Frequency of Fetal Heart Rate Categories and Short-term Neonatal Outcome

AbstractWe retrospectively compared a protocol using sufentanil and ropivacaine intrathecally with a protocol in which only ropivacaine was administered intrathecally and sufentanil was used epidurally to evaluate whether banning sufentanil from the intrathecal space results in a decreased incidence of adverse fetal heart rate changes.Some 520 cardiotocographic tracings were examined for changes in fetal heart rate and uterine activity following two different protocols of combined spinal epidural analgesia. Charts were consulted for neonatal and labor outcome.When sufentanil was used epidurally instead of intrathecally, the incidence of adverse changes in fetal heart trace was less, demonstrated by a higher percentage of normal reassuring tracings (74.5% vs. 60.4% when sufentanil was used intrathecally; P=0.007), less tracings showing bradycardia (7.5% vs. 14.1%; P=0.035), and more tracings displaying 3 or more accelerations in fetal heart rate in 45 min (93.5% vs. 83.9%; P=0.003) together with less episodes of tachycardia (3.5% vs. 11.4%; P=0.005). There were no differences in labor and neonatal outcome.Based on fetal heart tracing, it seems favorable to ban sufentanil from the intrathecal compartment.

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Validation of a new algorithm for the short-term variation of the fetal heart rate: an antepartum prospective study

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0035 ◽

2018 ◽

Vol 46 (6) ◽

pp. 599-604 ◽

Cited By ~ 5

Author(s):

Christina Kouskouti ◽

Hella Jonas ◽

Kerstin Regner ◽

Pia Ruisinger ◽

Julia Knabl ◽

...

Keyword(s):

Heart Rate ◽

Reference Values ◽

Fetal Heart Rate ◽

Fetal Heart ◽

Normal Values ◽

Short Term ◽

Mean Values ◽

Relevant Reference ◽

Term Variation ◽

The Mean

Abstract Aims: Currently one of the most widespread systems for the computerized analysis of the fetal heart rate (FHR) is the Dawes-Redman system, where the short-term variation (STV) of the FHR is measured by dividing each minute into 16 segments (STV16). Technical progress has allowed for the development of a new algorithm, which measures the STV by dividing each minute into 240 segments (STV240), thus approximating the beat-to-beat variation. The STV240 still lacks reference values. Our aim was to develop clinically relevant reference values for the STV240 and compare them to the ones for the STV16. Methods: In a single centre, observational study, a total of 228 cardiotocograms were registered and subsequently analyzed with both algorithms (STV240 and STV16). Results: The 95% confidence interval (CI) was calculated for both algorithms. The values of the STV240 were significantly lower in comparison to the ones of the STV16. Not only the mean values but also the 95th percentile of the STV240 lay beneath the existent cut-off value for the STV16. Conclusions: Every clinician using the new algorithm must be aware that the normal values for the STV240 lie beneath the, up until now, established cut-off values for the STV16.

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Fetal heart rate short term variation during labor in relation to scalp blood lactate concentration

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.13390 ◽

2018 ◽

Vol 97 (10) ◽

pp. 1274-1280 ◽

Cited By ~ 6

Author(s):

Ke Lu ◽

Malin Holzmann ◽

Fahrad Abtahi ◽

Kaj Lindecrantz ◽

Pelle G Lindqvist ◽

...

Keyword(s):

Heart Rate ◽

Blood Lactate ◽

Fetal Heart Rate ◽

Fetal Heart ◽

Lactate Concentration ◽

Blood Lactate Concentration ◽

Short Term ◽

Term Variation

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Correlation of reduced amniotic fluid index with neonatal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172320 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2401 ◽

Cited By ~ 1

Author(s):

Rachna Chaudhary ◽

Vandana Dhama ◽

Shakun Singh ◽

Madhumita Singh

Keyword(s):

Heart Rate ◽

Birth Weight ◽

Low Birth Weight ◽

Amniotic Fluid ◽

Fetal Heart Rate ◽

Neonatal Death ◽

Neonatal Outcome ◽

Fetal Heart ◽

Birth Asphyxia ◽

Apgar Scores

Background: Amniotic fluid assessment is an essential part of evaluation of fetus health in terms of fetal distress, meconium aspiration, IUGR, Non-reassuring fetal heart rate patterns, birth asphyxia, low birth weight, low Apgar-scores and NICU Admissions.Methods: This prospective observational study included 200 antenatal patients of term gestation of which 100 cases with AFI<8 and 100 controls with AFI ≥8 but ≤ 15 were included in study. Ultrasonography and NST were done and results of both groups compared for the presence of meconium passage, non-reactive NST, birth asphyxia, low Apgar-scores, low birth weight, NICU admissions and neonatal deaths.Results: There was increased incidence of non-reactive NST (40% vs 12%), meconium stained (33% vs 10%) in oligohydramnios group. In cases 49% of patients had vaginal delivery while in controls 78%. 51% underwent LSCS in cases while in controls 22%. Apgar score <7 was found in 7% vs 4%. Birth weight was <2.5 kg in 35% vs 13%. NICU admissions in study group was 15% vs 11%. The neonatal death was similar in both cases groups.Conclusions: Oligohydramnios affect the neonatal outcome in terms of meconium stained liquor, non-reassuring fetal heart rate, low birth weight, birth asphyxia, low Apgar-scores and NICU Admissions and neonatal death but the difference was not statistically significant. Early detection of oligohydramnios and its management may help in reduction of perinatal morbidity and decreased caesarean deliveries.

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