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PubMed1994

A non-invasive optical technique for intrapartum fetal monitoring: preliminary clinical studies.

A relatively new optical method based on near infra-red spectroscopy was evaluated in preliminary clinical trials for noninvasive intrapartum fetal monitoring. The measurements were performed using mainly the light reflection mode of monitoring. Continuous monitoring of changes in the concentrations of oxygenated and deoxygenated haemoglobin and thus changes in total haemoglobin concentration in the fetal brain was achieved. It was found that uterine contractions can influence in a distinctive manner the near infra-red derived cerebral haemoglobin concentration changes in the fetus. The results indicate that near infra-red spectroscopy could offer a non-invasive real-time monitoring method for in vivo monitoring of blood oxygenation in the fetal brain. We conclude that this technique may be useful for intrapartum fetal monitoring and in predicting fetal cerebral hypoxia.

Brain Chemistry↗
PubMed2005

The Cook-Swartz venous Doppler probe for the post-operative monitoring of free tissue transfers in the United Kingdom: a preliminary report.

Accurate assessment of the perfusion of free tissue transfers has always been a challenge for surgeons undertaking microvascular reconstructive procedures. The complexities of flap microcirculation are often difficult to assess despite all the subjective and objective examination techniques available today, particularly when the free tissue transfer is buried, and not visible for monitoring. The Cook-Swartz venous Doppler system is a technique for monitoring venous flow in free tissue transfer consisting of an implantable, removable, 20 MHz ultrasonic probe around the venous pedicle and a battery operated portable monitor. We perceive it as a quick and easy to use system, which in our study was well received by both medical and nursing staff. It can be used in conjunction with other monitoring techniques and we found it of value following revascularisation, during inset and in post-operative monitoring of free flaps particularly when operating outside our base hospital. We believe our initial experiences, on 24 patients, with the device, supports the use of a Cook-Swartz probe as an adjunct to traditional clinical monitoring techniques. We have had no technical difficulties with its application, use and removal, so far and we plan to continue with its use when it becomes available outside of a clinical trial.

Arm Injuries↗
PubMed2006

Monitoring analgesia.

Analgesia (pain relief) amnesia (loss of memory) and immobilisation are the three major components of anaesthesia. The perception of pain, and therefore, the need for analgesia, is individual, and the monitoring of analgesia is indirect and, in essence, of the moment. Under general anaesthesia, analgesia is continually influenced by external stimuli and the administration of analgesic drugs, and cannot be really separated from anaesthesia: the interaction between analgesia and anaesthesia is inescapable. Autonomic reactions, such as tachycardia, hypertension, sweating and lacrimation, although non-specific, are always regarded as signs of nociception or inadequate analgesia. Autonomic monitoring techniques, such as the analysis of heart rate variability, laser Doppler flowmetry, phlethysmographically derived indices and the pupillary light reflex, may help to quantitate reactions of the autonomic nervous system. For the past few years, automated electroencephalographic analysis has been of great interest in monitoring anaesthesia and could be useful in adapting the peroperative administration of opioids. A range of information collected from the electroencephalogram, haemodynamic readings and pulse plethysmography might be necessary for monitoring the level of nociception during anaesthesia. Information theory, multimodal monitoring, and signal processing and integration are the basis of future monitoring.

Analgesia↗
PubMed2006

Clinical evaluation of the eBsensor hand-held blood glucose monitoring system.

BACKGROUND: Home glucose monitoring system is increasingly recognized as an important tool for glycemic control. We evaluated the clinical performance of the eBsensor glucose monitoring system. METHODS: Fingertip capillary blood glucose concentrations from 282 subjects were measured using eBsensor glucose monitoring system and compared against predicate devices and the Yellow Springs Instruments (YSI) 2300 blood glucose analyzer. Accuracy and precision of the eBsensor glucose monitoring system were assessed using several methods. The comparative study between the eBsensor and 2 currently marketed monitoring systems was performed. RESULTS: The 282 eBsensor readings covered a wide range from 2.6 to 24.4 mmol/l. Deming regression and Pearson correlation analyses showed a linear relationship between the eBsensor readings and the YSI reference method (eBsensor=0.9496 YSI+0.4127 mmol/l; r=0.98). Error Grid analysis demonstrated that 100% of the eBsensor readings in clinically acceptable zones A and B. The CVs for the 6 lots of strips were within the satisfactory interval (<6%). The comparative study showed that the eBsensor readings correlated well with the OneTouch Ultra values (r=0.97) and the Glucocard II values (r=0.97). CONCLUSIONS: eBsensor is a reliable glucose monitoring system which provides high accurate and precise glucose readings over a wide range of glucose concentrations.

Blood Glucose Self-Monitoring↗
PubMed2006

Continuous EEG monitoring in a paediatric intensive care unit.

Monitoring with continuous EEG (cEEG) has become a valuable tool in the adult neurointensive care unit. The benefits of cEEG or amplitude-integrated EEG in neonatal intensive care have also been described. The aim of the present study was to describe and evaluate the use of cEEG in a paediatric intensive care unit. The study is a description of children and adolescents with acute neurological disorders monitored by cEEG in a paediatric intensive care unit for more than 12h. The indication for cEEG and the outcome are reported for 54 patients during a 4-year period. Twelve patients were monitored for high intracranial pressure, eight of whom died. Fourteen were monitored due to suspected, but not detected, epilepsy, their underlying diagnoses being variable. Refractory status epilepticus was the reason for cEEG in 24 cases. All of these patients survived the acute phase of status epilepticus. Four patients had seizure activity on cEEG due to global anoxia; these were not classified as status epilepticus. In conclusion, in the paediatric intensive care unit the most important indication for cEEG monitoring is in patients with suspected refractory status epilepticus where it adds to the diagnosis and choice of treatment. Continuous EEG should therefore be part of the paediatric intensive care unit technical support to select and monitor, among children with critical neurological disorders, those with refractory status epilepticus.

Adolescent↗
PubMed2006

Placement of the Bravo wireless pH monitoring capsule onto the gastric wall under endoscopic guidance.

BACKGROUND: The Bravo system was designed mainly to monitor esophageal pH, and there have been no reports on gastric pH monitoring using this system. OBJECTIVE: To place the Bravo capsule on the gastric wall and monitor gastric pH. DESIGN: Experimental clinical trial with the cooperation of volunteers. SETTING: Academic medical center. PATIENTS: Eleven volunteers (9 men, 2 women; mean age 38 years; 3 had symptoms of GERD). INTERVENTIONS: The Bravo system was introduced into the esophagus and stomach along a thin endoscope and capsules were attached, one each to the esophageal and gastric walls under direct vision through the endoscope. Esophageal and gastric pHs were simultaneously monitored. RESULTS: The 2 capsules were successfully placed in 10 of the 11 subjects, and both esophageal and gastric pHs were monitored for 48 hours in 9 subjects. Mild to moderate precordial pain was observed in 7 subjects, but no other complications or side effects were observed in this study. The gastric pH of 10 subjects increased after meals and returned to baseline pH 2 hours later. Decrease of esophageal pH was observed 1 hour after a meal in the symptomatic subjects and corresponded to the time when gastric pH decreased secondary to the increase of pH with meals. CONCLUSIONS: The Bravo capsule is easily placed on the gastric wall under endoscopic assistance and enables long ambulatory monitoring of gastric pH.

Adult↗
PubMed2004

Peripheral nerve stimulators can inhibit monitor display of pacemaker pulses.

The operating room monitors that are currently available use digital signal processing techniques to acquire and display electrocardiograms (ECGs). As a result, pacemaker impulses are interpreted as noise and thus filtered from the final display. For these signals to be displayed, the monitor must be manually reconfigured away from the default state. However, the displaying of the pacemaker impulse remains a digital process, and the monitor "paints" this signal (and other noise) back into the displayed ECG as a pacemaker impulse. Two surgical cases are reported that demonstrate monitor malfunction in systems with digitally processed ECGs during application of nerve stimulator signals to the patient. In one case, application of a 100-Hz tetany signal completely abolished the displayed pacemaker pulses. In the second case, application of a 50-Hz tetany signal abolished appropriate display but caused the monitor to display artifactual pacemaker pulses. Knowledge of undesirable monitor behavior can reduce inappropriate therapy in the operating room.

Aged↗
PubMed2005

Influence of bispectral index monitoring on decision making during cardiac anesthesia.

STUDY OBJECTIVE: To assess bispectral index (BIS) monitoring on decision making during cardiac surgery with cardiopulmonary bypass (CPB) by measuring the number of preset standardized comments with and without knowing the BIS value and by classifying the interventions following the BIS data. DESIGN: Prospective, randomized study. SETTING: University Hospital. PATIENTS: One hundred twenty-one patients scheduled for elective cardiac surgery (89 coronary patients, 24 valve replacement patients, and 8 valve replacement and coronary surgery). INTERVENTIONS: Patients were divided into 3 groups. An observing anesthesiologist recorded on a special form ("parallel" anesthesia record) data from the devices of the workstation and the BIS monitor. Conditions in which BIS monitoring was subjectively considered that might have been useful in anesthetic decision making were recorded as "events." In group A (36 patients), the responsible anesthesiologist had continuous access to BIS information. In group B (44 patients), intraoperative anesthetic management was "blinded" to BIS values, whereas in group C (41 patients), the anesthesiologist observing the BIS monitor was free to inform the attending anesthesiologist about the BIS score. The number of events was considered as negatively reflecting the quality of the clinical course of a patient. The reduction of events was considered as improvement in decision making. All patients received the same anesthetic regimen (propofol + remifentanil). Monitoring was equal in all cases. Mild hypothermic CPB was applied in 73 patients. Statistical analysis used 1-way analysis of variance, Student 2-tailed t test, and chi2 analysis. MAIN RESULTS: Patient demographic data, underlying pathology, operation performed, hypothermia application, times of anesthesia, duration of operation, and CPB were similar in the 3 groups. In group B, the BIS value was considered by the observer as useful to know in 220 events (5.00 +/- 1.58 per patient). In group C, the BIS value was considered by the observer as useful to know in 143 events (3.49 +/- 1.31 per patient, P < 0.001) and, at the same time, the attending anesthesiologist was informed about BIS. In 112 (78.3%) cases, measures were taken. Titration of anesthetic drugs was done in 79 (70.5%) patients, whereas titration of vasoactive drugs was done in 9 (8.0%) patients, titration of both in 13 (11.6%) patients, and other diagnostic or corrective actions in 11 (9.8%) patients. Distributions of BIS values did not differ statistically (39.19 +/- 10.32, 37.38 +/- 10.21, and 38.29 +/- 10.01 in group A, group B, and group C, respectively). "Zenith" and "nadir" BIS values after induction also did not differ statistically. Awakening and extubation times were similar in both groups. CONCLUSIONS: Subjectivity, although reduced as much as possible, can play a confining role in the value of our results. The usefulness of BIS monitoring is shown by the fact that BIS data resulted in corrective measures. Attending anesthesiologist's actions, based on BIS information, reduced the events in group C.

Aged↗
PubMed2006

An algorithm for continuous real-time QT interval monitoring.

QT interval measurement in the patient monitoring environment is receiving much interest because of the potential for proarrhythmic effects from both cardiac and noncardiac drugs. The American Heart Association and American Association of Critical Care Nurses practice standards for ECG monitoring in hospital settings now recommend frequent monitoring of QT interval when patients are started on a potentially proarrhythmic drug. We developed an algorithm to continuously measure QT interval in real-time in the patient monitoring setting. This study reports our experience in developing and testing this automated QT algorithm. Compared with the environment of resting ECG analysis, real-time ECG monitoring has a number of challenges: significantly more amounts of muscle and motion artifact, increased baseline wander, a varied number and location of ECG leads, and the need for trending and for alarm generation when QT interval prolongation is detected. We have used several techniques to address these challenges. In contiguous 15-second time windows, we average the signal of tightly clustered normal beats detected by a real-time arrhythmia-monitoring algorithm to minimize the impact of artifact. Baseline wander is reduced by zero-phase high-pass filtering and subtraction of isoelectric points as determined by median signal values in a localized region. We compute a root-mean-squared ECG waveform from all available leads and use a novel technique to measure the QT interval. We have tested this algorithm against standard and proprietary ECG databases. Our real-time QT interval measurement algorithm proved to be stable, accurate, and able to track changing QT values.

Algorithms↗
PubMed2005

Underwater video as a monitoring tool to detect change in seagrass cover.

To date seagrass monitoring has involved the removal of seagrass from its environment. In fragile or highly disturbed systems, monitoring using destructive techniques may interfere with the environment or add to the burden of disturbance. Video photography is a form of non-destructive monitoring that does not require the removal of seagrass or interference with the environment and has the potential to be a valuable tool in monitoring seagrass systems. This study investigated the efficacy of video photography as a tool for detecting change in seagrass cover, using the temperate Australian species Amphibolis antarctica (Labill.) Sonder ex Aschers. Using visual and random point estimates of seagrass cover from video footage, it was possible to determine the minimum sample size (number of random video frames) needed to detect change in seagrass cover, the minimum detectable change in cover and the probability of the monitoring design committing a Type II error. Video footage was examined at three scales: transects (m apart), sites (km apart) and regions (tens of km apart). Using visual and random point estimation techniques, a minimum sample size of ten quadrats per transect was required to detect change in uniform and variable seagrass cover. With ten quadrats it was possible to identify a minimum detectable change in cover of 15% for uniform and 30% for variable seagrass cover. Power analysis was used to determine the probability of committing a Type II error from the data. Region level data had low power, corresponding to a high risk of committing a Type II error. Site and transect level data had high power corresponding to a low risk of committing a Type II error. Based on this study's data, managers using video to monitor for change in seagrass cover are advised to use data from the smaller scale, for example, site and transect level data. By using data from the smaller scale, managers will have a low risk of incorrectly concluding there has not been a disturbance when one has actually occurred.

Ecosystem↗
PubMed2006

Using the symptom monitor in a randomized controlled trial: the effect on symptom prevalence and severity.

This randomized controlled trial investigated the effect of reporting physical symptoms by using a systematic symptom monitoring instrument, the Symptom Monitor, on symptom prevalence and severity among patients with cancer in the palliative phase. The overall objective was to achieve symptom relief through systematic and regular symptom reporting by patients themselves. One hundred forty-six patients with cancer in the palliative phase were randomized to either the intervention group (n = 69 with Symptom Monitor) or the control group (n = 77 without Symptom Monitor). Ten physical symptoms with regard to prevalence and severity were monitored. After 2 months, the prevalence of symptoms was lower in the intervention group compared to the control group (prevalent differences 2.1-24.3%) for 9 out of 10 symptoms (except coughing). The intervention group scored a statistically significantly lower prevalence in constipation and vomiting (prevalence differences 24.3% and 18.0%, respectively). In four symptoms (fatigue, lack of appetite, shortness of breath, and nausea), the intervention group had a lower, although not statistically significant, severity score (median differences 0.5-1). In four symptoms (pain, coughing, sleeplessness, and diarrhea), the severity score was the same in both groups (medians 2-4). In two symptoms (constipation and vomiting), the severity score was lower in the control group (median differences -1 and -2). A comparison between the study groups on improved, deteriorated, or steady-state cases showed that the severity score had deteriorated less for 8 out of 10 symptoms in a larger proportion of patients in the intervention group. Although statistical significance was not reached, the prevalence as well as severity of symptoms in the palliative phase of cancer can be influenced by using the Symptom Monitor.

Aged↗
PubMed2005

Techniques for delivery and monitoring of TOOKAD (WST09)-mediated photodynamic therapy of the prostate: clinical experience and practicalities.

Photodynamic therapy of solid organs requires sufficient PDT dose throughout the target tissue while minimizing the dose to proximal normal structures. This requires treatment planning for position and power of the multiple delivery channels, complemented by on-line monitoring during treatment of light delivery, drug concentration and oxygen levels. We describe our experience in implementing this approach in Phase I/II clinical trials of the Pd-bacteriophephorbide photosensitizer TOOKAD (WST09)-mediated PDT of recurrent prostate cancer following radiation failure. We present several techniques for delivery and monitoring of photodynamic therapy, including beam splitters for light delivery to multiple delivery fibers, multi-channel light dosimetry devices for monitoring the fluence rate in the prostate and surrounding organs, methods of measuring the tissue optical properties in situ, and optical spectroscopy for monitoring drug pharmacokinetics of TOOKAD in whole blood samples and in situ in the prostate. Since TOOKAD is a vascular-targeted agent, the design and implementation of the techniques are different than for cellular-targeted agents. Further development of these delivery and monitoring techniques will permit full on-line monitoring of the treatment that will enable real-time, patient-specific and optimized delivery of PDT.

Bacteriochlorophylls↗
PubMed2004

Long-term marine litter monitoring in the remote Great Australian Bight, South Australia.

The Anxious Bay beach litter clearance is the longest running annual survey of ocean-based litter in Australia. It's remoteness from centres of human population and location (with respect to prevailing winds and currents) make it an ideal place for monitoring ocean or ship-based litter in Australia's southern oceans and particularly, the Great Australian Bight. Over the 1991-1999 period, a large but gradual decline in the amount of beach washed litter was recorded (with minor peaks recorded during the 1992 and 1994 surveys). Beach washed litter decreased by approximately 86%, from 344 kg recorded in 1991 (13.2 kg/km) to 49 kg in 1999 (i.e. 1.9 kg/km), reaching a maximum of 390 kg in 1992 (or 15 kg/km of beach). However, a sharp increase in litter was recorded in 2000 (i.e. 252 kg or 9.7 kg/km). This increase in litter yield in 2000 is probably due to stronger than average onshore surface flow (or Ekman Transport) in the western Eyre Peninsula and Bight region. Prior to the survey in 2000, the results appeared to indicate that ocean litter on Anxious Bay beach was beginning to level out at around 50-70 kg/year (i.e. 2-3 kg/km). As the beach surveys involve the assumption that the beach is completely cleared of litter, this may represent a baseline level for ocean-based litter in the region. The yields and type of litter collected from the annual survey indicates that the majority of litter washed ashore originates from commercial fishing activities within the Great Australian Bight. Most of the fishing-related litter was directly sourced to the Southern Rock Lobster Fishery (i.e. bait buckets, baskets, pots), the Great Australian Bight Trawl Fishery (i.e. codends, trawl nets) and the Southern Shark Fishery (i.e. monofilament gillnets and longlines). Between 1994 and 1999, large reductions were observed in the amount of bait straps (77% reduction), lobster bait baskets/buckets (86% reduction), nets/ropes (62% reduction) and floats/buoys (83% reduction). Significantly, fishing-related litter in the Bight has reduced at a slower rate than domestic litter. While the level of glass and soft plastics on the beach have both reduced by almost 93% (i.e. 103-7 kg and 119-8 kg, respectively), the level of hard plastics, has diminished at a slower rate, with reductions of only 75% (i.e. 122-30 kg). Some fisheries (i.e. rock lobster, Southern Shark Fishery) have shown marked reductions in fishing-related litter. This is probably due, to some extent, to significant reductions in fishing effort in the region, although this requires further investigation. The information from the Anxious Bay beach litter survey is crucial in monitoring trends in ocean litter in Australia's southern oceans and compliance with international litter regulations. While fishing-related litter remains the major source of ship-based or ocean litter in Australia's southern oceans, the continued reduction in ship-based litter since 1991 supports increasing compliance to MARPOL (Annex V) by commercial fisheries and shipping in the Great Australian Bight. While Australia participates in marine debris monitoring programs in the Antarctic (under CCAMLR), there is currently no national program or management framework to assess, manage and monitor ocean-based litter along Australia's coasts, and monitor compliance with MARPOL. Apart from the commitments under CCAMLR for Antarctic (and sub-Antarctic) marine environments, there are no other regional programs, guidelines or monitoring protocols or to assess and manage ocean litter in the Southern Ocean.

Environmental Monitoring↗
PubMed2006

The availability and use of oxygen saturation monitoring in primary care in order to assess asthma severity.

INTRODUCTION: The BTS/SIGN guideline recommends oxygen saturation (SaO2) monitoring as an objective measure of acute asthma severity, particularly in children, in both primary and secondary care. We assessed the availability and use of SaO2 monitoring for acute asthma assessment in primary care. METHODS: Fax and telephone questionnaire of Primary Care services in the Edinburgh region to assess use of SaO2 monitoring in the past 24 months, in association with a 24-month retrospective assessment of A&E attendances with acute wheeze. Children over 12 months of age registered with eligible general practices attending A&E with wheeze and/or asthma were included. RESULTS: There were replies from 103 general practices (100%) and eight Out-of-hours cooperatives (100%). Oxygen saturation monitoring was available in four general practices (3.9%) and three Out-of-hours cooperatives (37.5%). 1408 children attended A&E with wheeze/asthma, 721 referred by primary care. Oxygen saturation monitoring was available to 7.9% of A&E attendees from primary care, but documented in only 1.8% of primary care referrals. CONCLUSIONS: SaO2 monitoring is not widely available in primary care and is infrequently used for the assessment of acute asthma. SaO2 measurement as an adjunct to clinical assessment of asthma in primary care needs encouragement.

Adolescent↗
PubMed2004

Quality assurance program for whole blood prothrombin time-international normalized ratio point-of-care monitors used for patient self-testing to control oral anticoagulation.

Whole blood coagulation monitors are increasingly used for patient self-testing to control oral anticoagulation, but there are no comprehensive quality assurance (QA) programs to check their performance. We report on the experience with one of such programs applied in a field study where patients on prothrombin time (PT)-international normalized ratio (INR) self-testing were asked to bring their monitors to the anticoagulation clinic for checking. PT-INR testing was performed three times over 3 months with 14 patient's monitors and test strips on three recalcified QA plasmas by an experienced laboratory operator. Each patient was also asked to perform PT-INR self-testing (his/her own capillary blood) which was then compared to the laboratory PT-INR (plasma). Overall, the comparison between the observed and the consensus PT-INR on QA plasmas was acceptable with the majority of measurements lying within +/-15% or 20% of the consensus values. The comparison between the PT-INR self-testing and the laboratory method was also acceptable: overall, there was no statistical significant difference between the mean PT-INR values and the majority of paired measurements were less than 15% or 20% apart. In conclusion, our results show that the proposed QA scheme is feasible and may be implemented on a larger scale. Monitors should be recalled periodically to the clinic where they have been prescribed to the patient. During each visit, the clinic may check the monitors and patient self-testing performance as described. Such comprehensive QA system would make monitoring of oral anticoagulant treatment by self-testing safer and more effective.

Administration, Oral↗
PubMed2004

History of C2 monitoring in heart and liver transplant patients treated with cyclosporine microemulsion.

Therapeutic drug monitoring of CsA has evolved since the introduction of CsA microemulsion. The purpose of the present review is to summarize the history of CsA concentration 2 hours postdose (C2) monitoring in heart and liver transplantation. C2 has been shown to be the best single time point that correlates with the area-under-the-curve, with a correlation coefficient (r2) ranging between .83 and.93. C2 monitoring (300 to 600 ng/mL) has resulted in a significant clinical benefit in long-term heart and liver transplant patients compared to trough level (C0) monitoring. Moreover, a C2 range of 300 to 600 ng/mL resulted in a similar calcineurin inhibition compared to a C2 range of 700 to 1000 ng/mL or a C0 range of 100 to 200 ng/mL while being less injurious to renal function. In de novo liver transplant patients not receiving induction therapy, the achievement of a target C2 of 850 to 1400 ng/mL by postoperative day 3 has resulted in a low acute rejection rate. Furthermore, C2 monitoring has been associated with a lower rejection rate in hepatitis C virus (HCV)-negative patients and with an overall lesser severity of acute rejection compared to C0 monitoring. In de novo heart transplant patients who receive antithymocyte globulin induction, a lower C2 range may be sufficient to prevent rejection and renal dysfunction. Future studies should help to fine-tune the optimal C2 range in heart or liver transplant patients receiving induction therapy and different maintenance immunosuppressive combinations.

Administration, Oral↗
PubMed1996

Safety and feasibility of continuous monitoring of coronary flow velocity in acute myocardial infarction by Doppler guide wire.

We investigated the safety and limitations of the Doppler guide wire for continuous monitoring of coronary flow velocity outside the catheterization laboratory in 17 patients with acute myocardial infarction. After direct angioplasty, patients were taken to the coronary care unit with the Doppler guide wire positioned within the artery. Flow velocity was continuously monitored. Heparin was titrated to an active clotting time > 200 seconds. Clinical outcome and angiographic analyses were evaluated. Flow velocity monitoring was conducted with an 88.2% success rate and lasted for 16 +/- 5 hours. Monitoring failed in 2 of the 4 right coronary artery cases. Small amounts of thrombus were seen to adhere to the Doppler guide wire at the end of monitoring. No complications were related to the procedure. No deterioration of angiographic findings was observed. This preliminary study confirmed the safety of the Doppler guide wire for continuous monitoring of coronary flow in patients with acute myocardial infarction.

Aged↗
PubMed1992

Characterization of fetal body movement recorded by the Hewlett-Packard M-1350-A fetal monitor.

OBJECTIVE: The purpose of this study was to evaluate the ability of a commercially available monitor, the Hewlett-Packard M-1350-A fetal monitor, to record and discriminate between various fetal body movements. STUDY DESIGN: Twenty-four patients between 29 and 42 weeks' gestation were monitored over a 20 to 30 minute period simultaneously by the Hewlett-Packard instrument and ultrasonography. RESULTS: All 593 single or clustered fetal movements recorded by the monitor were seen ultrasonographically as being extremity movements that were either isolated or combined with trunk motion. Discriminating between these two types of movements was not possible on the basis of the duration of recorded movements. All adequate fetal heart rate accelerations were attributed to combined trunk and extremity movements. Detection of fetal hiccups was less exact, and recording of fetal hand, mouth, breathing, and rapid eye movements was beyond the sensitivity of the monitor. Signal artifacts were attributable to either motion of the maternal abdomen or Doppler transducer and became less of a problem with experience. CONCLUSION: Fetal extremity movements were recorded with accuracy by this new fetal monitor.

Adult↗