scholarly journals Fetal Heart Rate Fragmentation

2021 ◽  
Vol 9 ◽  
Author(s):  
Matilde Costa ◽  
Mariana Xavier ◽  
Inês Nunes ◽  
Teresa S. Henriques
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Average Length ◽  
Perinatal Outcomes ◽  
Real Time Analysis ◽  
Inflection Points ◽  
Adverse Perinatal Outcomes ◽  
New Biomarkers ◽  
Symbolic Approach

Intrapartum fetal monitoring's primary goal is to avoid adverse perinatal outcomes related to hypoxia/acidosis without increasing unnecessary interventions. Recently, a set of indices were proposed as new biomarkers to analyze heart rate (HR), termed HR fragmentation (HRF). In this work, the HRF indices were applied to intrapartum fetal heart rate (FHR) traces to evaluate fetal acidemia. The fragmentation method produces four indices: PIP-Percentage of inflection points; IALS-Inverse of the average length of acceleration/deceleration segments; PSS-Percentage of short segments; PAS-Percentage of alternating segments. On the other hand, the symbolic approach studied the existence of different patterns of length four. We applied the measures to 246 selected FHR recordings sampled at 4 and 2 Hz, where 39 presented umbilical artery's pH ≤ 7.15. When applied to the 4 Hz FHR, the PIP, IASL, and PSS showed significantly higher values in the traces from acidemic fetuses. In comparison, the percentage of “words” W1h and W2s showed lower values for those traces. Furthermore, when using the 2 Hz, only IASL, W0, and W2m achieved significant differences between traces from both acidemic and normal fetuses. Notwithstanding, the ideal sampling frequency is yet to be established. The fragmentation indices correlated with Sisporto variability measures, especially short-term variability. Accordingly, the fragmentation indices seem to be able to detect pathological patterns in FHR tracings. These indices have the advantage of being suitable and straightforward to apply in real-time analysis. Future studies should combine these indexes with others used successfully to detect fetal hypoxia, improving the power of discrimination in a larger dataset.

A Linear Time Series Analysis of Fetal Heart Rate to Detect the Variability

2017 ◽  
pp. 471-495 ◽  
Author(s):  
Sahana Das ◽  
Kaushik Roy ◽  
Chanchal Kumar Saha
Keyword(s):  
Heart Rate ◽  
Time Series ◽  
Feature Extraction ◽  
Time Series Analysis ◽  
Real Time ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Linear Time ◽  
Automated Diagnosis ◽  
Real Time Analysis

Real time analysis and interpretation of fetal heart rate (FHR) is the challenge posed to every clinician. Different algorithms had been developed, tried and subsequently incorporated into Cardiotocograph (CTG) machines for automated diagnosis. Feature extraction and accurate detection of baseline and its variability has been the focus of this chapter. Algorithms by Dawes and Redman and Ayres-de-Campos have been discussed in this chapter. The authors are pleased to propose an algorithm for extracting the variability of fetal heart. The algorithm's accuracy and degree of agreement with clinician's diagnosis had been established by various statistical methods. This algorithm has been compared with an algorithm proposed by Nidhal and the new algorithm is found to be better at detecting variability in both ante-partum and intra-partum period.

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.

654: Does central fetal heart rate monitoring system improve perinatal outcomes?

2011 ◽  
Vol 204 (1) ◽  
pp. S258
Author(s):  
Maged Costantine ◽  
Giuseppe Chiossi ◽  
Antonio Saad ◽  
Alberto Falquez ◽  
Ruth Soulsby-Monroy ◽  
...  
Keyword(s):  
Heart Rate ◽  
Monitoring System ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
Heart Rate Monitoring ◽  
Fetal Heart Rate Monitoring

scholarly journals Clinical characteristics and perinatal outcomes of eight cases of umbilical cord vascular rupture

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091924
Author(s):  
Xiaomei Wang ◽  
Zhaozhen Liu ◽  
Shouzhen Chen ◽  
Yu Wang ◽  
Sheng Lin
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Umbilical Cord ◽  
Fetal Heart Rate ◽  
Vaginal Bleeding ◽  
Clinical Characteristics ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
Related Factors ◽  
Umbilical Cord Insertion

Objectives To analyze the clinical characteristics and perinatal outcomes of umbilical cord vascular rupture, and to investigate the diagnosis and treatment strategies for reducing adverse perinatal outcomes. Methods Clinical data of patients with a singleton pregnancy with umbilical cord rupture who were admitted to Fujian Maternity and Child Health Hospital were collected. The incidence, related factors, clinical features and perinatal outcomes of umbilical cord rupture were retrospectively analyzed. Results There were eight cases of umbilical cord rupture (incidence rate: 1/8370). Among them, seven were secondary to umbilical cord insertion abnormality, and one may have been related to a relatively short umbilical cord and umbilical cord traction. There were eight cases of abnormal fetal heart rate, two of vaginal bleeding, five of bloody amniotic fluid, five of premature rupture of the membranes, and two of placental abruption. With regard to outcomes, 50% of patients had cesarean section, 12.5% had forceps delivery, and 50% had perinatal mortality. Conclusions Vaginal bleeding, amniotic fluid, fetal heart rate, and umbilical cord insertion should be closely monitored in pregnancy. When abnormal conditions occur, obstetricians should be aware of rupture of the umbilical vessels and terminate pregnancy as soon as possible, which could improve perinatal outcomes.

scholarly journals Recent Clinical Characteristics of Labors Using Three Japanese Systems of Midwife-Led Primary Delivery Care

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Shunji Suzuki
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
The Other ◽  
Delivery Care ◽  
The Status ◽  
Failure To Progress

Objective. The objective of this study was to describe the recent clinical characteristics of labor using 3 systems of Japanese midwife-led primary delivery care, as follows: (1) those intending to give birth at home managed by midwives who do not belong to our hospital, (2) those planning to give birth in our hospital managed by the same midwives, and (3) those planning to give birth managed by midwives who belong to our hospital.Methods. A retrospective cohort study was performed.Results. There were no significant differences in the obstetric or neonatal outcomes among the 3 groups. The rate of transfers during labor with the system involving midwives belonging to our hospital was higher than those with the other 2 systems. In addition, the timing of transfers in the system with the midwives belonging to our hospital was earlier than with the other 2 systems. Among the 3 groups, there were no significant differences in the rate of the main 2 indications for transfers: fetal heart rate abnormality and failure to progress.Conclusion. There were no significant differences in perinatal outcomes among the 3 systems; however, there were some differences in the status of transfers to obstetric shared care.

scholarly journals Study of perinatal outcomes in normal and borderline oligamnios

2019 ◽  
Vol 9 (1) ◽  
pp. 279
Author(s):  
Divya R. Prasad ◽  
Neelima V. Nair
Keyword(s):  
Heart Rate ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Amniotic Fluid Index ◽  
Meconium Staining

Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.

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