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Results for “Fetal Monitoring”

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At least 19 recordsLinked to original sources
PubMed1986

The indirectly obtained fetal heart rate: comparison of first- and second-generation electronic fetal monitors.

Fetal heart rate variability has become an essential component in evaluation of the fetus during continuous electronic fetal monitoring. Because of technical deficiencies of monitoring equipment, fetal heart rate variability may not always be available, such as during indirect monitoring of the fetus. In lieu of integration, a mathematical procedure called autocorrelation has, with the use of microprocessors, been incorporated into the fetal monitor, creating the "second generation" of electronic fetal monitoring. This study examined the accuracy of the first- and second-generation monitors by comparing simultaneously obtained indirect and direct real-time fetal heart rate data. The second-generation monitor produced an indirectly obtained fetal heart rate that was more accurate when compared with the directly obtained data than that with the first-generation fetal monitor. In addition, the variation in data from the first-generation monitor was substantially higher than that with the second-generation monitor. It is concluded that the fetal heart rate tracing from the second-generation monitor is more accurate when compared with the fetal electrocardiogram and may facilitate a truer interpretation of fetal heart rate variability than that obtained with the first-generation monitor.

Electrocardiography↗
PubMedDate not supplied

Labor and delivery nurses' attitudes toward intermittent fetal monitoring.

Fetal monitoring is a routine procedure overseen by labor and delivery nurses and upon which they exert considerable influence. There is a discrepancy, however, between the type of fetal monitoring routinely used and the evidence provided by current research and professional organization recommendations. This study provides the first look at labor and delivery nurses' attitudes toward fetal monitoring in more than 20 years. A descriptive, correlational study was conducted at five southeastern Michigan hospitals to evaluate attitudes toward intermittent fetal monitoring and the effect of selected demographic variables on their attitudes. Of the labor and delivery nurses who participated (N = 145), 72.4% agreed that intermittent fetal monitoring should be the standard of care. Although 87% of the respondents stated that they were willing to provide intermittent monitoring, 53.9% indicated that nurse/patient ratios were a problem in providing this service. Nurses' attitudes were significantly influenced by education level (P = .004), and 48% were unsure about current research findings related to intermittent auscultation. Nurses have a positive attitude toward intermittent monitoring, although safe nurse/patient ratios and clear policies need to be addressed. Lack of knowledge regarding the current evidence and other barriers may contribute to intermittent auscultation not being used routinely, despite the fact that its use for women of low obstetrical risk is supported by current research and professional organizations.

Adult↗
PubMedDate not supplied

Near infrared spectroscopy in fetal monitoring.

Fetal monitoring using near infrared spectroscopy offers the first realistic prospect of documenting real-time changes in fetal cerebral oxygenation during labour. This article explores the technical background, presents some of the results obtained and speculates on potential future developments.

Female↗
PubMed1985

Autocorrelation techniques in fetal monitoring.

Fetal monitors that feature autocorrelation have recently been introduced. This paper discusses autocorrelation and describes how it extracts periodic signals from a noisy background. An example of its performance under clinical conditions demonstrating advantages and limitations is discussed.

Computers↗
PubMed2000

Fetal electrocardiogram plus heart rate recording for fetal monitoring during labour.

BACKGROUND: It is thought that adding fetal electrocardiography (ECG) to cardiotocography (CTG) alone may provide better information about fetal heart activity. OBJECTIVES: The objective of this review was to assess the effects of simultaneous recording of fetal electrocardiographic waveforms plus conventional cardiotocography, with cardiotocography alone, during labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA: Randomised trials of electrocardiogram waveform analysis with or without cardiotocography during labour. DATA COLLECTION AND ANALYSIS: Trial quality was independently assessed by two reviewers. Data extraction was done by one reviewer and checked by the second reviewer. Study authors were contacted for additional information. MAIN RESULTS: One study of 2434 pregnant women was included. This trial was of sound methodological quality. The number of operative deliveries for fetal distress was reduced by half in the electrocardiographic waveform and cardiotocography group (odds ratio 0.53, 95% confidence interval 0.39 to 0.73). There was no apparent effect on the rate of operative delivery for poor progress of labour (odds ratio 1.05, 95% confidence interval 0.87 to 1.27). The use of the electrocardiographic waveform analysis monitor had no obvious effect on the condition of the newborn. REVIEWER'S CONCLUSIONS: Analysis of the fetal electrocardiographic waveform during labour may be associated with reduced obstetric intervention without jeopardising fetal outcome.

Cardiotocography↗
PubMed1983

[Fetal monitoring using fetal movement count perceived by patient].

To clarify the clinical significance of subjective fetal movements, I took and compared the fetal movements count (FMC) and its decreasing rate in 418 pregnant women who were classified into 2 groups, fetal poor outcome group and fetal good outcome group. The main results obtained were as follows: Subjective fetal movements were more frequent at night. The weekly mean number of FMC was highest in the 32nd week of pregnancy, and afterwards gradually decreased. Although the fetal poor outcome group had no distinctive average FMC throughout the course of pregnancy compared with that of the good outcome group, 48.8% of cases having a rate of decrease of 70% or over were found in fetal poor outcome group. On the other hand those showing fetal poor outcome were only 5.5% of the cases showing a decrease rate of less than 70%. There were significantly more cases having a rate of decrease of 70% in the cases showing non-reactive in the nonstress test. We concluded that the decreasing rate of FMC appeared useful in assessing the fetal prognosis.

Circadian Rhythm↗
PubMed1990

Patient-recorded domiciliary fetal monitoring.

Domiciliary fetal monitoring via a telephone link has been in clinical use at the Royal Free Hospital for 2 years, during which time 858 traces of 134 patients who were moderately at risk have been transmitted to the hospital. All recognized abnormal heart rate patterns were detected during the study period. In seven patients obstetric intervention took place on the basis of the domiciliary fetal monitoring recording and subsequent hospital monitoring. There were no intrauterine or neonatal deaths, and there was no overall increase in obstetric operative intervention. There appeared to be a significant reduction in the inconvenience suffered by the patient and her family, compared with conventional monitoring. Fetal heart recordings performed solely by the patient were of a high quality and reduced the demand on midwifery resources. To allow this only 3 hours of midwifery time daily was required and no additional demands on obstetric staff were made. It is anticipated that domiciliary fetal monitoring, performed by patients, will become an essential and established service throughout the United Kingdom (and probably Europe) as the principal means of monitoring fetal well-being.

Adult↗
PubMed1980

A two-channel radiotelemetry system for clinical fetal monitoring.

A radiotelemetry system for monitoring fetal heart rate and uterine contractions during labor has been developed and evaluated. The two-channel transmitter utilizes a miniature intrauterine pressure sensor which frequency modulates a subcarrier. The fetal electrocardiogram picked up by a scalp electrode is summed with the subcarrier and this direct frequency modulates the RF carrier. The transmitter has been constructed in a miniature package using conventional electronic components. A receiver system which obtains the original signals and feeds them to a conventional fetal monitor has been developed for use with this transmitter. Clinical evaluation has shown the telemetry system to provide efficacious signals.

Electrocardiography↗
PubMed2006

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour.

BACKGROUND: Cardiotocography (sometimes known as electronic fetal monitoring), records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic), so additional assessments of fetal well-being may be used, or the baby delivered by caesarean section or instrumental vaginal birth. OBJECTIVES: To evaluate the effectiveness of continuous cardiotocography during labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (March 2006), CENTRAL (The Cochrane Library 2005, Issue 4), MEDLINE (1966 to December 2005), EMBASE (1974 to December 2005), Dissertation Abstracts (1980 to December 2005) and the National Research Register (December 2005). SELECTION CRITERIA: Randomised and quasi-randomised controlled trials involving a comparison of continuous cardiotocography (with and without fetal blood sampling) with (a) no fetal monitoring, (b) intermittent auscultation (c) intermittent cardiotocography. DATA COLLECTION AND ANALYSIS: Two authors independently assessed eligibility, quality and extracted data. MAIN RESULTS: Twelve trials were included (over 37,000 women); only two were high quality. Compared to intermittent auscultation, continuous cardiotocography showed no significant difference in overall perinatal death rate (relative risk (RR) 0.85, 95% confidence interval (CI) 0.59 to 1.23, n = 33,513, 11 trials), but was associated with a halving of neonatal seizures (RR 0.50, 95% CI 0.31 to 0.80, n = 32,386, nine trials) although no significant difference was detected in cerebral palsy (RR 1.74, 95% CI 0.97 to 3.11, n = 13,252, two trials). There was a significant increase in caesarean sections associated with continuous cardiotocography (RR 1.66, 95% CI 1.30 to 2.13, n =18,761, 10 trials). Women were also more likely to have an instrumental vaginal birth (RR 1.16, 95% CI 1.01 to 1.32, n = 18,151, nine trials). Data for subgroups of low-risk, high-risk, preterm pregnancies and high quality trials were consistent with overall results. Access to fetal blood sampling did not appear to influence the difference in neonatal seizures nor any other prespecified outcome. AUTHORS' CONCLUSIONS: Continuous cardiotocography during labour is associated with a reduction in neonatal seizures, but no significant differences in cerebral palsy, infant mortality or other standard measures of neonatal well-being. However, continuous cardiotocography was associated with an increase in caesarean sections and instrumental vaginal births. The real challenge is how best to convey this uncertainty to women to enable them to make an informed choice without compromising the normality of labour.

Cardiotocography↗
PubMed1986

[Telemetric labor monitoring using the fetal monitor BMT 941-1].

Recommendation of a telemetric system for the direct fetal monitoring using the monitor BMT 914-1 (Zwönitz). The free movement of parturients during labor is more comfortable and involves an increasing uterine activity, a labor progress and a decrease of oxytocic infusion rate.

Electrocardiography↗
PubMed1989

[The validity of parameters in neonatal diagnosis and fetal monitoring of breech deliveries. 2. Problems in fetal monitoring in the breech position--a proposal for a standardized biochemical diagnosis].

By means of 149 fetal microblood samplings (FBA) from the breech in deliveries in breech presentation and by means of 64 cardiotocograms the validity of biochemical parameters and biophysical ones of fetal monitoring will be investigated. It takes an increased number of suspect or pathologic CTG into account in cases of breech presentation. By means of FBA it is possible to exclude or to confirm the supposed acidoses. By this the rate of operations during delivery can be reduced or the operation will be indicated respectively. A normal fetal pH resulting from the general biochemical monitoring does enlarge the obstetricians license when the fetus presents himself in advanced parturition in pelvic floor (hold back of breech during assisted spontaneous delivery). A pH less than 7.15 demands an immediate delivery. A prognosis of fetal outcome by means of FBA and CTG is not possible due to difficulties in calculation of the final stage of breech presentation. The difference between fetal pH measured in pelvic floor and pH in umbilical artery must be kept as small as possible and it might be regarded as criterion of the management of the delivery in breech presentation.

Acidosis↗
PubMed1997

Digital communication with fetal monitors.

BACKGROUND: Fetal heart rate (FHR) values in the averaged format that are provided by commercial computed cardiotocography analysis systems may be unsuitable for special analysis purposes. METHOD: I developed a communication software program to obtain any measured values of fetal monitors for individual analysis of computed cardiotocography. EXPERIENCE: The software program was used to study the data continuity of beat-to-beat FHR values as an experiment for chaos theory and power spectrum analysis. The results indicated that the signal loss was recognized at a precision of 95%. CONCLUSION: The described method of digital communication with fetal monitors was found to be useful for individual purposes in the field of computed cardiotocography analysis.

Algorithms↗