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Fetal Scalp pH

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21. 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

22. Scalp blood lactate for intra-partum assessment of fetal metabolic acidosis. (PubMed)

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

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2011 Acta Obstetricia et Gynecologica Scandinavica

23. Outcome of severe intrapartum acidemia diagnosed with fetal scalp blood sampling. (PubMed)

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

24. 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

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

Lactate Device: EKF Diagnostics 'SensPoint' Lactate Meter Detailed Description: A cardiotocograph (CTG) can be used in labour to assess the heartbeat and well-being of a baby. An abnormal CTG may be a sign that a baby has low oxygen levels (hypoxia) and is becoming distressed. In this situation a blood test can be taken from the scalp of the baby. A high lactate level or high acidity (low pH) in the blood indicates that urgent delivery is required to prevent long-term harm to the newborn. Obtaining (...) 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

2015 Clinical Trials

26. Fetal pulse oximetry for fetal assessment in labour. (PubMed)

status, several additional measures of evaluating fetal well-being have been considered. These have demonstrated some effect on reducing caesarean section rates, for example, fetal scalp blood sampling for pH estimation/lactate measurement. The adaptation of pulse oximetry for use in the unborn fetus could potentially contribute to improved evaluation during labour and therefore lead to a reduction in caesarean sections for nonreassuring fetal status, without any change in neonatal outcomes.To (...) Fetal pulse oximetry for fetal assessment in labour. The use of conventional cardiotocographic (CTG) monitoring of fetal well-being during labour is associated with an increased caesarean section rate, compared with intermittent auscultation of the fetal heart rate, resulting in a reduction in neonatal seizures, although no differences in other neonatal outcomes. To improve the sensitivity of this test and therefore reduce the number of caesarean sections performed for nonreassuring fetal

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2014 Cochrane database of systematic reviews (Online)

27. Spectral analysis of fetal heart rate variability for fetal surveillance: review of the literature

Spectral analysis of fetal heart rate variability for fetal surveillance: review of the literature Spectral analysis of fetal heart rate variability for fetal surveillance: review of the literature Spectral analysis of fetal heart rate variability for fetal surveillance: review of the literature van Laar JO, Porath MM, Peters CH, Oei SG CRD summary The authors' concluded that spectral analysis could be a promising method for foetal surveillance. The conclusions were supported by the data (...) vein. Intrapartum studies were conducted after 35 weeks gestation and used fast fourier transform or wavelet to analyse foetal heart rate measured using scalp electrodes or ultrasound and correlated these with blood gas measures from the umbilical artery. All studies provided data on spectral analysis at the low frequency (LF) band and all intrapartum studies also reported data at the high frequency (HF) band; some studies provided data at other bands, such as very low frequency (VLF), low low

2008 DARE.

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

(15,338 women) and one trial of PR interval analysis (957 women). In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no significant difference to primary outcomes: births by caesarean section (risk ratio (RR) 0.99, 95% confidence interval (CI) 0.91 to 1.08), the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (RR 0.78, 95% CI 0.44 to 1.37, data from (...) 14,574 babies), or babies with neonatal encephalopathy (RR 0.54, 95% CI 0.24 to 1.25). There were, however, on average fewer fetal scalp samples taken during labour (RR 0.61, 95% CI 0.41 to 0.91) although the findings were heterogeneous; there were fewer operative vaginal deliveries (RR 0.89, 95% CI 0.81 to 0.98) and admissions to special care unit (RR 0.89, 95% CI 0.81 to 0.99); there was no statistically significant difference in the number of babies with low Apgar scores at five minutes or babies

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2013 Cochrane database of systematic reviews (Online)

29. 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

30. 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 (...) Clinical practice guideline for the management of women who report decreased fetal movements Clinical Practice Guideline for the Management of Women who report Decreased Fetal Movements First edition, Version 1.1, July 2010 Clinical practice guideline for the management of women who report decreased fetal movements Produced by: The Australian and New Zealand Stillbirth Alliance (ANZSA). Compiled by: The Fetal Movement Study Group, as the Australian and New Zealand arm of the international Fetal

2010 Clinical Practice Guidelines Portal

31. Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace. (PubMed)

Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace. Fetal blood sampling for lactate estimation may be considered following identification of an abnormal or non-reassuring fetal heart rate pattern. The smaller volume of blood required for this test, compared with the more traditional pH estimation, may improve sampling rates. The appropriate use of this practice mandates systematic review of its safety and clinical (...) is indicated, fetal scalp blood lactate estimation is more likely to be successfully undertaken than pH estimation. Action cut-off lactate values need to consider the lactate meter used. Further studies may consider sub-group analysis by gestational age, the stage of labour and sampling within a prolonged second stage of labour. Additionally, future studies may address longer-term neonatal outcomes, maternal satisfaction with intrapartum fetal monitoring and an economic analysis.

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2010 Cochrane database of systematic reviews (Online)

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

) and one trial of PR interval analysis (957 women). In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no significant difference to primary outcomes: births by caesarean section (risk ratio (RR) 0.99, 95% confidence interval (CI) 0.91 to 1.08), the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (RR 0.78, 95% CI 0.44 to 1.37, data from 14,574 babies (...) ), or babies with neonatal encephalopathy (RR 0.54, 95% CI 0.24 to 1.25). There were, however, on average fewer fetal scalp samples taken during labour (RR 0.61, 95% CI 0.41 to 0.91) although the findings were heterogeneous; there were fewer operative vaginal deliveries (RR 0.90, 95% CI 0.81 to 0.98) and admissions to special care unit (RR 0.89, 95% CI 0.81 to 0.99); there was no statistically significant difference in the number of babies with low Apgar scores at five minutes or babies requiring neonatal

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2012 Cochrane database of systematic reviews (Online)

33. 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

34. 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

35. 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

36. 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

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

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

38. Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial. (PubMed)

Determination of pH or lactate in fetal scalp blood in management of intrapartum fetal distress: randomised controlled multicentre trial. To examine the effectiveness of pH analysis of fetal scalp blood compared with lactate analysis in identifying hypoxia in labour to prevent acidaemia at birth.Randomised controlled multicentre trial.Labour wards.Women with a singleton pregnancy, cephalic presentation, gestational age >or=34 weeks, and clinical indication for fetal scalp blood (...) % in the pH group (0.84, 0.47 to 1.50). There was no significant difference in Apgar scores <7 at 5 minutes (1.15, 0.76 to 1.75) or operative deliveries for fetal distress (1.02, 0.93 to 1.11).There were no significant differences in rate of acidaemia at birth after use of lactate analysis or pH analysis of fetal scalp blood samples to determine hypoxia during labour.ISRCT No 1606064.

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2008 BMJ Controlled trial quality: predicted high

39. Fetal Health Surveillance: Antepartum & Intrapartum Consensus Guideline

-Stress Test S15 Contraction Stress Test S17 Sonographic Assessment of Fetal Behaviour and/or Amniotic Fluid Volume S18 Uterine Artery Doppler S19 Umbilical Artery Doppler S20 Other Fetal Artery Doppler Parameters S21 CHAPTER 2 INTRAPARTUM FETAL SURVEILLANCE S25 HYPOXIC ACIDEMIA, METABOLIC ACIDOSIS ENCEPHALOPATHY, AND CEREBRAL PALSY S25 FETAL SURVEILLANCE IN LABOUR S27 Labour Support S28 Intermittent Auscultation S28 Admission Cardiotocography S32 Electronic Fetal Monitoring S33 Digital Fetal Scalp (...) Stimulation S38 Fetal Scalp Blood Sampling S39 Umbilicial Cord Blood Gases S41 NEW TECHNOLOGIES S43 Fetal Pulse Oximetry S43 Fetal Electrocardiogram Analysis S43 Intrapartum Scalp Lactate Testing S44 CHAPTER 3 MAINTAINING STANDARDS IN ANTENATAL/INTRAPARTUM FETAL SURVEILLANCE: QUALITY IMPROVEMENTS AND RISK MANAGEMENT S45 COMMUNICATION S45 DOCUMENTATION S46 INTERPROFESSIONAL ROLES AND EDUCATION S46 RISK MANAGEMENT ISSUES S48 REFERENCES S50 S2 SEPTEMBER JOGC SEPTEMBRE 2007SEPTEMBER JOGC SEPTEMBRE 2007 • S3

2008 British Columbia Perinatal Health Program

40. 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

2015 FP Notebook

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