scholarly journals Maternal-fetal acute responses to two moderate-intensity exercise types: a randomized clinical trial

10.3823/2558 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Jousilene de Sales Tavares ◽  
Adriana Suely Oliveira Melo ◽  
Suzana Farias Leite ◽  
Alexandre Sergio Silva ◽  
João Guilherme Alves ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Heart Rate ◽  
Randomized Clinical Trial ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Moderate Intensity ◽  
Maternal Heart Rate ◽  
Group A ◽  
Exercise Type ◽  
Group B

Objective:  This study aims to compare maternal and fetal responses during two physical exercise types. Design:  A randomized clinical trial compared 120 pregnant women, gestational age of 35-37 weeks, 56 exercising on a stationary bicycle (Group A) and 64 on a treadmill (Group B). Methods: Participants were monitored for three 20-minute phases: resting, exercise and recovery.  Fetal heart rate (FHR) and maternal heart rate (MHR) were monitored.  Glucose and lactate levels were evaluated at rest and during exercise. Results:  After the beginning of exercise, maximum lactate (L) levels were reached at 20 minutes and never exceeded 4 mmol/l.  FHR decreased by 22 bpm during exercise in relation to resting values, irrespective of the exercise type (p<0.001).  Comparing the exercise types, the incidence of bradycardia after 10’ was 23.2% in Group A and 35.9% in Group B (p>0.05), increasing at 20’ to 32% and 40.6%, respectively, (p>0.05).  The FHR decrease during exercise was accompanied by a simultaneous increase in its variability (p<0.001), nevertheless a rapid return to resting values was observed shortly after exercise end.  Glucose decreased in both groups irrespective of the exercise type (85 mg/dl at rest; 79 mg/dl during exercise and 81 mg/dl during recovery; p<0.001). There were no hypoglycemia cases. Conclusions: FHR variability increase and the rapid return to resting values after exercise suggests that the FHR fall and the presence of bradycardia during exercise is the fetal physiologic response to blood flow redistribution, with maintenance of fetal well-being. Key-words: Exercise; fetal heart rate; glucose; maternal heart rate; pregnancy Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01383889.

scholarly journals Maternal hemodynamic responses to two different types of moderate physical exercise during pregnancy: a randomized clinical trial

10.3823/2559 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Jousilene de Sales Tavares ◽  
Adriana Melo ◽  
Bruno Maciel ◽  
Amanda Vasconcelos ◽  
Joao Guilherme Alves ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Physical Exercise ◽  
Diastolic Blood Pressure ◽  
Randomized Clinical Trial ◽  
Systolic Pressure ◽  
Moderate Intensity ◽  
Hemodynamic Responses ◽  
Maternal Heart Rate

Background/Aim:  Maternal hemodynamic responses (heart rate, systolic and diastolic blood pressure) were compared during two types of moderate-intensity physical exercise. Methods:  A randomized clinical trial compared 120 pregnant women performing physical exercise on a treadmill (n=64) or stationary bicycle (n=56).  In 44 of these women (n=23 treadmill; n=21 bicycle), blood pressure was monitored for 24 hours following exercise.  Repeated-measures analysis compared maternal heart rate, systolic and diastolic blood pressure before, during and in the 24 hours following exercise in both groups.  Results:  Maternal heart rate increased significantly (p<0.001) with both types of exercise (from 84 at rest to 112 bpm on the treadmill and from 87 at rest to 107 bpm on the bicycle), without exceeding the limit of 140 bpm.  Systolic pressure increased from 110 at rest to 118 mmHg on the bicycle (p=0.06) and from 112 at rest to 120 mmHg on the treadmill (p=0.02).  Systolic pressure dropped steadily following exercise, reaching its lowest level (104 mmHg) after 14 hours, increasing thereafter and returning to pre-exercise levels by the 19th hour.  Diastolic pressure increased during exercise irrespective of the type of exercise (p=0.27), from 70 at rest to 75 mmHg on the bicycle (p=0.39) and from 70 at rest to 76 mmHg on the treadmill (p=0.18), with the lowest level (59 mmHg) being at the 13th hour. Conclusions:  A slight increase in blood pressure levels was found during exercise; however, this was not clinically significant and was followed by a substantial hypotensive effect that lasted around 19 hours. Register: Clinical Trials NCT01383889.

Application of a Proposed Algorithm to Cesarean Deliveries for Nonreassuring Fetal Heart Rate Tracing

2021 ◽  
Author(s):  
Dana Senderoff Berger ◽  
Adam Crosland ◽  
Rachel Newman ◽  
Bradley Bosse ◽  
Joshua Makhoul ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cesarean Delivery ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Tertiary Care ◽  
Academic Community ◽  
Neonatal Outcomes ◽  
Cesarean Deliveries ◽  
Group A ◽  
Group B

Objectives The aim of the study is to evaluate how current management of Category II fetal heart rate tracings compares with that suggested by a published algorithm and whether these differences lead to disparate neonatal outcomes. Study Design This is a retrospective observational study from the resident service at an academic-community tertiary care center from 2013 to 2018. We reviewed archived fetal heart rate tracings from patients with cesarean delivery performed for nonreassuring fetal heart rate tracing and interpreted tracings against the algorithm. We assigned tracings to one of three categories: Group A—consistent; Group B—inconsistent too early (algorithm permits the patient to labor longer); Group C—inconsistent too late (algorithm suggests performing the cesarean delivery sooner). Maternal demographics, features of labor, and neonatal outcomes were compared. Results Of the 110 cases, 27 (24.5%) had a cesarean delivery performed in group A, 49 (44.5%) in group B, and 34 (30.9%) in group C. Baseline characteristics were similar. Of the 49 in group B, 46 (93.9%) violated the algorithm at the same branchpoint. In group C, cesarean deliveries would have been performed on average 244 minutes earlier had the algorithm been used. Neonatal outcomes were not significantly different among the groups, including 5-minute Apgar <7, pH <7.1, and NICU admit. Conclusion Our retrospective application of the algorithm showed that 44.5% of patients who have cesarean delivery for nonreassuring fetal heart rate tracing may be able to labor longer and that violation at a common decision point on the algorithm (moderate variability or accelerations, but a lack of recurrent decelerations) is responsible for nearly all such cesarean deliveries. More studies are needed to evaluate if cesarean delivery rates for nonreassuring fetal heart rate tracing can be reduced without impacting neonatal outcomes using the algorithm. Key Points

scholarly journals COMPARISON OF FREQUENCY OF ABNORMAL FETAL HEART RATE IN CONTINUOUS VERSUS DISCONTINUOUS USE OF OXYTOCIN INFUSION FOR AUGMENTATION OF LABOUR

2021 ◽  
Vol 71 (3) ◽  
pp. 836-39
Author(s):  
Mehwish Anjum ◽  
Nilofar Mustafa ◽  
Qurratulain Mushtaq ◽  
Pakeza Aslam ◽  
Saima Qamar ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Cross Sectional ◽  
Gestation Age ◽  
Oxytocin Infusion ◽  
Group A ◽  
Group B

Objective: To compare the frequency of abnormal fetal heart rate in continuous versus discontinuous use of oxytocin infusion for augmentation of labour. Study Design: Comparative cross sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital Lahore, from Feb to Aug 2018. Methodology: After fulfilling the inclusion criteria, 76 patients were equally divided in two groups A and B. In both groups, at 3 cm dilatation, intravenous infusion of 5 IU oxytocin in 500 cc normal saline was initiated at infusion rate 3.3mIU/minute Carditocography was initiated 10 minutes before infusion and then continued. An increment in infusion of 3.3mIU/minute was done every 20 minutes till 4 to 5 contractions in 10 minutes were achieved. After this, no more increment was done. The maximum rate was 30mIU/minute. Once cervix was 5 cm dilated, infusion was continued in group A and discontinued in group B for 2 hours. Fetal heart rate was noted on cardiotocography from 20 minutes before initiation of infusion till 2 hours after 5cm. Results: Age of the patients was 25.4 ± 3.5 years in group A and 26.1 ± 2.4 years in group B. Mean gestation age was 39.2 ± 1.1 weeks in group A and 38.6 ± 1.3 weeks in group B. Group A had significantly more abnormal fetal heart rate compared to group B (p=0.016). Conclusion: Discontinuous oxytocin infusion in labour showed significantly less abnormal fetal heart rate compared to continuous oxytocin infusion (p=0.016).

scholarly journals Cerebral Hemodynamics and Fetal Behavioral States in IUGR Fetuses

2008 ◽  
Vol 2 (3) ◽  
pp. 76-79
Author(s):  
Graziano Clerici ◽  
Gian Carlo Di Renzo
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Cerebral Hemodynamics ◽  
Group A ◽  
The Mean ◽  
Behavioral States ◽  
Group B ◽  
Lower Impedance ◽  
Singleton Pregnancies

Abstract The aim of this study was to evaluate the hemodynamic patterns in the proximal (M1) and distal (M2) portions of the middle cerebral artery (MCA) during different fetal behavioral states (FBSs) in healthy and IUGR fetuses. After identification of the FBS in 20 normal (group A) and 8 IUGR (group B) singleton pregnancies (36- 40 weeks), flow velocity evaluation was performed on the M1 and M2 segment of the MCA during “quiescence” (FBS 1F) and “activity” (FBS 2F). In the group A, a statistically significant decrease of impedance to flow values was identified in both segments of the MCA during “activity”. In the group B not statistically significant differences were identified in the impedance to flow values during different FBSs. For each segments of MCA it was found significant lower impedance to flow values in the group B for all FBSs. The mean fetal heart rate during “quiescience” was significantly lower than during “activity” in both groups. The results of this study provide evidences of the influence of different FBSs on fetal cerebral hemodynamic patterns. These information should be considered in the evaluation of fetal cerebral hemodynamics.

scholarly journals Telemanagement of Home-Isolated COVID-19 Patients Using Oxygen Therapy With Noninvasive Positive Pressure Ventilation and Physical Therapy Techniques: Randomized Clinical Trial (Preprint)

2020 ◽  
Author(s):  
Aya Sedky Adly ◽  
Mahmoud Sedky Adly ◽  
Afnan Sedky Adly
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Physical Therapy ◽  
Randomized Clinical Trial ◽  
Health Care System ◽  
Oxygen Therapy ◽  
Early Stage ◽  
Home Based ◽  
Group A ◽  
Group B

BACKGROUND With the growing stress on hospitals caused by the COVID-19 pandemic, the need for home-based solutions has become a necessity to support these overwhelmed hospitals. OBJECTIVE The goal of this study was to compare two nonpharmacological respiratory treatment methods for home-isolated COVID-19 patients using a newly developed telemanagement health care system. METHODS In this single-blinded randomized clinical trial, 60 patients with stage 1 pneumonia caused by SARS-CoV-2 infection were treated. Group A (n=30) received oxygen therapy with bilevel positive airway pressure (BiPAP) ventilation, and Group B (n=30) received osteopathic manipulative respiratory and physical therapy techniques. Arterial blood gases of PaO<sub>2</sub> and PaCO<sub>2</sub>, pH, vital signs (ie, temperature, respiratory rate, oxygen saturation, heart rate, and blood pressure), and chest computed tomography scans were used for follow-up and for assessment of the course and duration of recovery. RESULTS Analysis of the results showed a significant difference between the two groups (<i>P</i>&lt;.05), with Group A showing shorter recovery periods than Group B (mean 14.9, SD 1.7 days, and mean 23.9, SD 2.3 days, respectively). Significant differences were also observed between baseline and final readings in all of the outcome measures in both groups (<i>P</i>&lt;.05). Regarding posttreatment satisfaction with our proposed telemanagement health care system, positive responses were given by most of the patients in both groups. CONCLUSIONS It was found that home-based oxygen therapy with BiPAP can be a more effective prophylactic treatment approach than osteopathic manipulative respiratory and physical therapy techniques, as it can impede exacerbation of early-stage COVID-19 pneumonia. Telemanagement health care systems are promising methods to help in the pandemic-related shortage of hospital beds, as they showed reasonable effectiveness and reliability in the monitoring and management of patients with early-stage COVID-19 pneumonia. CLINICALTRIAL ClinicalTrials.gov NCT04368923; https://clinicaltrials.gov/ct2/show/NCT04368923

663: Fetal heart rate and maternal heart rate confusion during intrapartum monitoring: comparison of trans-abdominal fetal ECG and Doppler telemetry

2011 ◽  
Vol 204 (1) ◽  
pp. S261-S262
Author(s):  
Tamara Stampalija ◽  
Maria Signaroldi ◽  
Cristina Mastroianni ◽  
Eleonora Rosti ◽  
Giorgia Loi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Maternal Heart Rate ◽  
Fetal Ecg

scholarly journals Comparison of the effect of Chamomile and Mefenamic Acid on primary dysmenorrhea, associated symptoms and menstrual bleeding – A randomized clinical trial study

2020 ◽  
Author(s):  
Fatemeh Shabani ◽  
Katayon Vakilian ◽  
Fereshteh Narenji ◽  
Mahbubeh Bozorgi ◽  
Soodabeh Bioos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Mefenamic Acid ◽  
Statistical Tests ◽  
Primary Dysmenorrhea ◽  
Verbal Scale ◽  
Associated Symptoms ◽  
Ethics Code ◽  
Group A ◽  
Group B

Abstract Background Dysmenorrhea is one of the most common pelvic pains in women, impairing their quality of life.This study investigated the effects of chamomile sachet and mefenamic acid on primary dysmenorrhea, associated symptoms and bleeding. Methods In this randomized clinical trial, 200 female students with primary dysmenorrhea from Arak universities were randomly assigned to two groups. The group (A) received mefenamic acid (250 mg) and group (B) received chamomile (5000 mg) plus one teaspoonful of honey )as a flavoring( for two days before up to the first three days of menstruation, three times a day in two consecutive cycles. Pain severity, associated symptoms and bleeding were assessed using visual analog scale, Andersch-Milsom Verbal Scale and Higham chart, respectively. Data were analyzed by descriptive and inferential statistical tests by SPSS 21. Results Severe pain during two months after intervention was in 6 (6.3%) of group (B) and 6 (6.3%) in group (A) (p = 0.351, p = 0.332). Mean severity of associated symptoms two months after the treatment was( 4.93 ± 3.54) in group (B) and (5.62 ± 3.54 ) in group (A), indicating further reduction in group (B) but not significant (p = 0.278). Mean of bleeding was (88.71 ± 66.4 vs. 70.54 ± 53. 34) in group (B) and (A) respectively, in two months later. therefore decrease in the two groups but was not significant between groups(p = 0.567). Conclusions It seems chamomile sachet can reduce the severity of pain and bleeding similar to mefenamic acid and even further mitigate the symptoms associated with dysmenorrhea. Trial registration: This study was performed with the proposal approval code of 2611, ethics code of (ARAKMU.REC.1395.164) at Arak University of medical sciences and code of IRCT 2016100825031N5 on 2016.11.08.

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