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Fetal heart monitoring

Junichi Sugawara, Daisuke Ochi, Riu Yamashita, Takafumi Yamauchi, Daisuke Saigusa, Maiko Wagata, Taku Obara, Mami Ishikuro, Yoshiki Tsunemoto, Yuki Harada, Tomoko Shibata, Takahiro Mimori, Junko Kawashima, Fumiki Katsuoka, Takako Igarashi-Takai, Soichi Ogishima, Hirohito Metoki, Hiroaki Hashizume, Nobuo Fuse, Naoko Minegishi, Seizo Koshiba, Osamu Tanabe, Shinichi Kuriyama, Kengo Kinoshita, Shigeo Kure, Nobuo Yaegashi, Masayuki Yamamoto, Satoshi Hiyama, Masao Nagasaki
PURPOSE: A prospective cohort study for pregnant women, the Maternity Log study, was designed to construct a time-course high-resolution reference catalogue of bioinformatic data in pregnancy and explore the associations between genomic and environmental factors and the onset of pregnancy complications, such as hypertensive disorders of pregnancy, gestational diabetes mellitus and preterm labour, using continuous lifestyle monitoring combined with multiomics data on the genome, transcriptome, proteome, metabolome and microbiome...
February 19, 2019: BMJ Open
Aura A Sanchez Mejia, Nathan J Rodgers
PURPOSE OF REVIEW: This review aims to describe the assessment of pulmonary hypertension and ventricular function in neonates with congenital diaphragmatic hernia and the long-term follow-up of their pulmonary vascular disease. RECENT FINDINGS: In 2015, the pediatric pulmonary hypertension guidelines from the American Heart Association and American Thoracic Society suggested class I level of evidence B guidelines for routine evaluation of patients with congenital diaphragmatic hernia, including longitudinal care in an interdisciplinary pulmonary hypertension program and following the recommendations offered for all children with pulmonary hypertension...
February 15, 2019: Current Treatment Options in Cardiovascular Medicine
David M Goodman, Pendo Mlay, Nathan Thielman, Maria J Small, John W Schmitt
BACKGROUND: Hypoxia during labor contributes to 2.2 million intrapartum and early neonatal deaths each year. An additional 0.6-1.0 million cases of life-long disability occur because of fetal hypoxia during labor. It is known that fetal heart rate changes in labor correspond to hypoxia and neurologic compromise, but a reliable, low-cost method for detecting these changes is not available. In this study we sought to compare the ability of a handheld Doppler device to detect accelerations as part of the fetal scalp stimulation test and to compare the diagnostic performance of routine intermittent auscultation with auscultation that is augmented with fetal scalp stimulation...
February 13, 2019: BMC Pregnancy and Childbirth
Jared Tepper, Kathryn Corelli, Reshama Navathe, Stephen Smith, Jason K Baxter
OBJECTIVE: To evaluate maternal and neonatal outcomes following management of preterm premature rupture of membranes (PPROM) by two fetal assessment strategies. METHODS: In a retrospective cohort study performed at two hospitals in Philadelphia, Pennsylvania between July 2010 and June 2015, data were reviewed from 180 singleton pregnancies with PPROM at 230 -336 weeks of gestation that underwent expectant management. Outcomes were compared between continuous electronic fetal heart monitoring (EFM) with daily biophysical profile (BPP) ("continuous monitoring") and a non-stress test (NST) three times per day ("periodic monitoring") by using Mann-Whitney U and Fisher exact tests...
February 1, 2019: International Journal of Gynaecology and Obstetrics
Li Yuan, Yanchao Yuan, Zhuhuang Zhou, Yanping Bai, Shuicai Wu
In this paper, a fetal electrocardiogram (ECG) monitoring system based on the Android smartphone was proposed. We designed a portable low-power fetal ECG collector, which collected maternal abdominal ECG signals in real time. The ECG data were sent to a smartphone client via Bluetooth. Smartphone app software was developed based on the Android system. The app integrated the fast fixed-point algorithm for independent component analysis (FastICA) and the sample entropy algorithm, for the sake of real-time extraction of fetal ECG signals from the maternal abdominal ECG signals...
January 22, 2019: Sensors
Janine Zöllkau, Eva-Maria Dölker, Alexander Schmidt, Uwe Schneider, Dirk Hoyer
Background Disturbances in maternal physiology can cause changes in the fetal condition that may lead to impaired fetal development. Synchronous monitoring of cardiac autonomic tone via the assessment of the fetal and maternal heart rate (HR) and heart rate variability (HRV) may provide an appropriate diagnostic window. Methods Partial rank correlation coefficients between the maternal and fetal HR and HRV indices were calculated and verified by testing surrogate data in 315 magnetocardiographic (MCG) recordings from 141 healthy women pregnant with singleton fetuses [18+6 to 39+2 weeks gestational age (WGA)]...
December 20, 2018: Journal of Perinatal Medicine
Eric M Schrauben, Brahmdeep Singh Saini, Jack R T Darby, Jia Yin Soo, Mitchell C Lock, Elaine Stirrat, Greg Stortz, John G Sled, Janna L Morrison, Mike Seed, Christopher K Macgowan
BACKGROUND: To date it has not been possible to obtain a comprehensive 3D assessment of fetal hemodynamics because of the technical challenges inherent in imaging small cardiac structures, movement of the fetus during data acquisition, and the difficulty of fusing data from multiple cardiac cycles when a cardiac gating signal is absent. Here we propose the combination of volumetric velocity-sensitive cardiovascular magnetic resonance imaging ("4D flow" CMR) and a specialized animal preparation (catheters to monitor fetal heart rate, anesthesia to immobilize mother and fetus) to examine fetal sheep cardiac hemodynamics in utero...
January 21, 2019: Journal of Cardiovascular Magnetic Resonance
Kelsey North, Ana Tobiasz, Ryan D Sullivan, Zoran Bursac, Jose Duncan, J Pierce Sullivan, Steven Davison, Danielle L Tate, Stacey Barnett, Giancarlo Mari, Anna N Bukiya
Approximately half of pregnant women engage in alcohol consumption some time during pregnancy. On the other hand, a small percentage of pregnant women undergo surgery and anesthesia at some time during pregnancy. In emergencies, anesthesia has to be administered to patients who are under alcohol intoxication. Anesthetic management during pregnancy while patients are intoxicated with alcohol is challenging. Here, we utilized a retrospective analysis of data available from 17 pregnant baboons that underwent anesthesia with alcohol exposure during mid-pregnancy...
June 2018: Journal of Drug and Alcohol Research
Katharina Schramm, Niklas Grassl, Juliane Nees, Janine Hoffmann, Holger Stepan, Thomas Bruckner, Markus W Haun, Imad Maatouk, Markus Haist, Timm C Schott, Christof Sohn, Sarah Schott
BACKGROUND: Pregnancy can be distressing, particularly if expectant mothers are worried about the well-being of their fetus. Consequently, the desire for reassurance and frequent fetal monitoring is often pronounced. Smart wearable devices and telemedicine are promising tools that could assist women in self-monitoring their pregnancy at home, hence disburdening emergency departments (EDs). They present the possibility to clarify the need for urgent care remotely and offer tighter pregnancy monitoring...
January 7, 2019: JMIR MHealth and UHealth
S F Li, Y Wang, G F Li, Y Y Zhao, L Chen, S Zhang
Objective: To investigate the diurnal rhythms of fetal heart rate in third trimester of pregnancy. Methods: From June 2014 and October 2017, 97 cases of low-risk pregnancy women who received antenatal care and deliveried in Peking University Third Hospital were collected. Totally 130 cases of fetal heart rate and maternal holter monitoring data were analyzed. All cases were singleton pregnancy, cephalic position and had normal perinatal outcome. They were divided into three groups based on gestational age, 29 cases (22...
December 25, 2018: Zhonghua Fu Chan Ke za Zhi
Juulia Lantto, Tiina Erkinaro, Mervi Haapsamo, Heikki Huhta, Hanna-Marja Voipio, A Roger Hohimer, Lowell E Davis, Ganesh Acharya, Juha Rasanen
NEW FINDINGS: What is the central question of this study? At near term gestation, foramen ovale blood flow accounts for a significant proportion of fetal left ventricular output. Can foramen ovale increase its volume blood flow, when right ventricular afterload is increased by main pulmonary artery occlusion? What is the main finding and its importance? Foramen ovale volume blood flow increased during main pulmonary artery occlusion. However, this increase was attributable to a rise in fetal heart rate, because left ventricular stroke volume remained unchanged...
December 22, 2018: Experimental Physiology
Tingting Xu, Xiaodong Wang, Hong Luo, Haiyan Yu
RATIONALE: Sirenomelia is a very rare congenital malformation and characterized by fused lower extremities, oligohydramnios, renal agenesis, absent urinary tract and external genitalia, single umbilical artery, and imperforate anus. Ultrasonography is an optimal method for prenatal screening and diagnosis of sirenomelia. The incidence of sirenomelia in the twin pregnancy is extremely low. PATIENT CONCERNS: We reported a case of 1 twin with sirenomelia in dichorionic-diamniotic twin pregnancy after in vitro fertilization and embryo transfer...
December 2018: Medicine (Baltimore)
Nicole R Gavin, Benjamin K Kogutt, William Fletcher, Linda M Szymanski
OBJECTIVE: The primary purpose of this study was to examine maternal and fetal responses to a typical, moderate-intensity yoga session in healthy pregnant women during the third trimester using continuous monitoring. METHODS: This prospective observational study in low-risk, pregnant women used the Monica AN24 Abdominal ECG wireless maternal-fetal monitor to measure fetal heart rate, maternal heart rate, and uterine activity during a prenatal yoga session. Sessions included 4 time periods: (1) 20-minute rest, (2) 50 minutes standard prenatal yoga, (3) 10-minute meditation, (4) 20-minute recovery...
December 20, 2018: Journal of Maternal-fetal & Neonatal Medicine
Radek Martinek, Radana Kahankova, Boris Martin, Jan Nedoma, Marcel Fajkus
This paper introduces a comprehensive fetal Electrocardiogram (fECG) Signal Extraction and Analysis Virtual Instrument that integrates various methods for detecting the R-R Intervals (RRIs) as a means to determine the fetal Heart Rate (fHR) and therefore facilitates fetal Heart Rate Variability (HRV) signal analysis. Moreover, it offers the capability to perform advanced morphological fECG signal analysis called ST segment Analysis (STAN) as it seamlessly allows the determination of the T-wave to QRS complex ratio (also called T/QRS) in the fECG signal...
November 28, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Sara Rivenes Lafontan, Johanne Sundby, Hussein L Kidanto, Columba K Mbekenga, Hege L Ersdal
In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants' perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning process is crucial to further improve training programs and ensure correct, long-term use...
December 14, 2018: International Journal of Environmental Research and Public Health
Tiziana Nervo, Alessia Bertero, Mariagrazia Poletto, Paola Pregel, Roberta Leone, Valentina Toffoli, Leila Vincenti
The aim of this study was to collect and analyze ultrasound measurements of fetal-maternal structures during normal and pathological pregnancies in jennies, a livestock species of growing interest. For two breeding seasons, 38 jennies of different breeds and crossbreeds aged between 3 and 18 years were monitored weekly by transrectal examination using a portable Esaote ultrasound (MyLab™ 30 GOLD VET) with a 5-7.5 MHz probe. The jennies were divided into two groups, < 250 kg and >250 kg body weight, and the dates of conception and parturition/abortion were recorded to calculate pregnancy length...
November 22, 2018: Theriogenology
Alan J Rosenbaum, Rachel M Smith, Erinn M Hade, Ashish Gupta, Alper Yilmaz, Michael Cackovic
INTRODUCTION: Fetal heart rate monitoring presents one of the few available methods for evaluating the fetus prior to birth. However, current devices on the market have significant shortcomings. We sought to describe the use and experiences with external fetal monitoring (EFM) devices among obstetrical providers. MATERIALS AND METHODS: We performed a cross-sectional survey in an academic medical center between April and July 2017 including nurse, midwife, and physician obstetrical providers (n = 217) who were invited to participate in this study regarding their experiences with the external fetal monitoring (EFM) device utilized by their hospital system in the outpatient, inpatient, and labor and delivery (L&D) settings...
December 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
Jennifer M Lynch, J William Gaynor, Daniel J Licht
Infants born with critical congenital heart disease are at risk for neurodevelopmental morbidities later in life. In-utero differences in fetal circulation lead to vulnerabilities which lead to an increased incidence of stroke, white matter injury, and brain immaturity. Recent work has shown these infants may be most vulnerable to brain injury during the early neonatal period when they are awaiting their cardiac surgeries. Novel imaging and monitoring modalities are being employed to investigate this crucial time period and elucidate the precise timing and cause of brain injury in this population...
December 2018: Seminars in Pediatric Neurology
Christopher A Lear, Jenny A Westgate, Austin Ugwumadu, Jan G Nijhuis, Peter R Stone, Antoniya Georgieva, Tomoaki Ikeda, Guido Wassink, Laura Bennet, Alistair J Gunn
Electronic fetal heart rate (FHR) monitoring is widely used to assess fetal well-being throughout pregnancy and labor. Both antenatal and intrapartum FHR monitoring are associated with a high negative predictive value and a very poor positive predictive value. This in part reflects the physiological resilience of the healthy fetus and the remarkable effectiveness of fetal adaptations to even severe challenges. In this way, the majority of "abnormal" FHR patterns in fact reflect a fetus' appropriate adaptive responses to adverse in utero conditions...
December 2018: Seminars in Pediatric Neurology
Kirsten Wisner, Carrie Holschuh
The use of intermittent auscultation (IA) for fetal surveillance during labor decreased with the introduction of electronic fetal monitoring (EFM). The increased use of EFM is associated with an increase in cesarean births. IA is an evidence-based method of fetal surveillance during labor for women with low risk pregnancies and considered one component of comprehensive efforts to reduce the primary cesarean rate and promote vaginal birth. Many clinicians are not familiar with IA practice. This practice monograph includes information on IA techniques; interpretation and documentation; clinical decision-making and interventions; communication; education, staffing, legal issues, and strategies to promote implementation of IA into practice...
December 2018: Nursing for Women's Health
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