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Fetal Scalp pH

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101. Cervical Ripening for Obese Women: A Randomized, Comparative Effectiveness Trial

hours. Once the cervix becomes favorable (Bishop score > 6), misoprostol administration will be discontinued. Similarly, further management will be left at the discretion of the labor team. In both groups, if IV oxytocin is indicated, it will be withheld until 4 hours after the last dose of misoprostol to prevent uterine hyperstimulation. Other aspects of labor management will be similar for both groups, including continuous electronic fetal monitoring with external Doppler device or fetal scalp (...) that obese women experience increased labor duration and oxytocin needs when compared to normal-weight women. This in turn results in increased rates for unplanned cesarean delivery (CD) as a result of failed induction of labor (IOL), arrest disorders and non-reassuring fetal heart rate tracing, that is dose-dependent with increasing class of obesity. The investigators hypothesize that obese pregnant women and unfavorable cervix (Bishop score ≤ 6), IOL ≥ 24 weeks gestation using the Foley balloon plus

2015 Clinical Trials

102. Effects of Mother Position in Skin-to-skin Contact Newborn on Oxygen Saturation Levels.

, anticonvulsants, antipsychotics, benzodiazepines, anxiolytics, hypnotics, antidepressants and sedative plants. Post randomization exclusion criteria (at the end of delivery) Related to childbirth: Caesarean section or instrumental delivery (forceps, vacuum) Maternal fever >38 degrees Celsius Mother hemodynamic instability (hypotension, tachycardia, altered level of consciousness, poor perfusion, striking pallor) Cord prolapse Signs of fetal distress with lower pH fetal scalp <7.25 or umbilical artery pH <7.20 (...) the first 10 minutes after birth. Small for normal fetal gestational age (genetic-family origin) 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 the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02585492 Locations Layout table for location information Spain Hospital Universitario Severo Ochoa Leganés

2015 Clinical Trials

103. Misodel or Angusta for Induction of Labour?

Measures Go to Primary Outcome Measures : Frequency of caesarean section [ Time Frame: 1,5 year ] No of patients with caesarean section, will be registered for every patient, in their chart after birth, and assessed after 1,5 year. Hyperstimulation [ Time Frame: 1,5 year ] No of patients with hyperstimulation will be registered in the patient chart and assessed after 1,5 year. Defined as tachysystoly with > 5 contractions in 10 minutes over a period of 30 minutes. Indeterminate or abnormal CTG. Scalp (...) -pH < 7,20 or umbilical cord pH < 7,10. Delivery within 24 hours [ Time Frame: 1,5 year ] Number of patients with delivery within 24 hours after induction, will be registered in the patient chart, and assessed after 1,5 year Secondary Outcome Measures : Timeline [ Time Frame: 1,5 year ] Number of hours from induction to delivery, daytime delivery Cost of primary induction method [ Time Frame: 1,5 year ] Cost of medication (DKK for primary method of induction ie. Angusta and Misodel) Experience

2015 Clinical Trials

104. 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

105. A consensus statement on the management of pregnancy and delivery in women who are carriers of or have bleeding disorders

, results of quantitative and functional assays for VWF) is desirable for delivery. If needed, factor replacement should be given to the mother as close to the time of delivery as possible. (Note: this does not normalise the baby’s factor levels.) Vacuum extraction is contraindicated. Use of forceps, fetal scalp blood sampling, and scalp electrodes should be avoided, if possible. DDAVP has poor efficacy in type 2 and type 3 von Willebrand disease, but may be used in carriers of haemophilia A. DDAVP may (...) of haemophilia A will develop “normal” factor levels as pregnancy progresses, and thus will not require replacement therapy. , , However, in carriers with a moderate-to-severe deficiency, factor levels may not adequately correct during pregnancy. , , Women with rare bleeding disorders, such as fibrinogen or factor XIII deficiency, may require antenatal treatment to prevent fetal loss. Women with type 1 von Willebrand disease (the most common and mildest form) also experience increased levels of factor VIII

2009 MJA Clinical Guidelines

106. Telavancin (Vibativ)

period after introduction to the market. A risk evaluation and mitigation strategy (REMS) was also implemented due to the risk of fetal toxicity and the Applicant was required to establish a pregnancy registry to collect data on fetal outcomes in women exposed to telavancin during pregnancy. In pursuit of the indication for the treatment of NP, the Applicant conducted two Phase 3 clinical trials (0015 and 0019) of non-inferiority design. These trials compared the safety and efficacy of telavancin

2013 FDA - Drug Approval Package

107. Sarcoma, Childhood Soft Tissue

Press, 2013. Dantonello TM, Int-Veen C, Leuschner I, et al.: Mesenchymal chondrosarcoma of soft tissues and bone in children, adolescents, and young adults: experiences of the CWS and COSS study groups. Cancer 112 (11): 2424-31, 2008. Steelman C, Katzenstein H, Parham D, et al.: Unusual presentation of congenital infantile fibrosarcoma in seven infants with molecular-genetic analysis. Fetal Pediatr Pathol 30 (5): 329-37, 2011. Evans HL: Low-grade fibromyxoid sarcoma: a clinicopathologic study of 33

2012 PDQ - NCI's Comprehensive Cancer Database

108. Genetics of Skin Cancer

.[ ] Epidermal appendages are also found in the dermal compartment. These are derivatives of the epidermal keratinocytes, such as hair follicles, sweat glands, and the sebaceous glands associated with the hair follicles. These structures are generally formed in the first and second trimesters of fetal development. These can form a large variety of benign or malignant tumors with diverse biological behaviors. Several of these tumors are associated with familial syndromes. Overall, there are dozens (...) criterion for BCNS, but most groups do not include it at this time.[ ] Other associated benign neoplasms include gastric hamartomatous polyps,[ ] pulmonary cysts,[ ] cardiac fibromas,[ ] meningiomas,[ - ] craniopharyngiomas,[ ] fetal rhabdomyomas,[ ] leiomyomas,[ ] mesenchymomas,[ ] basaloid follicular hamartomas,[ ] and nasal dermoid tumors. Development of meningiomas and ependymomas occurring postradiation therapy has been documented in the general pediatric population; radiation therapy for syndrome

2012 PDQ - NCI's Comprehensive Cancer Database

109. Normal Labor and Delivery (Overview)

be accomplished with blood sampling from fetal scalp capillaries. This procedure allows for a direct assessment of fetal oxygenation and blood pH. A pH of < 7.20 warrants further investigation for the fetus' well-being and for possible resuscitation or surgical intervention. Routine laboratory studies of the parturient, such as complete blood cell (CBC) count, blood typing and screening, and urinalysis, are usually performed. Intravenous (IV) access is established. Previous Next: Intrapartum Management (...) cardiotocography. This review concluded that continuous cardiotocography during labor is associated with a reduction in neonatal seizures but not cerebral palsy or infant mortality; however, continuous monitoring is associated with increased cesarean and operative vaginal deliveries. [ ] If nonreassuring fetal heart rate tracings by cardiotography (eg, late decelerations) are noted, a fetal scalp electrode may be applied to generate sensitive readings of beat-to-beat variability. However, a fetal scalp

2014 eMedicine.com

110. Factor IX (Overview)

, hematologists, and neonatologists in the United States for the treatment of pregnant carriers and newborns with hemophilia and intracranial hemorrhage (ICH) showed that more than 94% of the major facilities reviewed had no written guidelines. Survey findings led to the following recommendations [ , ] : Vacuum devices and fetal scalp monitors should not be used during vaginal delivery of known carriers of hemophilia All infants with intracranial hemorrhage should be evaluated for a bleeding disorder, Women (...) may have clinical bleeding resulting from reduced levels of FIX include X-mosaicism, Turner syndrome, testicular feminization, or situations in which the father has hemophilia B and the mother is a carrier for the disorder. Carriers with basal levels of FIX of less than 30% can be expected to have a clinically evident bleeding disorder. Age Hemophilia B can be detected prenatally by measuring FIX activity in fetal blood samples obtained at 20 weeks of gestation by fetoscopy, but the presence

2014 eMedicine.com

111. Skin Malignancies, Merkel Cell Carcinoma and Rare Appendageal Tumors

nerve growth factors to enable cutaneous nerves to develop into nerve endings. [ ] The embryological origin of Merkel cells is also controversial; initially, Merkel cells were believed to have arisen from neural crest cells. However, more recent evidence suggests that fetal Merkel cells are derived from epidermal keratinocytes. [ ] Others hypothesize that the cancerous cells in MCC arise from stem cells that develop neuroendocrine properties similar to the wild-type Merkel cells. [ ] Identifying MCC (...) to be effective for advanced stages of MCC with local and regional involvement. [ , ] In a retrospective study of 40 patients, Fenig and colleagues showed that chemotherapy alone was only effective short-term in a regional (lymph node) response, with a 69% partial or complete response. [ ] The addition of radiation significantly improved the effectiveness, with a 91% partial or complete response. Half forehead reconstruction with a single rotational scalp flap for dermatofibrosarcoma protuberans treatment

2014 eMedicine Surgery

112. Trauma and Pregnancy

Trauma and Pregnancy Trauma and Pregnancy: Overview, Maternal-Fetal Physiology, Maternal Trauma and the Fetus Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM1MjI0LW92ZXJ2aWV3 processing > Trauma and Pregnancy (...) increase in risk to the fetus occurs from surgery alone, and the risk appears to be greatest in the first and third trimesters. The concern for the fetus adds to complexity of diagnosis and management of trauma during pregnancy. Next: Maternal-Fetal Physiology An understanding of normal maternal-fetal physiology is critical in the diagnosis, surgical management, and postoperative care of pregnant women who require major surgery or who have been injured. Normal clinical and laboratory findings

2014 eMedicine Surgery

113. Gonorrhea (Diagnosis)

partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact in the child's household (...) disseminate to the blood due to a variety of predisposing factors, such as host physiologic changes, virulence factors of the organism itself, and failures of the host's immune defenses. [ ] For example, changes in the vaginal pH that occur during menses and pregnancy and the puerperium period make the vaginal environment more suitable for the growth of the organism and provide increased access to the bloodstream. (Three fourths of the cases of DGI occur in women; susceptibility is increased

2014 eMedicine Pediatrics

114. Shock and Pregnancy (Follow-up)

results in respiratory alkalosis with compensatory renal excretion of bicarbonate. The arterial carbon dioxide pressure reaches a plasma level of 28-32 mm Hg, and bicarbonate is decreased to 18-21 mmol/L, maintaining an arterial pH in the range of 7.40-7.47. Mild hypoxemia might occur in the supine position. Oxygen consumption increases at the beginning of the first trimester and increases 20-33% by term because of fetal demands and increased maternal metabolic processes. [ ] In active labor (...) of maternal hypoxemia and decreased cardiac output has a profoundly deleterious effect on fetal oxygenation. Variations in maternal pH also influence oxygen delivery; alkalosis causes vasoconstriction of the uterine artery, resulting in decreased fetal oxygen delivery. The interaction of maternal and fetal circulations in the placenta most likely follows a concurrent exchange mechanism. This is less efficient than a countercurrent exchange mechanism and helps explain why the PaO 2 of the fetal umbilical

2014 eMedicine.com

115. Gonococcus (Diagnosis)

partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact in the child's household (...) organisms disseminate to the blood due to a variety of predisposing factors, such as host physiologic changes, virulence factors of the organism itself, and failures of the host's immune defenses. [ ] For example, changes in the vaginal pH that occur during menses and pregnancy and the puerperium period make the vaginal environment more suitable for the growth of the organism and provide increased access to the bloodstream. (Three fourths of the cases of DGI occur in women; susceptibility is increased

2014 eMedicine.com

116. Gonococcal Infections (Diagnosis)

unprotected intercourse with new partners frequently enough to sustain the infection in a community are defined as core transmitters. Neonatal and pediatric gonococcal infection Neonatal gonococcal infection may follow conjunctival infection, which is obtained during passage through the birth canal. In addition, direct infection may occur through the scalp at the sites of fetal monitoring electrodes. In children, infection may occur from sexual abuse by an infected individual or possibly nonsexual contact (...) . Neisserial organisms disseminate to the blood due to a variety of predisposing factors, such as host physiologic changes, virulence factors of the organism itself, and failures of the host's immune defenses. [ ] For example, changes in the vaginal pH that occur during menses and pregnancy and the puerperium period make the vaginal environment more suitable for the growth of the organism and provide increased access to the bloodstream. (Three fourths of the cases of DGI occur in women; susceptibility

2014 eMedicine.com

117. Blue Nevi (Diagnosis)

, and the epitheliod blue nevus. [ ] Next: Pathophysiology Although definitive experimental evidence is lacking, blue nevi are believed to represent dermal arrest in embryonal migration of neural crest melanocytes that fail to reach the epidermis. Collections of melanocytes can be found in fetal dermis, but they involute during later gestation. Because of the variation of blue nevi in different populations, a genetic predisposition has been suggested. However, familial cases of blue nevi are exceedingly rare (...) . 49(2):310-2. . Di Cesare A, Sera F, Gulia A, Coletti G, Micantonio T, Fargnoli MC, et al. The spectrum of dermatoscopic patterns in blue nevi. J Am Acad Dermatol . 2011 Oct 24. . Dailey VL, Hameed O. Blue nevus of the prostate. Arch Pathol Lab Med . 2011 Jun. 135(6):799-802. . Cooper PH. Deep penetrating (plexiform spindle cell) nevus. A frequent participant in combined nevus. J Cutan Pathol . 1992 Jun. 19(3):172-80. . Munoz C, Quintero A, Sanchez JL, Ruiz-Santiago H. Persistent blue nevus

2014 eMedicine.com

118. Abnormal Labor (Follow-up)

reveals signs of compromise with decelerations, and fetal scalp pH is an option when indicated. Probably the most common complication of the medical induction of labor is hyperstimulation of the uterus. If unrecognized and untreated, excessive stimulation of the uterus can result in fetal compromise, cord compression, and uteroplacental insufficiency. , postpartum uterine atony, and may occur and can be life-threatening complications requiring emergent action. Allen et al found that increased duration (...) : May 08, 2017 Author: Nina S Olsen, MD; Chief Editor: Ronald M Ramus, MD Share Email Print Feedback Close Sections Sections Abnormal Labor Follow-up Complications Maternal infection is a risk, especially when rupture of membranes occurs for more than 18 hours. Administer antibiotics for signs and symptoms of chorioamnionitis. Fetal compromise can occur from the inability to tolerate labor (eg, uterine hyperstimulation) or infection, and it must be closely evaluated. Fetal heart monitoring often

2014 eMedicine.com

119. Vacuum Extraction (Diagnosis)

position or station not resolved by examination or real-time ultrasound study Suspicion of fetopelvic disproportion (advanced cranial molding, bone overlap, caput) An inappropriate fetal presentation (eg, breech, face, brow) A known or suspected fetal bleeding diathesis or demineralizing bone disease Relative contraindications are as follows: Prior scalp sampling Prior failed forceps Gestational diabetes or pregestational diabetes Known or suspected fetal macrosomia Definitions The American Congress (...) of Obstetricians and Gynecologists (ACOG) has established standard definitions for instrumental delivery operations. These include outlet, low, and midpelvic operations. While the guidelines were originally written for forceps procedures, the same descriptions are easily applied to vacuum extraction operations with minor modifications. [ ] Outlet forceps/vacuum The leading point of the fetal skull has reached the pelvic floor, and at or on the perineum, the scalp is visible at the introitus without separating

2014 eMedicine.com

120. Factor IX (Diagnosis)

, hematologists, and neonatologists in the United States for the treatment of pregnant carriers and newborns with hemophilia and intracranial hemorrhage (ICH) showed that more than 94% of the major facilities reviewed had no written guidelines. Survey findings led to the following recommendations [ , ] : Vacuum devices and fetal scalp monitors should not be used during vaginal delivery of known carriers of hemophilia All infants with intracranial hemorrhage should be evaluated for a bleeding disorder, Women (...) may have clinical bleeding resulting from reduced levels of FIX include X-mosaicism, Turner syndrome, testicular feminization, or situations in which the father has hemophilia B and the mother is a carrier for the disorder. Carriers with basal levels of FIX of less than 30% can be expected to have a clinically evident bleeding disorder. Age Hemophilia B can be detected prenatally by measuring FIX activity in fetal blood samples obtained at 20 weeks of gestation by fetoscopy, but the presence

2014 eMedicine.com

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