Using the traditional diagnostic criteria for fetal distress, the investigators found that fetal blood sampling was indicated in 58% of cases in the asphyxia group and in 20% of controls but was only performed in 16% of asphyxiated infants and in 8% of controls. FHR patterns during labor and the results of developmental screening at age 4 were compared between the groups. In one, the condition was almost certainly unrelated to prenatal or perintal factors, whereas in the other five, evidence of chronic fetal asphyxia as well as perinatal asphyxia was elicited.
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment.
The neonatal charts and the autopsy reports were also reviewed. Late decelerations and severe variable decelerations were significant factors associated with fetal acidosis.There is increasing interest in the outcomes of multiple pregnancies as their numbers rise, mainly owing to advances in fertility-enhancing techniques. At E19-20, decelerations typical of early gestation terms were replaced by acceleration-type reactions typical for mature organism, which is related to maturation of coordination function of the nervous system. Newborn rats demonstrated acceleration episodes; their parameters depend on the force of motor bouts; respiratory arrhythmia was not observed.Decreasing fetal distress and possible side effects of it is a golden aim in obstetrics, so diagnosis of fetal distress is important in labour. The incidence of births, stillbirths, neonatal and post-neonatal deaths at each gestation after 28 completed weeks. Design: Two questionnaires on ease of use were also completed. Les résultats de l'étude ont montré que les deux techniques étaient corrélées (R=0.945). We attempted to improve the prediction of acidosis by including meconium staining of the amniotic fluid, but 65% of the variation in umbilical cord artery pH and 72 and 86% of the variation in 1- and 5-minute Apgar scores, respectively, remained unexplained.
The significance of "atypical" SHR pattern with increased amplitude is discussed, along with the need to adhere to strict definition of the SHR pattern.In a large randomized, controlled study of fetal heart rate monitoring with either continuous electronic fetal heart monitoring or auscultation at specified intervals, only one pattern of deviation in the fetal heart rate correlated significantly with neonatal neurologic examinations at 0 to 48 hours and 72 hours to 1 week: late decelerations in stage 1 and in stage 2.
None of the 147 preterm fetuses demonstrated the saltatory pattern (P less than .02). Download Citation | Rythme cardiaque fœtal pendant le travail : définitions et interprétation | Continuous fetal heart rate monitoring is widely used during labor even in low risk pregnancies. Randomised trials comparing fetal ECG waveform analysis with alternative methods of fetal monitoring during labour. In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no obvious difference to primary outcomes: births by caesarean section (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.96 to 1.08; six trials, 26,446 women; high quality evidence); the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (average RR 0.72, 95% CI 0.43 to 1.20; six trials, 25,682 babies; moderate quality evidence); or babies with neonatal encephalopathy (RR 0.61, 95% CI 0.30 to 1.22; six trials, 26,410 babies; high quality evidence). In light of these poor correlations, the current practice of considering cardiotocogram abnormality, meconium staining of the amniotic fluid, acidosis, and low Apgar scores as indicating one single disorder, "fetal distress," is not valid.The type of acidemia (umbilical arterial pH less than 7.2) occurring in newborns with second-stage baseline fetal heart rate (FHR) abnormalities was evaluated in 277 term gestations.
No significant etiologic correlation was found between these clinical correlates and FHR deceleration patterns.
Electronic fetal monitoring is a method to detect risk of fetal asphyxia; analysis and interpretation of FHR patterns are difficult with a high false positive rate, increasing operative deliveries. Les critères d’exclusion étaient une pathologie contre-indiquant des efforts expulsifs ou un antécédent d’utérus cicatriciel, ou une anomalie du rythme cardiaque foetal avant la randomisation. Objectif : L’objectif de l’étude était de déterminer les facteurs prédictifs d’échec de l‘induction du travail à la Maternité Régionale universitaire de Nancy (MRUN) en cas de présentation du siège. Conclusions: Trois facteurs ont influé de manière significative: l’analgésie locorégionale qui a diminué le pourcentage de confusion, la tachycardie maternelle et l’obésité qui l’ont augmenté. Grasset, 2005, p. 179 - Methods: Nous avons évalué la praticabilité d'un analyseur de gaz du sang, le GEM 4000 (IL France), en biologie délocalisée pour la mesure du pH, des lactates et de l'excès de bases au scalp.
In the group with variable decelerations, the umbilical vein PO2 was similar to that of the reference group, whereas the PO2 value in the artery was significantly lower. Population:
contractions frequency, duration, amplitude and relaxation time must be also normal. Matched case-control study based on incidence density sampling of controls. Late deceleration is associated with uterine contraction; the onset, nadir, and recovery occur after onset, peak and end of the contraction.
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