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.

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.

scholarly journals Extraction of Fetal Heart Rate from Maternal ECG—Non Invasive Approach for Continuous Monitoring during Labor

Proceedings ◽  
2018 ◽  
Vol 2 (13) ◽  
pp. 1009 ◽  
Author(s):  
Tashreque Mohammed Haq ◽  
Safkat Arefin ◽  
Shamiur Rahman ◽  
Tanzilur Rahman
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Continuous Monitoring ◽  
Good Accuracy ◽  
Fetal Heart ◽  
Signal Separation ◽  
Invasive Approach ◽  
Non Invasive ◽  
Proposed Model ◽  
Fetal Scalp

Here, we propose a signal processing based approach for the extraction of the fetal heart rate (FHR) from Maternal Abdominal ECG (MAECG) in a non-invasive way. Datasets from a Physionet database has been used in this study for evaluating the performance of the proposed model that performs three major tasks; preprocessing of the MAECG signal, separation of Fetal QRS complexes from that of maternal and estimation of Fetal R peak positions. The MAECG signal is first preprocessed with improved multistep filtering techniques to detect the Maternal QRS (MQRS) complexes, which are dominant in the MAECG. A reference template is then reconstructed based on MQRS locations and removed from the preprocessed signal resulting in the raw FECG. This extracted FECG is further corrected and enhanced before obtaining the Fetal R peaks. The detection of FQRS and calculation of FHR has been compared against the reference Fetal Scalp ECG. Results indicate that the approach achieved good accuracy.

Effects of electronic fetal heart rate monitoring on perinatal outcome and obstetric practices

1980 ◽  
Vol 137 (7) ◽  
pp. 758-763 ◽  
Author(s):  
Eberhard Mueller-Heubach ◽  
Hugh M. MacDonald ◽  
Dale Joret ◽  
Mary Ann Portman ◽  
Daniel I. Edelstone ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Heart Rate Monitoring ◽  
Fetal Heart Rate Monitoring

scholarly journals Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace

2010 ◽  
Author(s):  
Christine E East ◽  
Leo R Leader ◽  
Penelope Sheehan ◽  
Naomi E Henshall ◽  
Paul B Colditz
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Scalp

scholarly journals A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Emma R. Allanson ◽  
Robert C. Pattinson ◽  
Elizabeth A. Nathan ◽  
Jan E. Dickinson
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
Heart Rate Monitoring ◽  
Post Intervention ◽  
Fetal Heart Rate Monitoring ◽  
Resource Setting ◽  
The Impact

Abstract Introduction Rates of cesarean section (CS) are increasing and abnormal fetal heart rate tracing and concern about consequent acidosis remain one of the most common indications for primary CS. Umbilical artery (UA) lactate sampling provides clinicians with point of care feedback on CTG interpretation and intrapartum care and may result in altered future practice. Materials and methods From 3rd March - 12th November 2014 we undertook a before and after study in Pretoria, South Africa, to determine the impact of introducing a clinical package of fetal heart rate monitoring education and prompt feedback with UA cord lactate sampling, using a hand-held meter, on maternal and perinatal outcomes. Results Nine hundred thirty-six consecutive samples were analyzed (pre n = 374 and post n = 562). There was no difference in mean lactate (4.6 mmol/L [95%CI 4.4–4.8] compared with 4.9 mmol/L [95%CI 4.7–5.1], p = 0.089). Suspected fetal compromise was reduced in the post-intervention period: 30·2% vs 22·1%, aOR 0·71, 95% CI 0·52–0·96, p = 0·027. Cesarean section rates were significantly reduced in the univariate analysis: pre- 40·3% vs post-intervention 31·6% (p = 0·007). This reduction remained significant when adjusted for previous cesarean section, primiparity, maternal HIV infection and preterm birth (aOR 0·72, 95%CI 0·54–0·98, p = 0·035). Neonatal outcomes did not differ between the two groups. Conclusion The introduction of a clinical practice package of fetal heart rate monitoring education combined with routine UA cord lactate sampling has the potential to reduce the cesarean section rate without increasing adverse neonatal outcomes in a low-resource setting.

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