal fetal monitoring. Despite frequent antibiotic prophylaxis (95% cesarean section v. 11% vaginal), cesarean section was the most significant factor associated with increased maternal puerperal infectious morbidity (13.75% cesarean section v. 3.9% vaginal). Although hours of labor, hours of rupture of membranes, hours of internal catheter, number of exams and presence of meconium were not associated with increased

1982 Journal of Reproductive Medicine Controlled trial quality: uncertain

204. A study on intrauterine fetal resuscitation with terbutaline. (PubMed)

A study on intrauterine fetal resuscitation with terbutaline. A randomized study on the effect of terbutaline on fetal distress was carried out in 20 patients who showed evidence of ominous fetal heart rate patterns and fetal scalp blood pH values of less than 7.25. Of those, 11 received terbutaline (study group) and nine did not (control group). There was a significant improvement in the acid-base status of the fetus in the study group compared with those in the control group (p less than 0.01 (...) ). No significant maternal or fetal morbidity occurred in the study group. Apgar scores at 1 minute were 7 or greater in 10 of the 11 study subjects whereas only four of the nine control subjects had a score of 7 or greater. These results suggest that terbutaline may become a useful agent in the treatment of intrauterine fetal distress.

1987 American journal of obstetrics and gynecology Controlled trial quality: uncertain

205. The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. (PubMed)

The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. In a randomized controlled trial involving 12,964 women, a policy of continuous electronic intrapartum fetal heart monitoring was compared with an alternative policy of intermittent auscultation, both policies including an option to measure fetal scalp blood pH. Women allocated to electronic fetal heart monitoring had shorter labors and received less analgesia. The caesarean delivery rates were 2.4 (...) % for electronic fetal heart monitoring and 2.2% for intermittent auscultation but this small difference arose from the identification of nearly twice as many fetuses with low scalp pH (less than 7.20) in the electronic fetal heart monitoring group. The forceps delivery rate was 8.2% in the electronic fetal heart monitoring group compared with 6.3% in the intermittent auscultation group, and this excess was explained by more instrumental deliveries prompted by fetal heart rate abnormalities. There were 14

1985 American journal of obstetrics and gynecology Controlled trial quality: uncertain

206. Electronic fetal heart monitoring, auscultation, and neonatal outcome. (PubMed)

, duration of labor after hospital admission, failure of labor to progress, number of fetal scalp pH values, and presence of meconium were important predictors of neonatal outcome in the regression analyses. The fetal heart rate deviations did contribute significantly to the percent variance accounted for in the regression analyses with neonatal outcomes of Apgar scores at 1 and 5 minutes and serial neonatal neurologic examinations. (...) Electronic fetal heart monitoring, auscultation, and neonatal outcome. In a large randomized, controlled study of fetal heart rate monitoring with either continuous electronic fetal heart monitoring or auscultation at specified intervals, only one pattern of deviation in the fetal heart rate correlated significantly with neonatal neurologic examinations at 0 to 48 hours and 72 hours to 1 week: late decelerations in stage 1 and in stage 2. Other variables from labor and delivery, specifically

1991 American journal of obstetrics and gynecology Controlled trial quality: uncertain

207. A randomized trial of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation. (PubMed)

fetuses and gestational ages of 26 weeks or greater were eligible for inclusion. The participants were assigned to continuous EFM or intermittent auscultation based on the flip of a coin. Both groups were followed during labor according to the most recent ACOG guidelines. However, fetal scalp blood pH and crossover from one group to the other were not used.A total of 1428 patients were included, 746 in the EFM group and 682 in the auscultation group. There were no differences between the groups (...) Apgar scores less than 7), acidotic (cord artery pH at or below 7.13) infants. The perinatal death rate related to fetal hypoxia was significantly less in the EFM group (zero of 746 versus six of 682; P = .03).In this controlled trial, intrapartum EFM, as the primary and only method of intrapartum fetal surveillance, was associated with decreased perinatal mortality due to fetal hypoxia but also with higher rates of surgical intervention for suspected fetal distress.

1993 Obstetrics and Gynecology Controlled trial quality: uncertain

208. Fetal electrocardiogram (ECG) for fetal monitoring during labour. (PubMed)

electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis (three trials, 8872 women) was associated with fewer babies with severe metabolic acidosis at birth (cord pH less than 7.05 and base deficit greater than 12 mmol/L) (relative risk (RR) 0.64, 95% confidence interval (CI) 0.41 to 1.00, data from 8108 babies), fewer babies with neonatal encephalopathy (three trials, RR 0.33, 95% CI 0.11 to 0.95) although the absolute number of babies with encephalopathy was low (n = 17 (...) ), fewer fetal scalp samples during labour (three trials, RR 0.76, 95% CI 0.67 to 0.86) and fewer operative vaginal deliveries (three trials, RR 0.87, 95% CI 0.78 to 0.96). There was no statistically significant difference in caesarean section (three trials, RR 0.97, 95% CI 0.84 to 1.11), Apgar score less than seven at five minutes (three trials, RR 0.80, 95% CI 0.56 to 1.14), or admissions to special care unit (three trials, RR 0.90, 95% CI 0.75 to 1.08). Apart from a trend towards fewer operative

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2006 Cochrane database of systematic reviews (Online)

209. ST segment analysis of the fetal electrocardiogram plus electronic fetal heart rate monitoring in labor and its relationship to umbilical cord arterial blood gases. (PubMed)

ST segment analysis of the fetal electrocardiogram plus electronic fetal heart rate monitoring in labor and its relationship to umbilical cord arterial blood gases. This study was undertaken to determine the ability of intrapartum electronic fetal heart rate monitoring (EFM) plus fetal electrocardiogram (ECG) ST segment automated ANalysis (STAN, Neoventa Medical, Goteborg, Sweden) monitoring to predict metabolic acidemia (defined as an umbilical cord artery pH < 7.15 and base deficit > or = 12 (...) mmol/L) at birth.Women with singleton, term pregnancies who had a clinical indication for internal EFM with a fetal scalp electrode were included in the study. Attending physicians were blinded to the ST analysis information, only using available EFM as per current clinical practice. After delivery, 2 trained observers blinded to neonatal outcome and ST analysis information performed visual classification of the EFM tracing in 10-minute epochs according to FIGO guidelines. ST events automatically

2004 American Journal of Obstetrics and Gynecology

210. Cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. (PubMed)

perinatal outcome compared with cardiotocography alone.At three Swedish labour wards, 4966 women with term fetuses in the cephalic presentation entered the trial during labour after a clinical decision had been made to apply a fetal scalp electrode for internal cardiotocography. They were randomly assigned monitoring with cardiotocography plus ST analysis (CTG+ST group) or cardiotocography only (CTG group). The main outcome measure was rate of umbilical-artery metabolic acidosis (pH <7.05 and base (...) Cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. Previous studies indicate that analysis of the ST waveform of the fetal electrocardiogram provides information on the fetal response to hypoxia. We did a multicentre randomised controlled trial to test the hypothesis that intrapartum monitoring with cardiotocography combined with automatic ST-waveform analysis results in an improved

2001 Lancet Controlled trial quality: predicted high

211. Improved intrapartum surveillance with PR interval analysis of the fetal electrocardiogram: a randomized trial showing a reduction in fetal blood sampling. (PubMed)

Improved intrapartum surveillance with PR interval analysis of the fetal electrocardiogram: a randomized trial showing a reduction in fetal blood sampling. Our goal was to test the hypothesis that the addition of fetal electrocardiogram time-interval analysis to conventional electronic fetal monitoring would significantly reduce the number of cases requiring fetal scalp blood sampling without an increase in adverse outcome.A randomized prospective trial was performed in 214 women with high-risk (...) labor.There was a significant reduction in the number of cases that had fetal blood sampling performed in the fetal electrocardiogram plus electronic fetal monitoring group (risk ratio for electronic fetal monitoring alone 3.53; p < 0.01, 95% confidence interval 1.39 to 8.95). The fetal blood samplings performed in the electronic fetal monitoring alone group were less likely to be abnormal (pH < 7.25, base excess < -8.0) than those performed in the fetal electrocardiogram plus electronic fetal monitoring

1996 American journal of obstetrics and gynecology Controlled trial quality: uncertain

212. Influence on fetal blood pH when adding amniotic fluid: an in vitro model. (PubMed)

in a significant pH rise. There was no significant difference between the two inversely performed dilution series.Amniotic fluid influences in vitro fetal venous blood pH immediately after contact. This observation indicates the possible masking of a fetus in distress by fetal scalp blood pH determination when amniotic fluid contaminates the sample. (...) Influence on fetal blood pH when adding amniotic fluid: an in vitro model. To assess the effect of contamination with amniotic fluid in different quantities on fetal capillary blood pH.In vitro model.Department of Obstetrics, St Pölten Hospital.Venous umbilical blood and amniotic fluid from 35 women who underwent amniotomy during labour.Venous umbilical blood was mixed in vitro with amniotic fluid in diluted series (venous umbilical blood/amniotic fluid, 10:1 to 1:1). In every case two parallel

2003 BJOG

213. Lactate compared with pH analysis at fetal scalp blood sampling: a prospective randomised study. (PubMed)

Lactate compared with pH analysis at fetal scalp blood sampling: a prospective randomised study. Fetal scalp blood sampling is a widely used method for assessing fetal condition in the event of ominous fetal heart rate patterns. The purpose of this randomised trial was to compare the value of fetal scalp blood lactate and pH management in cases of abnormal intrapartum fetal heart rate tracings.Of 341 cases of ominous fetal heart rate patterns, 169 were randomly assigned to pH analysis, and 172 (...) was inversely related to the degree of cervical dilatation. Compared with the pH subgroup, the lactate subgroup was characterised by fewer fetal scalp incisions per blood sampling attempt (median 1.0 [interquartile range (IQR) 1-1] vs 2.0 [IQR 1-2]), and significantly less time required for the sampling procedure (median 120 s [IQR 90-147] vs 230 s [IQR 180-300]). The groups did not differ in mode of delivery, neonatal outcome and umbilical artery acid-base balance and lactate levels.This trial showed

1998 British journal of obstetrics and gynaecology Controlled trial quality: uncertain

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