443 Lack of association of spontaneous fetal heart rate decelerations during antepartum non-stress testing with fetal compromise

1991 ◽  
Vol 164 (1) ◽  
pp. 368
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Stress Testing ◽  
Fetal Heart ◽  
Fetal Compromise

scholarly journals Recognising Fetal Compromise in the Cardiograph during the Antenatal Period: Pearls and Pitfalls

2020 ◽  
pp. 72-83
Author(s):  
Susana Pereira ◽  
Caron Ingram ◽  
Neerja Gupta ◽  
Mandeep Singh ◽  
Edwin Chandraharan
Keyword(s):  
At Risk ◽  
Heart Rate ◽  
Neurological Disorders ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
International Guidelines ◽  
Antenatal Period ◽  
Uterine Contractions ◽  
Computerised Analysis ◽  
Fetal Compromise

There are several national and international guidelines to aid the interpretation of the cardiotocograph (CTG) trace during labour. These guidelines are based on assessing changes in the fetal heart rate (i.e. cardiograph) in response to mechanical and hypoxic stresses during labour secondary to ongoing frequency, duration and strength of uterine contractions (i.e. tocograph). However, during the antenatal period, uterine contractions are absent, and therefore, these intrapartum CTG guidelines cannot be used to reliably identify fetuses at risk of compromise. Computerised analysis of CTG using the Dawes-Redman Criteria could be used to detect fetal compromise. However, clinicians should be aware of the multiple pathways of fetal damage (i.e. inflammation, infection, intrauterine fetal stroke, chronic fetal anaemia, acute feto-maternal haemorrhage and fetal cardiac or neurological disorders) which can cause changes on the CTG trace which may not be recognised by using CTG guidelines.

The Diagnostic Ability of the Cerebroplacental Ratio for the Prediction of Adverse Perinatal Outcome and Intrapartum Fetal Compromise within One Day of Delivery

2021 ◽  
pp. 1-10
Author(s):  
José Morales-Roselló ◽  
Gabriela Loscalzo ◽  
Vaidilė Jakaitė ◽  
Alfredo Perales Marín
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Diagnostic Ability ◽  
Adverse Perinatal Outcome ◽  
Cerebroplacental Ratio ◽  
Fetal Scalp ◽  
Fetal Compromise

<b><i>Objectives:</i></b> The objectives of this study were to evaluate the diagnostic abilities of the cerebroplacental ratio (CPR) for the prediction of adverse perinatal outcome (APO) and cesarean section for intrapartum fetal compromise (CS-IFC) within 1 day of delivery. <b><i>Design:</i></b> Retrospective observational case-control study. <b><i>Methods:</i></b> This was a study of 254 high-risk fetuses attending the day hospital unit of a tertiary referral hospital that underwent an ultrasound examination at 32–41 weeks and gave birth within 1 day of examination. APO was defined as a composite of abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH &#x3c;7.20 requiring urgent cesarean section, neonatal umbilical cord pH &#x3c;7.10, 5-min Apgar score &#x3c;7, and postpartum admission to neonatal or pediatric intensive care units. CS-IFC was defined in case of abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH &#x3c;7.20 requiring urgent cesarean section. The diagnostic ability of CPR for the prediction of APO and CS-IFC was calculated alone and in combination with estimated fetal weight and gestational clinical parameters, including the type of labor onset, using ROC curves and logistic regression analysis. <b><i>Results:</i></b> CPR in multiples of the median (MoM) was a moderate predictor of APO (area under the curve [AUC] = 0.77, <i>p</i> &#x3c; 0.0001) and CS-IFC (AUC = 0.82, <i>p</i> &#x3c; 0.0001). The predictive abilities of the multivariable model for APO (AUC = 0.81, <i>p</i> &#x3c; 0.0001) and CS-IFC (AUC = 0.82, <i>p</i> &#x3c; 0.0001) did not differ from those of CPR alone . <b><i>Limitations:</i></b> The small number of cases and the scarcity of information concerning labor induction. <b><i>Conclusion:</i></b> In high-risk pregnancies, CPR MoM is a moderate predictor of APO and CS-IFC when performed within 24 h of delivery.

scholarly journals Determination of fetal heart rate reactivity from a single 20-min window of non-stress testing in compromised fetuses

2009 ◽  
Vol 37 (4) ◽  
Author(s):  
Young-Sun Park ◽  
Jeong-Kyu Hoh ◽  
Seung-Kwon Koh ◽  
Nam-Su Kim ◽  
Moon-II Park
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Stress Testing ◽  
Fetal Heart ◽  
Heart Rate Reactivity

Continuous objective recording of fetal heart rate and fetal movements could reliably identify fetal compromise, which could reduce stillbirth rates by facilitating timely management

2014 ◽  
Vol 83 (3) ◽  
pp. 410-417 ◽  
Author(s):  
Rebecca Brown ◽  
Jayawan H.B. Wijekoon ◽  
Anura Fernando ◽  
Edward D. Johnstone ◽  
Alexander E.P. Heazell
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Movements ◽  
Objective Recording ◽  
Fetal Compromise

scholarly journals Uterine Tachysystole with Prolonged Deceleration Following Nipple Stimulation for Labor Augmentation

2017 ◽  
Vol 13 (3) ◽  
pp. 268-270
Author(s):  
D.M. Narasimhulu ◽  
L. Zhu
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Stress Testing ◽  
18Th Century ◽  
Fetal Heart ◽  
Singleton Pregnancy ◽  
Uterine Contractions ◽  
Contraction Stress ◽  
Lateral Positioning ◽  
Labor Augmentation

Breast stimulation for inducing uterine contractions has been reported in the medical literature since the 18th century. The American college of Obstetricians and Gynecologists (ACOG) has described nipple stimulation as a natural and inexpensive nonmedical method for inducing labor.We report on a 37 year old P2 with a singleton pregnancy at 40 weeks gestation who developed tachysystole with a prolonged deceleration after nipple stimulation for augmentation of labor. Initial resuscitative measures, including oxygen by mask, a bolus of intravenous fluids and left lateral positioning, did not restore the fetal heart rate to normal. After the administration of Terbutaline 250 mcg subcutaneously, the tachysystole resolved and the fetal heart rate recovered after five minutes of bradycardia.Most trials of nipple stimulation for induction or augmentation of labor have had small study populations, and no conclusions could be drawn about the safety of nipple stimulation, though its use is widespread. While there have been a few reports of similar complications during nipple stimulation for contraction stress testing, there are no previous reports of tachysystole with sustained bradycardia following nipple stimulation for labor augmentation.In this report, we draw attention to the dangers of nipple stimulation so that providers will be aware of this potential complication.

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