scholarly journals Fetal heart rate tracing interpretation in cases of fetal heart block: A case series

2021 ◽  
Author(s):  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Leuwan ◽  
Kuntharee Traisrisilp ◽  
Phudit Jatavan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Vaginal Delivery ◽  
Fetal Heart Rate ◽  
Heart Block ◽  
Fetal Heart ◽  
Complete Heart Block ◽  
Case Series ◽  
Fetal Surveillance ◽  
Degree Heart Block ◽  
Second Degree

Simple assessment of FHR baseline variability can differentiate second degree heart block (SHB) from complete heart block (CHB). In cases of SHB, antepartum NST can be reliably used for fetal surveillance. Intrapartum assessment of FHR variability as well as accelerations is useful to select cases for safe vaginal delivery

scholarly journals Asymptomatic complete heart block in labor: A case report of none response to atropine therapy

2020 ◽  
Author(s):  
Soha Mirreza ◽  
Manijeh Yousefi Moghaddam ◽  
Forough Mortazavi
Keyword(s):  
Heart Rate ◽  
Case Report ◽  
Pulse Rate ◽  
Fetal Heart Rate ◽  
Heart Block ◽  
Fetal Heart ◽  
Complete Heart Block ◽  
Good Condition ◽  
Optimal Care ◽  
Emergency Cesarean

Introduction: A complete heart block is a cardiac electrical conduction disorder with a very rare occurrence in pregnancy, which may be asymptomatic. There are no specific guidelines for the management of asymptomatic complete heart block in labor, vaginal delivery, and cesarean with only a few reports of cesarean management of patients with complete heart block. Case report: A 30-year-old woman, Gravida 4, abortion 3, gestational age of 41 weeks without any specific problems, was referred to our maternity hospital. The pulse rate and blood pressure were 68 and 60/110, respectively. Labor was induced with oxytocin and, after three hours, was discontinued due to late decelerations of fetal heart rate. Electrocardiography confirmed a maternal pulse rate of 42. Cardiac consultation led to the diagnosis of a complete heart block. Due to the frequent late decelerations of fetal heart rate and no response to atropine therapy, the patient was a candidate for a cesarean. Before cesarean, the pacemaker was installed. Cesarean was performed with general anesthesia, and the infant was delivered in good condition. In Postpartum, the pacemaker was removed (PR=55, BP=125/80), and the mother was discharged the next day. Due to the lack of specific guidelines, fetal indication for an emergency cesarean, mother poor obstetrics history, and none response to atropine therapy, we chose to incorporate pacemakers and remove it after cesarean safely. Conclusion: Vital signs assessment during pregnancy and childbirth is recommended to detect cases of complete heart block and provide optimal care.

scholarly journals The Successful Use of Nitroglycerin for Uterine Hyperstimulation with Fetal Heart Rate Abnormality Caused by a Controlled-Release Dinoprostone Vaginal Delivery System (PROPESS): A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 478
Author(s):  
Sho Takakura ◽  
Hiroaki Tanaka ◽  
Naosuke Enomoto ◽  
Shintaro Maki ◽  
Tomoaki Ikeda
Keyword(s):  
Heart Rate ◽  
Controlled Release ◽  
Vaginal Delivery ◽  
Delivery System ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Cervical Ripening ◽  
Emergency Cesarean ◽  
Uterine Hyperstimulation ◽  
Uterine Relaxation

The PROPESS, a controlled-release dinoprostone vaginal delivery system, is a pharmacological cervical ripening intervention and promotes cervical change causing uterine contraction. During insertion of the PROPESS, uterine hyperstimulation could occur and result in fetal heart rate (FHR) abnormality. We report a case of uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS in a pregnant woman. Postural change, oxygenation, fluid infusion, and the immediate PROPESS removal were ineffective to address the adverse event, so we administered nitroglycerin for acute uterine relaxation. The nitroglycerin resulted in uterine relaxation, and the FHR abnormality was resolved immediately, thereby preventing an emergency cesarean section. Therefore, nitroglycerin could be considered an effective option for uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS.

Fetal heart rate changes observed on the CTG trace during instrumental vaginal delivery

2017 ◽  
Vol 32 (1) ◽  
pp. 117-124 ◽  
Author(s):  
Wanying Xie ◽  
Abigail Archer ◽  
Chao Li ◽  
Hongyan Cui ◽  
Edwin Chandraharan
Keyword(s):  
Heart Rate ◽  
Vaginal Delivery ◽  
Fetal Heart Rate ◽  
Fetal Heart

Cesarean delivery due to nonreassuring fetal heart rate: the effect of phase of labor on subsequent vaginal delivery success

2019 ◽  
Vol 33 (22) ◽  
pp. 3798-3803
Author(s):  
Hadas Ganer Herman ◽  
Zviya Kogan ◽  
Tahel Bar-Nof ◽  
Jacob Bar ◽  
Michal Kovo
Keyword(s):  
Heart Rate ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Fetal Heart Rate ◽  
Fetal Heart

Computerized analysis of antepartum fetal heart rate tracings

1997 ◽  
Vol 9 (1) ◽  
pp. 19-34 ◽  
Author(s):  
Edwin R Guzman ◽  
Anthony M Vintzileos
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Death ◽  
Visual Analysis ◽  
Fetal Heart ◽  
Meta Analysis ◽  
Observer Variation ◽  
Fetal Heart Rate Monitoring ◽  
Fetal Surveillance ◽  
Legal Constraints

For several decades, visual analysis of the antepartum fetal heart rate tracing has been a primary mode of fetal surveillance despite lack of proof from randomized trials that its use leads to a reduction in perinatal mortality in high risk pregnancies. A meta-analysis of these trials offered the same conclusion. The trials were performed in the early 1980's with fetal monitors with poor signal to noise ratios and poorer testing schemes in comparison to today. Therefore the results may no longer be pertinent, however, it is unlikely that these trials will be repeated because of present medico-legal constraints. Nonetheless, the use of non-stress testing alone is an accepted mode of fetal surveillance because of associated low fetal death rates within 1 week of a normal test; 1.9 to 3.2/1000 patients tested. The expense associated with this low fetal death rate is a low positive predictive value of 25% to 50%. Interrelated with this inefficiency, is the considerable inter- and intra-observer variation in the interpretation of antepartum fetal heart rate tracings. Variation in the interpretation of antepartum fetal heart rate tracings continues to exist despite the increase in experience and knowledge of fetal heart rate monitoring and improvement in fetal heart rate monitors. The end result is a form of fetal surveillance that is of questionable value and inefficient, requiring frequent back up testing to clarify fetal condition.

scholarly journals Self limiting fetal bradycardia associated with maternal evidence of dengue and chikungunya virus co-infection: a case report

2019 ◽  
Vol 8 (5) ◽  
pp. 2103
Author(s):  
Alka Goel ◽  
Anupriya Narain ◽  
Atul Goel
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Chikungunya Virus ◽  
Fetal Heart ◽  
Baseline Heart Rate ◽  
Tropical Country ◽  
Fetal Bradycardia ◽  
The Third ◽  
Fetal Surveillance ◽  
History Of

Dengue and chikungunya infections are commonly encountered by the clinicians in a tropical country like India. We report this case to emphasize the rare manifestations of self-limiting intrapartum bradycardia in fetuses of chikungunya and dengue infected mothers. A primigravida at 32 weeks of gestation presented with history of fever for one day. The blood investigations were positive for both dengue and chikungunya virus infection. On the third day of fever, NST showed a low baseline fetal heart rate of 95 to 100 beats per minute but good beat to beat variability and three accelerations in 10 minutes. This pattern persisted for 48 hours. Although, the finding initially appeared alarming, the change in baseline heart rate of fetus was transient and self-limiting and recovered completely. Hence, a judicious approach and close fetal surveillance can avoid hasty decisions regarding an early termination of pregnancy.

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