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Fetal Scalp pH

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21. Spontaneous Fetal EEG Recording During Labor

is to validate the feasibility of acquiring the new modality of human fetal bioelectrical activity, EEG, derived from the routinely used scalp FHR monitor. The investigators expect that in some newborns acidemia will be detected based on cord blood pH. In these babies, the investigators will trace back the EEG recordings to further validate whether the EEG - FHR patterns were predictive of this outcome. In fetal sheep model of human labour the investigators were able to see the onset of acidemia <55 min (...) ahead of severe drop of pH to <7.00. This corresponded to an average pH of 7.20. The investigators hypothesize that they will be able to acquire fetal EEG during labour such that the normal behavioural sleep states will be observed and their disruption, followed by emergence of the pathognomonic EEG-FHR pattern will be seen with incipient acidemia. At-risk pregnant women routinely admitted for intrapartum monitoring will be asked to consent when the Fetal Scalp Monitor (FSM) is placed

2017 Clinical Trials

22. Can Conventional ECG Technology Capture Fetal Cardiac Activity?

/treatment Phase Fetal Monitoring Device: Holter Device Early Phase 1 Detailed Description: The objective of this study is to determine if it is feasible to capture a fetal ECG signal using a Holter ECG device. As comparison we will use a standard Doppler Fetal Heart Rate (FHR) device. To obtain the raw FHR data from this standard device we will use the currently approved "fetal EEG" monitor. The important distinction is that "fetal EEG" monitor will not be connected to fetal scalp electrode, but, rather (...) maternal-fetal ECG monitors to improve maternal and fetal health during pregnancy and delivery. Based on the diffusion-based channel selection, here we present the mathematical formalism and clinical validation of an algorithm capable of accurate separation of maternal and fetal ECG from a two channel signal acquired over maternal abdomen. Subjects: Medical Physics (physics.med-ph); Data Analysis, Statistics and Probability (physics.data-an); Applications (stat.AP); Machine Learning (stat.ML) Cite

2017 Clinical Trials

23. 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

24. Evaluation of the discrepancy between pH and lactate in combined fetal scalp blood sampling. (Abstract)

Evaluation of the discrepancy between pH and lactate in combined fetal scalp blood sampling. To evaluate the rate of discrepancy between pH and lactate values in fetal blood sampling (FBS). To evaluate differences in obstetric management in response to combined tests (pH and lactate) and single tests (pH or lactate).Descriptive study.Uppsala University Hospital, Sweden.Labors monitored by FBS during one year (n=241).Discrepancy in the combined tests was defined as a test having one abnormal (...) and one normal value. Abnormal pH was defined as 7.24 or lower and abnormal lactate as 4.2 or higher. The results were categorized according to whether the test was normal or abnormal and according to whether it was a combined or single analysis.Discrepancy between pH and lactate values in combined tests. Frequency of operative delivery for fetal distress (ODFD). Time interval from the last FBS to ODFD.In the combined tests with abnormality, a discrepancy between pH and lactate values occurred in 55

2011 Acta Obstetricia et Gynecologica Scandinavica

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

placental insufficiency, and, in severe cases, diastolic flow may stop completely or even reverse. Therefore, a systolic-to-diastolic umbilical blood flow ratio higher than 3 after 30 weeks' gestation is associated with fetal compromise. Researchers continue to investigate the utility of measuring fetal arterial velocity in assessing redistribution in the hypoxic fetus and as indicators of placental circulation in pathologic placental processes, such as pregnancy-induced hypertension. Fetal scalp pH (...) be performed on blood samples for diagnosis of fetal infections (eg, specific immunoglobulin M [IgM] for toxoplasmosis, rubella, cytomegalovirus [CMV], varicella zoster, HIV); viral DNA can be detected by using PCR for certain infections, such as parvovirus B19 Fetal arterial oxygen tension (PaO 2 ), carbon dioxide tension (PCO 2 ), and pH - These can provide critical indicators of fetal well-being in a or compromised fetus and thus can help guide management decisions Complications associated

2014 eMedicine Pediatrics

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

placental insufficiency, and, in severe cases, diastolic flow may stop completely or even reverse. Therefore, a systolic-to-diastolic umbilical blood flow ratio higher than 3 after 30 weeks' gestation is associated with fetal compromise. Researchers continue to investigate the utility of measuring fetal arterial velocity in assessing redistribution in the hypoxic fetus and as indicators of placental circulation in pathologic placental processes, such as pregnancy-induced hypertension. Fetal scalp pH (...) be performed on blood samples for diagnosis of fetal infections (eg, specific immunoglobulin M [IgM] for toxoplasmosis, rubella, cytomegalovirus [CMV], varicella zoster, HIV); viral DNA can be detected by using PCR for certain infections, such as parvovirus B19 Fetal arterial oxygen tension (PaO 2 ), carbon dioxide tension (PCO 2 ), and pH - These can provide critical indicators of fetal well-being in a or compromised fetus and thus can help guide management decisions Complications associated

2014 eMedicine Pediatrics

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

placental insufficiency, and, in severe cases, diastolic flow may stop completely or even reverse. Therefore, a systolic-to-diastolic umbilical blood flow ratio higher than 3 after 30 weeks' gestation is associated with fetal compromise. Researchers continue to investigate the utility of measuring fetal arterial velocity in assessing redistribution in the hypoxic fetus and as indicators of placental circulation in pathologic placental processes, such as pregnancy-induced hypertension. Fetal scalp pH (...) be performed on blood samples for diagnosis of fetal infections (eg, specific immunoglobulin M [IgM] for toxoplasmosis, rubella, cytomegalovirus [CMV], varicella zoster, HIV); viral DNA can be detected by using PCR for certain infections, such as parvovirus B19 Fetal arterial oxygen tension (PaO 2 ), carbon dioxide tension (PCO 2 ), and pH - These can provide critical indicators of fetal well-being in a or compromised fetus and thus can help guide management decisions Complications associated

2014 eMedicine Pediatrics

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

placental insufficiency, and, in severe cases, diastolic flow may stop completely or even reverse. Therefore, a systolic-to-diastolic umbilical blood flow ratio higher than 3 after 30 weeks' gestation is associated with fetal compromise. Researchers continue to investigate the utility of measuring fetal arterial velocity in assessing redistribution in the hypoxic fetus and as indicators of placental circulation in pathologic placental processes, such as pregnancy-induced hypertension. Fetal scalp pH (...) be performed on blood samples for diagnosis of fetal infections (eg, specific immunoglobulin M [IgM] for toxoplasmosis, rubella, cytomegalovirus [CMV], varicella zoster, HIV); viral DNA can be detected by using PCR for certain infections, such as parvovirus B19 Fetal arterial oxygen tension (PaO 2 ), carbon dioxide tension (PCO 2 ), and pH - These can provide critical indicators of fetal well-being in a or compromised fetus and thus can help guide management decisions Complications associated

2014 eMedicine Pediatrics

29. 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 (...) intensity ultrasound to detect the presence or absence of blood flow velocity in arteries or veins. Fetal death See “Stillbirth” Fetal to maternal transfusion/hemorrhage Bleeding across the placental interface from the fetus to mother. FMH is diagnosed using the Betke -Kleihauer stain, a test which detects the amount of fetal blood cells in the mother’s blood. Although the definition of massive FMH is often arbitrary (varying from >50ml to >150ml), it has a clear association with fetal mortality

2010 Clinical Practice Guidelines Portal

30. 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

2010 Clinical Practice Guidelines Portal

31. Scalp blood lactate for intra-partum assessment of fetal metabolic acidosis. Full Text available with Trip Pro

Scalp blood lactate for intra-partum assessment of fetal metabolic acidosis. To study to what extent the fetal scalp blood lactate concentration during labor correlates with fetal scalp pH and base deficit, and metabolic acidosis at birth, and to suggest lactate cut-off values to serve as indicators for either reassurance or immediate intervention.A retrospective observational study.Labor ward at a university medical center.Fetal scalp and cord blood samples with acid-base and lactate values (...) from 486 singleton pregnancies beyond 34 weeks' gestation.The relation between lactate, pH and base deficit (BD) in fetal scalp blood was tested by Spearman's rho correlation coefficient. Lactate cut-off values indicating either reassuring fetal status or immediate intervention were estimated using percentile distribution and compared with pH and BD.Metabolic acidosis, defined as umbilical cord artery pH below 7.05 and BD calculated for the blood compartment above 12 mmol/l.After 127 (21

2011 Acta Obstetricia et Gynecologica Scandinavica

32. Outcome of severe intrapartum acidemia diagnosed with fetal scalp blood sampling. (Abstract)

Outcome of severe intrapartum acidemia diagnosed with fetal scalp blood sampling. To analyze short-term neonatal outcome and the sampling to delivery interval in cases with severe intrapartum acidemia diagnosed with fetal scalp blood sampling (FBS).This is a secondary analysis of data from a trial of 2992 women, who were, when indicated, randomized to either lactate or pH analyses by FBS. Median and 95(th) centile values for lactate analyses were 2.9 mmol/L and 6.6 mmol/L, respectively (...) . Corresponding pH values were 7.30 and 7.17. We defined severe intrapartum acidemia as lactate >6.6 mmol/L or pH <7.17. Outcome measures were cord artery pH <7.00, Apgar <7 at 5 min, hypoxic ischemic encephalopathy and time interval from FBS to delivery.Severe intrapartum acidemia was present in 85/1355 (6.3%) cases with lactate analyses and in 69/1008 (6.8%) cases with pH analyses. Cord artery pH <7.00 occurred in 12/154 (7.8%), Apgar <7 at 5 min in 16/154 (10.4%) and hypoxic ischemic encephalopathy in 4

2011 Journal of perinatal medicine Controlled trial quality: uncertain

33. 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

34. Lactate production as a response to intrapartum hypoxia in the growth-restricted fetus. Full Text available with Trip Pro

Lactate production as a response to intrapartum hypoxia in the growth-restricted fetus. To analyse whether the increase in lactate in response to intrapartum hypoxia differs between small- (SGA), appropriate- (AGA) and large-for-gestational-age (LGA) fetuses.Observational cohort study.Ten obstetric units in Sweden.A cohort of 1496 women.A secondary analysis of a randomised controlled trial, in which 1496 women with fetal heart rate abnormalities, indicating fetal scalp blood sampling, were (...) randomised to lactate analyses. After delivery, the neonates were divided according to birthweight for gestational age into SGA, AGA and LGA groups.Lactate concentration in fetal scalp blood.Acid-base balance in cord artery blood and Apgar score <7 at 5 minutes.Median lactate concentrations in the SGA, AGA and LGA groups were 3.8, 3.0 and 2.2 mmol/l, respectively (SGA versus AGA, P = 0.017; LGA versus AGA, P = 0.009). In the subgroups with scalp lactate >4.8 mmol/l (lactacidaemia), the corresponding

2012 BJOG Controlled trial quality: uncertain

35. Comparative effect of pethidine, trichloroethylene, and Entonox on fetal and neonatal acid-base and PO2. Full Text available with Trip Pro

Comparative effect of pethidine, trichloroethylene, and Entonox on fetal and neonatal acid-base and PO2. The second stage of labour is associated with relative fetal hypoxia and progressive metabolic acidosis. Maternal analgesia can increase the danger, especially for the high-risk fetus.In 152 patients the effect on the fetus of pethidine alone, pethidine + trichloroethylene, or pethidine + Entonox was assessed by fetal scalp blood sampling. Fetal pH, Pco(2), and Po(2) were measured and base

1971 British medical journal Controlled trial quality: uncertain

36. Continuous monitoring of fetal scalp temperature in labor: a new technology validated in a fetal lamb model. (Abstract)

Continuous monitoring of fetal scalp temperature in labor: a new technology validated in a fetal lamb model. To evaluate a new technical equipment for continuous recording of human fetal scalp temperature in labor.Experimental animal study.Two temperature sensors were placed subcutaneously and intracranially on the forehead of 10 fetal lambs and connected to a temperature monitoring system. The system records temperatures simultaneously on-line and stores data to be analyzed off-line (...) . Throughout the experiment, the fetus was oxygenated via the umbilical cord circulation. Asphyxia was induced by intermittent cord compression, as assessed by pH in jugular vein blood. The intracranial (ICT) and subcutaneous (SCT) temperatures were compared with simple and polynomial regression analyses.Absolute and delta ICT and SCT changes.ICT and SCT were both successfully recorded in all 10 cases. With increasing acidosis, the temperatures decreased. The correlation coefficient between ICT and SCT had

2010 Acta Obstetricia et Gynecologica Scandinavica

37. 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

38. Coronavirus (COVID-19) infection and pregnancy

in a woman who is pregnant or has recently given birth. o Titrate oxygen to keep saturations >94%. • Radiographic investigations should be performed as for the non-pregnant adult; this includes chest X-ray and computerised tomography (CT) of the chest. o Chest imaging, especially CT chest, is essential for the evaluation of the unwell patient with COVID-19 and should be performed when indicated, and not delayed because of fetal concerns. 48-50 o Abdominal shielding can be used to protect the fetus as per (...) . • The diagnosis of PE should be considered in women with chest pain, worsening hypoxia (particularly if there is a sudden increase in oxygen requirements) or in women whose breathlessness persists or worsens after expected recovery from COVID-19. • The frequency and suitability of fetal heart rate monitoring should be considered on an individual basis, taking into consideration the gestational age of the fetus and the woman’s condition. If urgent intervention for birth is indicated for fetal reasons, birth

2020 Royal College of Obstetricians and Gynaecologists

39. Prevention of Early-Onset Group B Streptococcal Disease in Newborns

Prevention of Early-Onset Group B Streptococcal Disease in Newborns INTERIM UPDATE ACOGCOMMITTEEOPINION Number 797 (Replaces Committee Opinion No. 782, June 2019) Committee on Obstetric Practice The American Academy of Pediatrics, the American College of Nurse-Midwives, the Association of Women’s Health, Obstetric and Neonatal Nurses, and the Society for Maternal-Fetal Medicine endorse this document. Although the American Society for Microbiology cannot endorse this document because the content (...) birth and occurs secondary to vertical trans- mission, fetal or neonatal aspiration during labor and birth, or both; it is characterized primarily by sepsis, pneumonia, or less frequently meningitis and is most likely to manifest within the first 12–48 hours after birth (1, 10, 16). In con- trast, GBS late-onset disease presents between 7 days after birth and 2–3 months of age and is characterized by bac- teremia, meningitis, or less commonly, organ or soft tissue infection. Late-onset disease

2020 American College of Obstetricians and Gynecologists

40. Prevention of Group B Streptococcal Early-Onset Disease in Newborns

was published for this title. . ), and penicillin dose ( ). The American Academy of Pediatrics, the American College of Nurse-Midwives, the Association of Women’s Health, Obstetric and Neonatal Nurses, and the Society for Maternal-Fetal Medicine endorse this document. Although the American Society for Microbiology cannot endorse this document because the content is outside the organization's scope, they have reviewed the document. This Committee Opinion was developed by the American College of Obstetricians (...) of invasive GBS disease in the newborn exist. One is GBS EOD, which presents within 7 days after birth and occurs secondary to vertical transmission, fetal or neonatal aspiration during labor and birth, or both; it is characterized primarily by sepsis, pneumonia, or less frequently meningitis and is most likely to manifest within the first 12–48 hours after birth . In contrast, GBS late-onset disease presents between 7 days after birth and 2–3 months of age and is characterized by bacteremia, meningitis

2020 American College of Obstetricians and Gynecologists

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