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intrauterine resuscitation during labor

Robert D Eden, Mark I Evans, David W Britt, Shara M Evans, Barry S Schifrin
OBJECTIVE: The cardiotocograph (CTG) or electronic fetal monitoring (EFM) was developed to prevent fetal asphyxia and subsequent neurological injury. From a public health perspective, it has failed these objectives while increasing emergency operative deliveries (emergency operative deliveries (EODs) - emergency cesarean delivery or operative vaginal delivery) for newborns, who in retrospect, actually did not require the assistance. EODs increase the risks of complications and stress for patients, families, and medical personnel...
October 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
Nandini Raghuraman, Leping Wan, Lorene A Temming, Candice Woolfolk, George A Macones, Methodius G Tuuli, Alison G Cahill
Importance: Two-thirds of women in labor receive supplemental oxygen to reverse perceived fetal hypoxemia and prevent acidemia. Oxygen is routinely administered for category II fetal heart tracings, a class of fetal tracing used to designate intermediate risk for acidemia. This liberal use of oxygen may not be beneficial, particularly because neonatal hyperoxygenation is harmful. Objective: To test the hypothesis that room air is noninferior to oxygen in improving fetal metabolic status among patients with category II fetal heart tracings...
September 1, 2018: JAMA Pediatrics
Hadas Ganer Herman, Liliya Tamayev, Rotem Houli, Hadas Miremberg, Jacob Bar, Michal Kovo
BACKGROUND: We aimed to characterize factors associated with nonreassuring fetal heart (FHR) tracings after artificial rupture of membranes (AROM), during the active phase of labor. METHODS: Delivery charts of patients who presented in spontaneous labor, at term, between 2015 and 2016 were reviewed. We identified cases in which AROM was performed during the active stage of labor. We compared deliveries with a normal FHR and those who developed nonreassuring FHR...
April 24, 2018: Birth
Nana-Ama E Ankumah, Sean C Blackwell, Mesk A Alrais, Farah H Amro, Rachel L Wiley, Patricia Heale, Maria Hutchinson, Baha M Sibai
BACKGROUND:  Although supplemental oxygen (SO2 ) is routinely administered to laboring gravidas, benefits and harms are not well studied. OBJECTIVE:  This article compares strategies of liberal versus indicated SO2 therapy during labor on cesarean delivery (CD) rate and neonatal outcomes. STUDY DESIGN:  A controlled, before-and-after trial of laboring women with term, singleton pregnancies. During an initial 8-week period, maternal SO2 was administered at the discretion of the provider followed by an 8-week period where SO2 was to be given only for protocol indications...
September 2018: American Journal of Perinatology
Mark I Evans, Robert D Eden, David W Britt, Shara M Evans, Barry S Schifrin
BACKGROUND: Even key opinion leaders now concede that electronic fetal monitoring (EFM) cannot reliably identify fetal acidemia which many vouch as the only labor mediated pathophysiologic precursor for cerebral palsy (CP). We have developed the "Fetal Reserve Index" - an algorithm combining five dynamic components of EFM (1. Rate, 2. Variability, 3. Accelerations, 4. Decelerations, and 5. Excessive uterine activity) considered individually that are combined with the presence of: 6...
February 28, 2018: Journal of Maternal-fetal & Neonatal Medicine
Nandini Raghuraman, Alison G Cahill
Electronic fetal monitoring (EFM) is widely used to assess fetal status in labor. Use of intrapartum continuous EFM is associated with a lower risk of neonatal seizures but a higher risk of cesarean or operative delivery. Category II fetal heart tracings (FHTs) are indeterminate in their ability to predict fetal acidemia. Certain patterns of decelerations and variability within this category may be predictive of neonatal morbidity. Adjunct tests of fetal well-being can be used during labor to further triage patients...
December 2017: Obstetrics and Gynecology Clinics of North America
Lauren M Bullens, Suzanne Moors, Pieter J van Runnard Heimel, M Beatrijs van der Hout-van der Jagt, S Guid Oei
OBJECTIVE: Solid evidence on the effect of intrauterine resuscitation on neonatal outcome is limited, and superiority of one intervention over the others is not clear. We therefore surveyed the clinical practice variation in fetal monitoring and the management of fetal distress during labor, in Dutch labor wards. In addition, we have compared recommendations from international guidelines. STUDY DESIGN: We conducted a survey among all 86 Dutch hospitals, using a questionnaire on fetal monitoring and management of fetal distress...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lauren M Bullens, Pieter J van Runnard Heimel, M Beatrijs van der Hout-van der Jagt, S Guid Oei
IMPORTANCE: Intrauterine resuscitation techniques during term labor are commonly used in daily clinical practice. Evidence, however, to support the beneficial effect of intrauterine resuscitation techniques on fetal distress during labor is limited and sometimes contradictory. In contrast, some of these interventions may even be harmful. OBJECTIVE: To give insight into the current evidence on intrauterine resuscitation techniques. In addition, we formulate recommendations for current clinical practice and propose directions for further research...
August 2015: Obstetrical & Gynecological Survey
A Herrera-Gómez, O García-Martínez, J Ramos-Torrecillas, E De Luna-Bertos, C Ruiz, F M Ocaña-Peinado
OBJECTIVE: our objective was to determine the association between epidural analgesia and different variables. BACKGROUND: the effect on newborns of epidural analgesia administered to the mother during labour remains under debate. METHOD: this association was retrospectively investigated in a cohort of 2399 children born in a Spanish public hospital. Only full-term (>37 weeks of gestation) deliveries were included. Other exclusion criteria were: induced delivery (medical or obstetric indication), elective caesarean section, or the presence of an important pregnancy risk factors (hypertension, diabetes, severe disease, toxaemia, retarded intrauterine growth, chronologically prolonged pregnancy, prolonged membrane rupture (>24 hours), oligoamnios, or polyhydramnios)...
June 2015: Midwifery
Kathleen Rice Simpson
No abstract text is available yet for this article.
March 2015: MCN. the American Journal of Maternal Child Nursing
Fatima A Haggar, Gavin Pereira, David Preen, C D'Arcy Holman, Kristjana Einarsdottir
OBJECTIVE: To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring. METHODS: Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982-2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery...
2014: PloS One
O Parant, P Guerby, F Bayoumeu
OBJECTIVES: To describe the characteristics of post-partum hemorrhage (PPH) associated with cesarean section (CS), the modalities diagnosis and specific obstetric and anesthetic management. MATERIALS AND METHODS: Bibliographic search restricted to French and English languages using Medline database(®) and international guidelines of medical societies. RESULTS: Primary PPH associated with CS (incidence 3-15%) is defined as vaginal bleeding ≥500mL within 24hours after surgery...
December 2014: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Nicolette A Hodyl, Luke E Grzeskowiak, Michael J Stark, Wendy Scheil, Vicki L Clifton
OBJECTIVE: To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes. DESIGN: Retrospective cohort study from 1 January 1999 to 31 December 2008. SETTING: All singleton births in South Australia. PARTICIPANTS: Population-based birth records of pregnancies to Aboriginal women (n = 4245) and non-Aboriginal women (n = 167 746). MAIN OUTCOME MEASURES: Adjusted odds ratios (aORs) and 95% CIs for adverse maternal and neonatal outcomes according to Aboriginal status and maternal smoking in pregnancy...
September 1, 2014: Medical Journal of Australia
Ho Sik Moon, Jin Young Chon, Weon Joon Yang, Hae Jin Lee
Subdural injection of epidural anesthesia is rare and is usually undiagnosed during epidural anesthesia causing severely delayed maternal hypotension, hypoxia, and fetal distress. A 38-year-old primiparous woman was administered epidural labor analgesia at 40(+6) weeks' gestation, and developed progressive maternal respiratory depression, bradycardia, and hypotension after accidental subdural administration of the anesthetic agent. Furthermore, fetal distress occurred soon after administration. The patient was managed with oxygen, position changes, fluid resuscitation, and ephedrine...
June 2013: Korean Journal of Anesthesiology
R Marr, J Hyams, V Bythell
This case report describes the management of a patient, diagnosed with an intrauterine death at 31 weeks' gestation, who suffered a cardiorespiratory arrest during her induced labour while using a remifentanil PCA. She made a full recovery from resuscitation which included a peri-mortem caesarean section.
March 2013: Anaesthesia
Maria Katarzyna Kornacka, Katarzyna Kufel
Cesarean section is the most commonly performed procedure all over the world. Both American and European data reveal constant and steady increase of pregnancies resolved by a cesarean section. The reasons include: growing number of medical indications or requests of the pregnant women. Regardless of the fact that elective cesarean section decreases the risk of intrauterine hypoxia, meconium aspiration and injury during labor it remains a significant risk factor for respiratory failure in the course of transient tachypnea of the newborn, infant respiratory distress syndrome and pulmonary hypertension, both for term and late preterm infants...
August 2011: Ginekologia Polska
Thomas J Garite, Kathleen Rice Simpson
Intrauterine resuscitative measures are commonly initiated during labor when the fetal heart rate (FHR) pattern is indeterminate or abnormal. The most effective use of these measures is directed at the presumed underlying cause. However, some FHR patterns are nonspecific, while others are such that intrauterine resuscitation will not remedy the situation. The goals of intrauterine resuscitation during labor are, at its best, to reverse any hypoxia that might lead to further deterioration, and at the very least to avoid prolonged periods of indeterminate or abnormal FHR patterns, which may cause unnecessary concern for caregivers and patients and unnecessary operative intervention...
March 2011: Clinical Obstetrics and Gynecology
Myrvete Paçarada, Fehmi Zeqiri, Sejdullah Hoxha, Zeqir Dervishi, Niltene Kongjeli, Gyltene Kongjeli, Hana Qavdarbasha
PURPOSE: The main goal of this study was to investigate the impact of parity and intrauterine fetal condition on vacuum extraction. MATERIAL AND METHODS: This study included 10742 newborns who were delivered during 2008 in obstetrics/gynecology clinics in Kosovo, Yugoslavia. One hundred fifty-eight of these were vacuum deliveries. Data were collected for indicators such as parity, maternal age, gestation duration, newborn vitality, and birth weight. RESULTS: Vacuum extraction was used in 158 cases (1...
2010: Medicinski Arhiv
Kathleen Rice Simpson
Intrauterine resuscitation techniques are often used during labor when the fetal heart rate pattern is nonreassuring. These techniques have not been well studied; common practices are based on classic studies many years old. Models of intrauterine resuscitation using one (or more) technique as a first-line intervention and adding others in a specific series or clinical algorithm based on fetal response have not been tested. Maternal oxygen therapy is often used; however, recent evidence suggests potential risks to the mother and fetus or newborn...
December 2008: Seminars in Fetal & Neonatal Medicine
E Verspyck, L Sentilhes
OBJECTIVES: To determine labour management procedures associated with an increased risk of fetal heart rate anomalies and to assess the effectiveness of various intrauterine resuscitation techniques for fetal distress. METHODS: The literature search was carried out systematically on Medline and Cochrane database between 1980 and June 2007 was performed. RESULTS: Early amniotomy and/or active management of labour reduce the duration of the first stage of labour without affecting the rate of caesarean section (level of evidence 1)...
February 2008: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
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