scholarly journals Clinical Validation of Mobile Cardiotocograph Device for Intrapartum and Antepartum Monitoring Compared to Standard Cardiotocograph: An Inter-Rater Agreement Study

2019 ◽  
Author(s):  
Manoja Kumar Das ◽  
Reva Tripathi ◽  
Neeraj Kumar Kashyap ◽  
Sunita Fotedar ◽  
Surender Singh Bisht ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Monitoring ◽  
Clinical Validation ◽  
Rater Agreement ◽  
Electronic Fetal Monitoring ◽  
Blinded Manner ◽  
Fetal Wellbeing ◽  
High Level ◽  
Agreement Study ◽  
Timely Referral

Objective: Electronic fetal monitoring (EFM) using cardiotocograph (CTG) is commonly used both to assess fetal wellbeing in late antepartum and for intervention during intrapartum period. We validated the performance of indigenously developed mobile cardiotocograph (CTG) device with wireless probes compared to standard CTG device. Materials and methods: We sequentially used mobile and standard CTG devices in 495 pregnant women in labour and 359 pregnant women with gestation > 32 weeks. The CTG interpreted by two independent obstetricians in a blinded manner were compared to estimate the agreement by kappa (k) statistic. Results: High level of agreements between mobile and standard CTG devices for both intrapartum (87.9%; kappa 0.61) and antepartum monitoring (91.2%; kappa 0.60) were observed. Most of the pregnant women (80% in intrapartum and 70% in antepartum groups) and all nurses and obstetricians preferred the mobile CTG device over standard CTG device. Conclusion: The mobile CTG device can reliably be used for both intrapartum and antepartum monitoring instead of the standard CTG devices. The smaller size, portability and ability to transmit the recordings for second opinion make it suitable for use by midwives for appropriate triaging and referral. Wider availability of CTG and interpretation support at the peripheral facilities would assist identifying at-risk pregnancies and foetuses for timely referral and appropriate action to reduce perinatal deaths, stillbirths and birth asphyxi.

scholarly journals Self-Fetal Wellbeing Monitoring and Ante-Natal Care during the COVID-19 Pandemic: A Qualitative Descriptive Study among Pregnant Women in Indonesia

2021 ◽  
Vol 18 (21) ◽  
pp. 11672
Author(s):  
Restuning Widiasih ◽  
Dini Hidayat ◽  
Hasballah Zakaria ◽  
Dody Qori Utama ◽  
Maria Komariah ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Care Service ◽  
Descriptive Study ◽  
Structured Interview ◽  
Monitoring Tools ◽  
Qualitative Descriptive ◽  
Fetal Wellbeing ◽  
High Level ◽  
Interview Analysis ◽  
Natal Care

Pregnant women are expected to have a high level of awareness when it comes to checking their fetal health and ensuring their welfare. This study explored the experiences of pregnant women in Indonesia who were monitoring their fetal wellbeing during the COVID-19 pandemic. A qualitativedescriptive study design with a constructivist paradigm was used. Twenty-two pregnant women were recruited and participated in a semi-structured interview. Analysis of the transcribed interviews used a content, thematic and comparative process. Three themes emerged from the analysis: feelingsand responses, changes to the ante natal care service during the COVID-19 pandemic, and the fetal wellbeing monitoring, tools, and methods used. Advice on how pregnant women should conduct fetal wellbeing monitoring during COVID-19 is urgently needed. The results of this study indicate there is a need for interventions to help pregnant women carry out self-fetal wellbeing monitoring in times where they have fewer contacts with health professionals such as during the COVID-19 pandemic.

scholarly journals Characteristics of Heart Rate Tracings in Preterm Fetus

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 528
Author(s):  
Maria F. Hurtado-Sánchez ◽  
David Pérez-Melero ◽  
Andrea Pinto-Ibáñez ◽  
Ernesto González-Mesa ◽  
Juan Mozas-Moreno ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
Fetal Monitoring ◽  
Public Health Issue ◽  
Second Trimester ◽  
Medline Search ◽  
Electronic Fetal Monitoring ◽  
Fetal Wellbeing ◽  
Low Amplitude

Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM). The aims of this narrative review were to summarize the most relevant concepts in the field of CTG interpretation in preterm fetuses, and to provide a practical approach that can be useful in clinical practice. Materials and Methods: A MEDLINE search was carried out, and the published articles thus identified were reviewed. Results: Compared to term fetuses, preterm fetuses have a slightly higher baseline FHR. Heart rate is faster in more immature fetuses, and variability is lower and increases in more mature fetuses. Transitory, low-amplitude decelerations are more frequent during the second trimester. Transitory increases in FHR are less frequent and become more frequent and increase in amplitude as gestational age increases. Conclusions: The main characteristics of FHR tracings changes as gestation proceeds, and it is of fundamental importance to be aware of these changes in order to correctly interpret CTG patterns in preterm fetuses.

738 Sex-specific differences in electronic fetal monitoring patterns

2021 ◽  
Vol 224 (2) ◽  
pp. S462-S463
Author(s):  
Erin Bailey ◽  
Nandini Raghuraman ◽  
Fan Zhang ◽  
Jeny Ghartey ◽  
George A. Macones ◽  
...  
Keyword(s):  
Fetal Monitoring ◽  
Electronic Fetal Monitoring

scholarly journals COVID-19 Pandemic-Related Anxiety in Pregnant Women

2021 ◽  
Vol 18 (14) ◽  
pp. 7221
Author(s):  
Urszula Nowacka ◽  
Szymon Kozlowski ◽  
Marcin Januszewski ◽  
Janusz Sierdzinski ◽  
Artur Jakimiuk ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Pregnant Women ◽  
Generalized Anxiety Disorder ◽  
Social Contact ◽  
Anxiety Level ◽  
Generalized Anxiety ◽  
Daily Routine ◽  
Main Concern ◽  
Pregnancy Anxiety ◽  
Fetal Wellbeing

The COVID-19 pandemic outbreak influenced general and mental health worldwide. The objective of this study was to assess the anxiety level during the COVID-19 pandemic among pregnant women and compare it between COVID-infected and non-infected groups. We prospectively assessed the daily routine and anxiety level using a bespoke questionnaire and GAD-7 scale validated for pregnant women. With logistic regression, we established possible risk factors of generalized anxiety disorder spectrum and main causes of concern. The dataset included 439 responders of our survey. Of which, 21% had COVID-19 infection during pregnancy; 38% were screened for possible generalized anxiety disorder and the proportion was higher in women who suffered from COVID-19 (48% vs. 35%, p = 0.03). Pre-pregnancy anxiety or depression diagnosis and intentional social contact avoidance increased the risk of anxiety (aOR 3.4 and 3.2). Fetal wellbeing was the main concern for 66% of the responders. The COVID-19 pandemic and related restrictions substantially altered daily lives of pregnant women, exaggerating the prevalence of anxiety compared with the pre-COVID-19 studies (38% vs. 15%). COVID-19 infection during pregnancy was associated with increased levels of generalized anxiety scores. Patient-tailored psychological support should be a mainstay of comprehensive antenatal medical care in order to avoid anxiety- and stress-related complications.

Electronic fetal monitoring in the twenty-first century: Language, logic and Lewis Carroll

2020 ◽  
pp. 147775092097180
Author(s):  
Thomas P Sartwelle ◽  
James C Johnston ◽  
Berna Arda ◽  
Mehila Zebenigus
Keyword(s):  
Medical Literature ◽  
Medical Profession ◽  
Scientific Research ◽  
Fetal Monitoring ◽  
First Century ◽  
Lewis Carroll ◽  
Evidence Based ◽  
Electronic Fetal Monitoring ◽  
Complete Failure ◽  
Twenty First Century

The Alice Books, full of illogical thoughts, words, and contradictions, were unrivaled entertainment until the publication of the medical literature promoting electronic fetal monitoring (EFM) for every pregnancy. The modern-day EFM advocates acknowledge EFM’s decades long failure but simultaneously recommend EFM use for lawsuit protection and because the profession has used EFM for every pregnancy for fifty years, therefore, it must be efficacious. These self-indulgent, illogical rationalizations ignore the half century of evidence-based scientific research proving that EFM is a complete failure as well as ignoring the fact that continued EFM use violates the fundamental principles of modern bioethics. This blind advocacy perpetuates four pernicious EFM harms occurring to mothers, babies, and the medical profession itself. This article sets out these four EFM harms with the goal of abolishing the misguided, illogical, contradictory, arguments used by the twenty-first century EFM Lewis Carroll mimics.

Electronic Fetal Monitoring: Physician Liability and Informed Consent

1984 ◽  
Vol 10 (1) ◽  
pp. 31-91
Author(s):  
Myra Gerson Gilfix
Keyword(s):  
Informed Consent ◽  
Fetal Monitoring ◽  
Standard Of Care ◽  
Legal Issues ◽  
Standards Of Care ◽  
Monitoring Technique ◽  
Electronic Fetal Monitoring ◽  
Monitoring Procedure ◽  
Practice Standard ◽  
Physician Liability

AbstractElectronic fetal monitoring (EFM) has been criticized as ineffective, unsafe and costly. Despite existing controversy regarding the risks involved in using EFM, this monitoring procedure continues to be widely employed. In many jurisdictions, in fact, the use of EFM during labor may be considered the customary practice. This Article analyzes the medical and legal issues arising from a physician's use of or failure to use EFM. The Author argues that EFM subjects the mother and the fetus to risks which may be avoided if auscultation, a less intrusive monitoring technique, is employed. The ‘customary practice’ standard of care, the ordinary negligence standard of care, and the ‘best judgment’ and ‘duty to keep abreast’ standards of care are compared and applied to the physician's decision to use EFM. The Author contends that physicians who employ auscultation may not be liable for failing to use EFM; however, physicians who use EFM despite the evidence of its risks may be liable for failing to ‘keep abreast’ or to use their ‘best judgment’ or for negligence. Finally, the Author contends that both physicians and their patients are best protected when the physician elicits the mother's informed consent to employ a particular monitoring technique during labor.

Flattening of Affect and Personal Constructs

1970 ◽  
Vol 116 (530) ◽  
pp. 39-43 ◽  
Author(s):  
F. M. McPherson ◽  
Valerie Barden ◽  
A. Joan Hay ◽  
D. W. Johnstone ◽  
A. W. Kushner
Keyword(s):  
Emotional Expression ◽  
Emotional Response ◽  
Rater Agreement ◽  
Personal Constructs ◽  
Good Definition ◽  
Organic Psychoses ◽  
Tone Of Voice ◽  
High Level ◽  
The Given ◽  
Affective Flattening

Affective flattening is a disorder of emotional expression, of which a good definition is ‘a gross lack of emotional response to the given situation’ (Fish, 1962). It is a clinical sign whose assessment depends upon the clinician's intepretation of the patient's facial expression, tone of voice and content of talk (Harris ' Metcalfe, 1956). Although these are subtle cues, it has been shown that experienced clinicians can assess the severity of affective flattening with a high level of inter-rater agreement (Miller et al., 1953; Harris ' Metcaife, 1956; Wing, 1961; Dixon, 1968). The disorder is usually associated with a diagnosis of schizophrenia, although it may occur in other conditions, such as the organic psychoses (Bullock et al., 1951).

A Prospective Comparison of Selective and Universal Electronic Fetal Monitoring in 34,995 Pregnancies

1987 ◽  
Vol XXXI (3) ◽  
pp. 161???162
Author(s):  
K. LEVENO ◽  
F. CUNNINGHAM ◽  
S. NELSON ◽  
M. ROARK ◽  
M. WILLIAMS ◽  
...  
Keyword(s):  
Fetal Monitoring ◽  
Prospective Comparison ◽  
Electronic Fetal Monitoring
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