scholarly journals Late Deceleration

2020 ◽  
Author(s):  
Keyword(s):  
Author(s):  
Sudha V. Patil ◽  
Fatima Zahra Shaikmohammed

Background: Importance of amniotic fluid volume as an indicator of fetal status is being appreciated relatively recently. Around 3% to 8% of pregnant women are presenting with low amniotic fluid at any point of pregnancy. The present study was undertaken to study the outcome of pregnancies with Oligohydramnios [(amniotic fluid index) AFI≤5cm] at or beyond 34 weeks.Methods: This study consists of 50 cases of antenatal patients with oligohydramnios (AFI≤5) at or beyond 34 weeks of gestation compared with age and gestation matched 50 normal liquor (AFI≥5 and ≤25). The outcome measures recorded were labor, gestational age at delivery, amniotic fluid index (AFI), mode of delivery, indication for cesarean section or instrumental delivery, APGAR score and birth weight.Results: In the present study, AFI was significantly decreased in cases (3.74±1.2) compared (12.54±2.5) with controls. Variable deceleration was noted in 14 (28%) and late deceleration in 5 (10%) cases. In control group, 2 (4%) had late deceleration. In cases induced labor is in 14 (28%), spontaneous labor 36 (72%). In cases, term normal vaginal delivery was in 15 (30%), PVD in 6 (12%), LSCS in 28 (56%) and instrumental vaginal delivery in 1 (2%). In controls, full term normal vaginal delivery was in 41 (82%), PVD in 5 (10%), LSCS in 4 (8%). APGAR score <7 at 1 minute was in 19 (38%) and at 5 minutes was in 5 (10%) in cases. Birth weight is reduced in cases. IUGR was reported in 9 (18%) in cases.Conclusions: Pregnancies with Oligohydramnios (AFI≤5) is associated with increased rate of non-reactive NST. Routine induction of labor for Oligohydramnios is not recommended. It is preferable to allow patients to go into spontaneous labor with continuous FHR monitoring. Antepartum diagnosis of Oligohydramnios warrants close fetal surveillance.


Author(s):  
Luis A. Cibils ◽  
Mary Campau Ryerson
Keyword(s):  

Fetal brain damage develops after the loss of FHR variability followed by infantile cerebral palsy due to severe hypoxia in frequently repeated fetal heart rate (FHR) decelerations (transient bradycardia) or prolonged fetal bradycardia, where novel hypxia index is 25 or more, and it is prevented if the hpoxia index is 24 or less. The hypoxia index (HI) is the sum of FHR deceleration durations (min) divided by the lowest FHR (bpm), and multiplied by 100 (Figure 1). The HI is calculated by visual measurement, while it is also suitably calculated by computerized FHR monitoring. Cerebral palsy is prevented when HI is 24 or less with almost zero error probability in the delivery. The cases whose HI was 25 or more will develop cerebral palsy, thus, it can receive early cerebral palsy trearments in neonatal stage. As late deceleration disappeared when the parturient woman changed her posture to lateral one from supine, a parturient woman is recommended to have lateral posture, when they notice the appearance of FHR deceleration during the delivery to disappear deceleration to prevent the increase of HI value. As the HI is adopted not only late deceleration, but also all decelerations and continuous bradycardia, fetal diagnosis will change to objective numeric FHR analysis from the monitoring with vague subjective FHR pattern classification.


2014 ◽  
Vol 741 ◽  
pp. 658-680 ◽  
Author(s):  
Albert Dai

AbstractExperiments on the non-Boussinesq gravity currents generated from an instantaneous buoyancy source propagating on an inclined boundary in the slope angle range $0^{\circ } \le \theta \le 9^{\circ }$ with relative density difference in the range of $0.05 \le \epsilon \le 0.17$ are reported, where $\epsilon = (\rho _1-\rho _0)/\rho _0$, with $\rho _1$ and $\rho _0$ the densities of the heavy and light ambient fluids, respectively. We showed that a $3/2$ power-law, ${(x_f+x_0)}^{3/2}= K_M^{3/2} {B_0'}^{1/2} (t+t_{I0})$, exists between the front location measured from the virtual origin, $(x_f+x_0)$, and time, $t$, in the early deceleration phase for both the Boussinesq and non-Boussinesq cases, where $K_M$ is a measured empirical constant, $B_0'$ is the total released buoyancy, and $t_{I0}$ is the $t$-intercept. Our results show that $K_M$ not only increases as the relative density difference increases but also assumes its maximum value at $\theta \approx 6^{\circ }$ for sufficiently large relative density differences. In the late deceleration phase, the front location data deviate from the $3/2$ power-law and the flow patterns on $\theta =6^{\circ },9^{\circ }$ slopes are qualitatively different from those on $\theta =0^{\circ },2^{\circ }$. In the late deceleration phase, we showed that viscous effects could become more important and another power-law, ${(x_f+x_0)}^{2}= K_{V}^{2} {B_0'}^{2/3} {{A}^{1/3}_0} {\nu }^{-1/3} (t+t_{V0})$, applies for both the Boussinesq and non-Boussinesq cases, where $K_V$ is an empirical constant, $A_0$ is the initial volume of heavy fluid per unit width, $\nu $ is the kinematic viscosity of the fluids, and $t_{V0}$ is the $t$-intercept. Our results also show that $K_V$ increases as the relative density difference increases and $K_V$ assumes its maximum value at $\theta \approx 6^{\circ }$.


Author(s):  
Sunitha C. ◽  
P. S. Rao ◽  
Prajwal S. ◽  
Reema Kumar Bhat

Background: The importance of fetal monitoring during labour has been realized since long. The stress of uterine contractions may affect the fetus adversely especially if the fetus is already compromised, when the placental reserves are suboptimal, or when cord undergoes compression as in those associated with diminished liquor amnii or iatrogenic uterine hyperstimulation due to injudicious use of oxytocin. Even a fetus which is apparently normal in the antenatal period may develop distress during labour. Hence fetal monitoring during antepartum and intrapartum periods is of vital importance for timely detection of fetal distress so that appropriate management may be offered.Methods: This study was a prospective observational study included 100 patients of more than 34 weeks period of gestation were divided into two groups. Patients in labour were analyzed on an Electronic Monitor. Delivery conducted was either by vaginal route, instrumental or by caesarean section depending upon the fetal heart rate tracings and their interpretations as per the case. At the time of delivery umbilical cord blood was taken for the pH analysis. All new born babies were seen by the paediatrician immediately after the delivery and 1 and 5 minute APGAR score assessed for the delivered baby. The various EFM Patterns obtained were compared with the neonatal status at birth using the parameters already mentioned. The false positives and false negatives if any were tabulated. Data so obtained was analyzed statistically thereafter. Statistical Package for Social Sciences (SPSS) Version 13.0 was used for the purpose of analysis.Results: Results revealed that among the 50 subjects of the case group, 7 subjects showed the absence of the beat to beat variability, 12 subjects showed early deceleration, 32 subjects showed late deceleration, and 6 subjects showed the presence of variable deceleration. No significant association of beat to beat variability, early and variable deceleration could be established with meconium staining/NICU admissions/low APGAR. A significant positive association between persistent late deceleration with MSL, APGAR <7 at 1 min, and Instrumental/LSCS delivery was seen. A significant positive association between any CTG abnormality and APGAR at 1 min, type of delivery, and meconium staining was seen.Conclusions: EFM should be used judiciously. Cardiotocography machines are certainly required in the labour room. Equally important is the proper interpretation of the CTG tracings so that unjustified caesarean sections can be minimized, at the same time picking up cases of fetal distress in time which is likely to improve fetal outcome.


2010 ◽  
Vol 12 (4) ◽  
pp. 479-482
Author(s):  
Tatsuhiko Kawarabayashi ◽  
Tadao Kishikawa ◽  
Hideaki Shono ◽  
Hajime Sugimori

Sign in / Sign up

Export Citation Format

Share Document