Cesarean section for suspected fetal distress, continuous fetal heart monitoring and decision to delivery time

2008 ◽  
Vol 75 (12) ◽  
pp. 1249-1252 ◽  
Author(s):  
K.K. Roy ◽  
Jinee Baruah ◽  
Sunesh Kumar ◽  
A.K. Deorari ◽  
J.B. Sharma ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Delivery Time ◽  
Heart Monitoring

Cesarean section for suspected fetal distress, continuous fetal heart monitoring and decision to delivery time

2008 ◽  
Author(s):  
K. K. Roy ◽  
Jinee Baruah ◽  
Sunesh Kumar ◽  
A. K. Deorari ◽  
J. B. Sharma ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Delivery Time ◽  
Heart Monitoring

scholarly journals Spontaneous umbilical cord hematoma causing still birth: a case report in Madagascar

2018 ◽  
Vol 7 (5) ◽  
pp. 2031
Author(s):  
Lyn Z. A. Rabetsimamanga ◽  
Hary F. Rabarikoto ◽  
Eddie B. Rekoronirina ◽  
Hery R. Andrianampanalinarivo
Keyword(s):  
Case Report ◽  
Umbilical Cord ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Fetal Hypoxia ◽  
Female Fetus ◽  
Still Birth ◽  
Heart Monitoring ◽  
Short Time ◽  
Uncommon Complication

Spontaneous umbilical cord hematoma is uncommon complication during delivery. It is responsible for severe fetal distress or death. We report a case of a 28 year-old primigravida Malagasy woman at the 37th weeks of gestation. She was admitted in the delivery room for beat oscillating on the fetal heart monitoring at the beginning of labour. Cesarean section was indicated for acute fetal distress in monitoring at dilation 5cm of the cervix traduced by some decelerations.  But she gives birth to a still born female fetus by vaginal way short time after. A 5,5 cm hematoma was discovered on umbilical cord. This still birth may be due to anoxia during acute compression of the umbilical vessels by the hematoma. So, placental and cord examinations in cases of unexplained fetal hypoxia and stillbirth are very important.

scholarly journals Prophylactic amnioinfusion in oligohydramnios

2019 ◽  
Vol 9 (1) ◽  
pp. 305
Author(s):  
Dhiviya Narbhavi T. ◽  
Cicily T. J. ◽  
Kala B. S.
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Fetal Distress ◽  
Study Group ◽  
Amniotic Fluid Volume ◽  
Fetal Complications ◽  
Labour Room

Background: Oligohydramnios causes many intrapartum maternal and fetal complications. Intrapartum amnioinfusion effectively increases amniotic fluid volume and thereby decreases FH decelerations. The objective of this study was to compare the frequency of fetal heart decelerations and its perinatal outcome with and without amnioinfusion in patients with oligohydramnios and the cesarean rates for fetal distress between them.Methods: In study group, 100 patients in labour with AFI < 5 cm, oligohydramnios and IUGR with normal doppler, postdated pregnancies with AFI ≤ 5 cm with normal doppler were selected and prophylactic amnioinfusion with 300 ml lukewarm saline is given aseptically for 15 minutes after amniotomy. Continuous CTG monitoring done till delivery. If FH decelerations occur, the bolus was repeated up to 3 times. 100 age matched controls managed with conventional methods without amnioinfusion were selected retrospectively from labour room case records.Results: Incidence of FH decelerations was lower in study group (59% versus 84%). Cesarean section for fetal distress was reduced (20.9% versus 79.1%) Perinatal outcome was better. Babies with normal 1-minute Apgar was 86% compared to 75% in controls. Frequency of FH decelerations was reduced (20% versus 73%). Occurrence of 2 FH decelerations were 13% versus 33%, 3 FH decelerations were 7% versus 27% and > 3 times was 0% versus 13%.Conclusions: Prophylactic amnioinfusion can easily and effectively reduce the FH decelerations and caesarean section rate for fetal distress in oligohydramnios improving both maternal and fetal outcomes with negligible risks.

scholarly journals The excessive use of cesarean section and its contribution factors in Shanghai, China

2019 ◽  
Author(s):  
Yuyin Xiao ◽  
Chenshu Shi ◽  
Wu Zeng ◽  
Minye Dong ◽  
Chunling Lu ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Heart Rate ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Bayes Estimation ◽  
World Health ◽  
Medical Indications

Abstract Objectives: This study proposes a mathematical analysis framework to estimate the proportion of cesarean section (CS) with non-medical indications and of CS cases correctly diagnosed, examine the excessive use of CS, and investigate its contributing factors in Shanghai. Design and Settings A mathematical model (C-model), developed by the World Health Organization, was employed to estimate the expected proportion of women having CS based on clinical indicators. Cases in which CS occurred but vaginal delivery (VD) was recommended instead by the C-model were regarded as "Suspicious CS". Cases that are “CS of suspected non-medical indications” were identified and used for categorical principal component analysis to explore causes of "Suspicious CS". A Bayesian model was used to calculate the proportion of correctly diagnosed CS. The use of CS and medical conditions were collected from 5,686 pregnant women delivered in twenty public hospitals with obstetrics departments in 2016, which were randomly selected in Shanghai. The excessive use of CS in Shanghai and the cost of "CS suspected non-medical indications" were estimated. Results 43.96% of pregnant women performed CS in Shanghai in 2016, much higher than the expected CS rate of 30.13% according to the C-model. A total of 1271 CS cases were classified as “Suspicious CS”, representing 22.35% of the sample. There were 784 cases classified as “CS of suspected non-medical indications”, including CS caused by fetal heart rate abnormality/fetal distress and cesarean delivery on maternal request (CDMR), accounting for 13.79% of the sample. Based on Bayes estimation, only 42.5% of pregnant women who had CS were medically necessary. If the CS with non-medical indications were appropriately controlled, the hospitalization costs in the whole year in Shanghai would drop by about US$ 60 million (408 million RMB). Conclusion The study provides empirical evidence on non-medical indications of CS in Shanghai, and uses a mathematical model to estimate the excessive use of CS. The high rate of CS in Shanghai was associated with non-medical indications. Establishing clinical standards of CS, especially in relations to abnormal fetal heart rate/fetal distress, would help reduce CS without medical indications, which would significantly lower medical expenses of hospitalization.

scholarly journals Fetal Heart Rate Extraction Based on Wavelet Transform to Prevent Fetal Distress In Utero

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mengni Zhu ◽  
Liping Liu
Keyword(s):  
Heart Rate ◽  
Wavelet Transform ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Distress ◽  
In Utero ◽  
Control Group ◽  
Observation Group ◽  
Peak Point ◽  
Heart Monitoring

In order to improve the effective extraction of fetal heart rate and prevent fetal distress in utero, a study of fetal heart rate feature extraction based on wavelet transform to prevent fetal distress in utero was proposed. This paper adopts a fetal heart rate detection method based on the maximum value of the binary wavelet transform modulus. The method is simulated by the Doppler fetal heart signal obtained from the clinic. Compared with the original curve, the transformed curve can roughly see the change rule of the original signal and identify the peak point of the signal, but due to the large disturbance of the peak point, the influence on the computer processing is also great. The periodicity of the transformed signal is greatly enhanced, making it easier to deal with the computation. A total of 300 pregnant women with full-term fetal heart monitoring from January 2018 to January 2020 were selected as the research subjects and divided into the observation group and the control group. The observation group consisted of 100 patients with abnormal fetal heart monitoring, and the control group consisted of 200 patients with normal fetal heart monitoring. The uterine contractions and fetal heart rate were recorded, and the incidence of fetal distress, cesarean section, neonatal asphyxia, and amniotic fluid and fecal contamination were observed. The incidence of fetal distress, cesarean section, neonatal asphyxia, and amniotic fluid fecal stain in the observation group were significantly higher than those in the control group. Fetal heart monitoring can accurately judge the situation of the fetus in pregnant women and timely diagnose the abnormal fetal heart rate, which has a better effect on the prognosis of perinatal infants and can reduce their mortality. It can effectively solve the problems existing in the autocorrelation algorithm and extract the fetal heart rate more accurately. It is an effective improved scheme of fetal heart rate extraction. It is very helpful in preventing fetal distress in utero.

scholarly journals Doppler Ultrasound Imaging Combined with Fetal Heart Detection in Predicting Fetal Distress in Pregnancy-Induced Hypertension under the Guidance of Artificial Intelligence Algorithm

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Su Liu ◽  
Yue Sun ◽  
Na Luo
Keyword(s):  
Umbilical Artery ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Current Status ◽  
Control Group ◽  
Observation Group ◽  
Pregnancy Induced Hypertension ◽  
Heart Monitoring ◽  
Induced Hypertension ◽  
D Values

This study was to improve the feasibility and economic benefits of intelligent medical system Doppler ultrasound (DUS) imaging technology combined with fetal heart detection to predict the fetal distress in pregnancy-induced hypertension (PIH), so as to reduce the risk of deterioration of the patient’s condition. The characteristics of DUS images were analyzed, and a diffusion filter reducing the specificity was adopted to improve the smooth speckle noise of DUS images. 120 pregnant women in hospital were the subjects of the study, all of whom received ultrasound cord blood flow testing and fetal heart monitoring. 88 PIH patients with fetal distress were diagnosed and included in the observation group, and 32 healthy pregnant women tested during the same period were identified as the control group. Clinical data were reviewed and analyzed. The diagnostic rates of fetal distress by simple fetal heart monitoring and DUS detection combined with fetal heart monitoring were compared. The results showed that 26.7% of fetal distress were diagnosed by fetal heart monitoring alone, and 73.3% of fetal distress were diagnosed by combined testing, so the diagnostic accuracy of the combined detection method was greatly higher than the single fetal heart detection ( P < 0.05 ). The Pulsatility index (PI), resistance index (RI), and S/D values detected by the umbilical artery in the observation group were 1.48, 0.85, and 4.31, respectively. The PI, RI, and S/D values detected by the umbilical artery in the control group were 0.96, 0.64, and 3.59, respectively. The results of arterial detection were significantly higher than those of the control group, and the difference was of significant scientific significance ( P < 0.05 ). In summary, the PI and RI values of the middle cerebral artery (MCA) detected by DUS diagnosis can effectively reflect the current status of the fetus in the uterus and reduce the mortality of the fetus. The images guided by DUS imaging technology can clearly show the current status of the fetus in the uterus, effectively improve the medical diagnostic efficiency, and have important reference value for the development of intelligent medical equipment.

scholarly journals Cesarean Audit for fetal distress- A indispensable tool to reduce Obstetrician Distress

2021 ◽  
Vol 5 (1) ◽  
pp. 01-04
Author(s):  
Anuradha Singh
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Emergency Cesarean ◽  
Audit Period ◽  
Nicu Admission ◽  
Operative Findings

Background and Objectives: Overuse of cesarean section and its implications are of growing concern. Suspected fetal distress has been the commonest indication for cesarean in last few decades heart rate changes shown by fetus without being adversely affected and CTG has been criticized to create unnecessary higher rate of operative deliveries. There is need to know which fetal heart rate abnormality is important and leading to two adverse neonatal outcome to decrease unnecessary operative deliveries. Therefore Caesarean Audit was planned. Material and methods: A total of hundred women were included who underwent emergency cesarean section for suspected fetal distress in labour or without labour detected by cardiotocography or intermittent auscultation were included for analysis. Details were noted in pre designated proforma. Results: During the audit period, total number of caesarean done due to fetal distress analysed during the period were 100.The most common fetal heart rate abnormality was nonspecific in form of single or transient deceleration seen in 63% of cases where records were also incomplete, it was followed by persistent deceleration on cardiotocography which was present in 16% of the cases. In 57 women who were primigravida 14 (24%) patients had nonspecific fetal heart rate patterns and intra operative findings were normal in this group. These were avoidable cesareans. Various Intraoperative findings, observed ,maximum no. of cases had meconium stained liquor seen in 63% of the cases followed by abruption in 9 cases followed by other findings like loop of cord around the neck of foetus, thin scar or scar dehiscence . Maternal resuscitation was carried out only in 53% of cases. Detection delivery interval of less than 30 minutes was present in 4% of cases. In fetal outcomes 16% of babies diagnosed with fetal distress, had poor outcome where Apgar score < 7 and 12 babies had asphyxia related NICU admission. 82% of babies had absolutely normal fetal outcome among which majority (78%) did not require any form resuscitation. which were thus avoidable cases. Conclusions: Correct Knowledge about Standardized fetal heart rate interpretations on CTG and there standardized management protocols like Maternal resuscitative measures ,follow up to ensure fast detection delivery interval should be practiced strictly in all cases of non reassuring Fetal Heart rate patterns. There should be consistent efforts in reducing the rate of cesarean sections particularly primary cesarean deliveries and in order to understand the degree to which cesarean delivery is preventable it is important to know no why cesareans are being performed. Therefore caesarean audit is need of the hour

A Case of Emergency Cesarean Section on Client with Pseudopregnancy

2020 ◽  
pp. 1-6
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Medical Service ◽  
Fetal Heart ◽  
Placenta Previa ◽  
Urban Hospital ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Rural Health Center

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.

Antenatal electronic fetal heart monitoring for extremely and very preterm newborns

2019 ◽  
Vol 4 (26) ◽  
pp. 20
Author(s):  
Ali Saphia ◽  
George Alexandru Filipescu ◽  
Anca A. Simionescu
Keyword(s):  
Fetal Heart ◽  
Very Preterm ◽  
Heart Monitoring ◽  
Preterm Newborns
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