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At least 19 recordsLinked to original sources

Vibro-acoustic stimulation in high-risk pregnancies; maternal perception of fetal movements, fetal heart rate and fetal outcome.

Maternal perception of fetal movement in response to vibro-acoustic stimulation was compared with antenatal fetal heart rate monitoring as a test of fetal well-being in a population of gravidae with high-risk pregnancies (n = 517), admitted to the high-risk ward at Danderyd Hospital, Karolinska Institutet; a total of 2,015 tests were performed. The sensitivity and the specificity of the test compared to the fetal heart rate tracing was 81% and 89% respectively. If the test was performed within 24 hours of delivery, its predictive value for fetal asphyxia (i.e. a 5-minute Apgar score < 7) was 14% (7/49). Ten per cent of the patients felt no fetal movement in response to stimulation (irrespective of gestational age). In five cases where fetal heart rate tracings were pathological, stimulation nonetheless produced fetal movement and fetal outcome was good. Pathological heart rate tracings and no fetal movement in response to stimulation were present in 30 cases (out of 251 with no fetal movements at stimulation), in seven of which the infants had 5-minute Apgar scores < 7. Although many patients underwent repeated vibro-acoustic stimulation, there was no evidence of fetal habituation to the test. On 24 occasions (i.e. 1.2%), the patient denied vibro-acoustic stimulation, mostly because of previous discomfort due to vigorous fetal response. Where resources are limited, maternal perception of fetal movements in response to vibro-acoustic stimulation might be a useful alternative for preliminary screening of high-risk pregnancies.

Acoustic Stimulation↗

Development of fetal movement--fetal heart rate coupling from 20 weeks through term.

This study documents the development of fetal heart rate (FHR) change in response to fetal movement (FM) in healthy fetuses from 20 weeks' gestational age through term. Thirty-one fetuses received 50 min of Doppler-based monitoring at 20, 24, 28, 32, 36 and 38-39 weeks. FHR and FM were continuously digitized. A coupling index was computed as the percentage of FMs associated with increases in FHR of 5 beats/min or more within -5 or +15 s of movement onset. The latency between FM onset and FHR change was also computed, as were the amplitude and duration of all movements. FM and FHR became more integrated with advancing gestation. Coupling increased and the latency between FM and FHR changes decreased. Maternal age, blood pressure and fetal sex did not affect FM-FHR coupling, but fetuses of women who reported greater stress in their daily lives and had faster heart rates displayed reduced coupling. These data suggest that the development of FM-FHR coupling reflects the development of the central nervous system during gestation, and that development may be affected by maternal factors.

Adult↗

The relation between fetal heart rate accelerations and fetal movements.

Fetal heart rate (FHR) accelerations associated with fetal movements is considered a sign of fetal well-being. Fetal movements as felt by the pregnant woman and visualized by real-time ultrasonography were correlated to FHR accelerations in 52 normal and high-risk pregnant women. All fetal movements felt by the mother or seen in the real-time ultrasonography were associated with large FHR accelerations (more than 15 beats per minute lasting 15 seconds or more) or small accelerations (fewer than 15 beats per minute). The large accelerations were associated with 78.6% of fetal movements felt by the mother and 99.6% of fetal movements seen by real-time ultrasonography. The small accelerations were associated with 52.9% of fetal movements felt by the mother and 82.4% of fetal movements seen by ultrasonography. Mothers felt 75.7% of fetal movements seen by real-time ultrasonography. It was concluded that fetal movements could be verified by existence of large accelerations on the FHR tracing.

Female↗

A comparison between maternal, tocodynamometric, and real-time ultrasonographic assessments of fetal movement.

Fetal movements were simultaneously studied with maternal perception, tocodynamometry, and real-time ultrasonography. A comparison between these three modalities demonstrated good agreement. The percentage of agreement improved with increasing duration of fetal movements. For fetal movements lasting longer than 3 seconds, the agreement between ultrasonography and tocodynamometry was 95.6%. These findings suggest that tocodynamometry is a sensitive method for studying fetal movements.

Female↗

Fetal heart rate and fetal movements.

Fetal Heart Rate (F.H.R.) in association with fetal movement was evaluated in 141 normal and pathological pregnancies. In the normal cases only 31% showed an acceleration of F.H.R. in association with fetal movement. The majority of the normal cases, 62%, did not demonstrate changes in F.H.R. in association with fetal movement. In the pathological pregnancies there were no characteristic changes in F.H.R. associated with fetal movement. It appears that F.H.R. acceleration associated with fetal movement cannot be used as an index for fetal well being.

Female↗

Maternal perception and Doppler detection of fetal movement.

Fetal movement can be used as a tool for assessment of prenatal well-being. Maternal perception of fetal movement, using a formal graphic "count-to-ten" system is often used as an adjunct in high risk and normal pregnancies. Doppler detection of fetal movement is a newly introduced, easy to perform methodology. Identification of coupling fetal heart rate accelerations to fetal movement as an aid for nonstress testing and recognition of fetal behavior, fetal behavioral states and cycling between states, is a current clinical application of this new technique.

Female↗

The relationship between uterine contractions, fetal movements and fetal heart rate patterns in the active phase of labor.

The relationship between fetal movements, fetal heart rate and uterine contractions was studied with a computerized system in 18 parturients during the active phase of labor. 80% of FHR accelerations and 39% of uterine contractions were associated with fetal trunk movements. The probability of association was greater in longer movements and larger accelerations. 98% of fetal movements which lasted 10-15 s, 98% of accelerations with an amplitude of 25-30 bpm and 96.4% of accelerations with a duration of 40-50 s were associated with fetal trunk movements.

Female↗

[New ultrasonic Doppler fetal actograph and continuous recording of fetal movement].

Fetal movement has been recorded by marking maternal perception, observation of real-time B-mode or ultrasonic M-mode with conventional techniques. Continuous and objective recording of fetal movement is studied with the application of the ultrasonic Doppler method in the present paper. Continuous wave ultrasound Doppler probe of a fetal monitor is utilized, and a very low frequency Doppler signal of 8 Hz or more is introduced into a band pass filter with a band of 20 to 80 Hz. The output is changed into a spike-shaped signal, and recorded on the uterine contraction channel of the monitor. Vibrating steel ball movement with a velocity of 0.77 to 3.1cm/sec was recorded in the water bath experiment. The detecting area was as narrow as 8mm in diameter, but linearity was clear in the range of movement from 2.5 to 5.5mm. A clinical study showed simultaneous occurrence of bursts of spiky fetal movement signals and FHR acceleration in the late stages of pregnancy. Fetal movement did not accompany this acceleration in the cases of 18 and 21 weeks of pregnancy. Very regular hiccup-like fetal movement with 25 to 28 cpm frequency was recorded in 2 cases of late stage gestation. The fetal hiccup did not accompany the acceleration. Fetal resting and active phases will be differentiated by the new recording technique.

Female↗

Maternal anxiety in late pregnancy: effect on fetal movements and fetal heart rate.

AIM: To determine whether maternal state and trait anxiety levels affect fetal movements or fetal heart rate (FHR) in the third trimester. SUBJECTS: Forty-one healthy pregnant nulliparous women not on medication and with a singleton pregnancy. STUDY DESIGN: Maternal anxiety was assessed using the Spielberger State- Trait Anxiety Inventory (Form Y) at 36 gestational weeks. The fetuses of the women were examined at 37-40 gestational weeks with ultrasound observation of fetal movements and cardiotocography (CTG). The results of the fetal examinations were compared between women with low and high anxiety scores (low scores being defined as scores below the median and high scores as scores equal to or above the median of the study population), and correlation analyses between anxiety scores and the outcome variables were performed. OUTCOME MEASURES: The presence and duration (expressed as a percentage of the total examination time) of FHR patterns A, B, C, and D, the percentage duration of fetal movements in each FHR pattern, baseline FHR and FHR variability in each FHR pattern. RESULTS: The presence of FHR patterns A, B, C, and D, the duration of FHR patterns A, B, and C, FHR variability in FHR patterns A, B, and C, baseline FHR and the percentage duration of fetal movements in each FHR pattern did not differ between women with low and high state and trait anxiety scores. In fetuses with FHR pattern D, the duration of FHR pattern D increased with increasing maternal trait anxiety scores, (rho=0.88; p=0.008), and FHR variability in FHR pattern D increased with maternal state and trait anxiety scores (r=0.86, p=0.01; r=0.96, p=0.001). CONCLUSION: Maternal anxiety does not seem to affect fetal movements or baseline FHR in late pregnancy, but there is a possible association between maternal anxiety and the duration of FHR pattern D and FHR variability in FHR pattern D.

Adult↗

Clinical evaluation of fetal movements.

Fetal movement was examined in 200 pregnancies to establish normal patterns, influencing factors, possible clinical value and practical application. The mean number of movements per hour was 26 in hospitalized and 40 in ambulatory patients. These values remained fairly steady throughout pregnancy except for a significant decrease in the week preceding labor. Individual variations were large. The number of movements was uninfluenced by parity and fetal sex but was lower for small-for-gestational-age babies, in mothers suffering from both hypertension and diabetes and in mothers treated with diazepam. Fetal movement count may be used as a parameter of fetal well-being.

Body Weight↗

Fetal movements and fetal outcome: a prospective study.

Two hundred sixty-four antenatal patients were monitored by maternal observation of fetal movements to predict fetal condition at birth. Abnormal fetal movements were significantly associated with fetal death as well as with poor fetal condition at birth. The sensitivity, specificity, and predictive value of monitoring abnormal fetal movements are presented. The mean weekly count decreased with advanced gestational age but not predictably so in each patient. Fetal outcome was studied prospectively in 138 patients with normal fetal movements and 23 patients with abnormal movements at term. Perinatal outcome was significantly poorer in the group with abnormal movements (P = .0015). Cognizance should be taken of patients reporting a decrease in fetal activity at term, as this may include fetal compromise.

Adult↗

Effects of maternal cigarette smoking on fetal trunk movements, fetal breathing movements and the fetal heart rate.

The acute effect of maternal cigarette smoking was studied in 10 patients between 37 and 40 weeks gestation. There was a significant reduction in the percentage of time the fetus spent moving during the first 16 min of smoking (P less than 0.02). No significant changes were seen in the proportion of time the fetus spent breathing or the number of times the fetus changed from high or intermediate to low heart period variability. There were significant reductions in the number of accelerations (P less than 0.01), beat-to-beat variation (P less than 0.01) and root-mean-square of the deviation around the mean (P less than 0.02).

Adult↗

Coupling of fetal movement and fetal heart rate accelerations as an indicator of fetal health.

OBJECTIVE: The purpose of this study was to determine the clinical value of identified coupling of fetal heart rate (FHR) accelerations (more than five beats per minute for any duration) with objectively detected fetal movements. METHODS: One hundred sixty-six patients underwent routine fetal testing using a Doppler device that recognized both FHR and fetal movements. The coupling index was determined to be the percentage of fetal movements associated with FHR accelerations, and various coupling indices were compared with nonstress test (NST) results. RESULTS: A coupling index above 25% and below 75% compared well with the traditional NST by standard epidemiologic criteria and by the kappa statistic. CONCLUSION: Coupling of even small FHR accelerations and fetal movements could substitute for or replace the NST in antenatal screening.

Female↗

Effect of abolition of fetal movement on fetal intravascular PO2 and incidence of tonic myometrial contractures in the pregnant ewe at 114 to 134 days' gestation.

The possibility that fetal movements play a role in the initiation of the bursts of tonic myometrial activity (contractures) that occur throughout the second half of pregnancy in the sheep has been examined by the administration of the curare derivative pancuronium to abolish fetal movement. The duration and frequency of the electromyographic bursts associated with contractures, as well as the increase in intrauterine pressure generated by the contractures, were unchanged. However, within 1 hour of the abolition of fetal movement, fetal jugular venous PO2 was significantly elevated and remained elevated for at least 6 hours. This observation is in keeping with the view that fetal skeletal muscle movement consumes significant amounts of oxygen.

Animals↗

[Correlation of the magnitude of fetal movement associated fetal heart rate accelerations, amplitude of "classical" accelerations and transcutaneous fetal oxygen partial pressure].

An attempt is made to provide non-empirical evidence of the "classical" amplitude of sporadic fetal heart rate accelerations of 15 bpm. Sporadic, fetal movement associated fetal heart rate accelerations are generally regarded as an indication of fetal wellbeing. A minimal amplitude of 15 bpm with unknown duration of the associated fetal body movement seems to be a prerequisite to establish an unimpaired fetal condition as reliably as possible. Including the "classical" acceleration amplitude in a ratio from the acceleration amplitude and associated fetal body movement and comparison of these calculated values with a total of 3851 actual ration from acceleration amplitudes and durations of associated body movements of 175 normotrophic and 72 hypotrophic fetuses showed that only a hypothetical acceleration amplitude of 15 bpm yields ratios which correspond to the actual values of unimpaired fetuses. There is a significant positive correlation between the actual ration and the transcutaneous basal fetal partial pressure of oxygen during birth.

Blood Gas Monitoring, Transcutaneous↗

Incidence of spontaneous and evoked fetal movements.

Fetal activity is composed of fetal movements (FM), which are either nonreflexive, originating in the fetus itself, or evoked reflexive FM which are stimulated by the fetal environment. The relative ratio of the spontaneous to evoked FM has not yet been documented. Since it is impossible to differentiate in a singleton pregnancy between these two types of FM on the basis of maternal perception alone, the natural model of twin pregnancy was used. It has previously been shown that the number of FM in a singleton pregnancy is similar to that of each individual fetus in a twin pregnancy of the same gestational age. It was assumed that the factors which cause spontaneous and evoked FM are similar in singleton and twin pregnancies. The fetal activity in 44 twin and 76 singleton pregnancies between 28 and 39 weeks of gestation was assessed during 20 min of nonstress test recording. The means of FM in twins were significantly higher than those in singleton pregnancies. The rate of the spontaneous FM was calculated to be 50-59% of all FM in singleton pregnancies and that of the evoked FM 41-50%.

Female↗

The umbilical artery blood flow velocity waveform in relation to fetal breathing movements, fetal heart rate and fetal behavioural states in normal pregnancy at 37 to 39 weeks.

In 19 normal pregnancies between 37 and 39 weeks of gestation, the blood flow velocity waveform (FVW) of the umbilical artery was studied in relation to fetal breathing movements, fetal heart rate (FHR) and the fetal heart rate patterns (FHRPs) A and B. FHRP A is stable, with a narrow oscillation bandwidth, FHRP B shows a wider oscillation bandwidth. Although for state-assessment it is necessary to record three variables simultaneously, the linkage of these variables in the near-term healthy fetus is such, that FHRP A and B may be used for the assignment of behavioural states 1F and 2F. The FVW was characterized by the Pulsatility-Index (PI). Presence of fetal breathing movements strongly disturbed the regularity of the FVW. A significant inverse relationship between FHR and PI was established. A weighted regression coefficient was calculated: PI decreases 0.0075 with an increase of FHR of 1 beat per minute (PI140 = PI / 0.0075(FHR - 140]. The PI was higher during periods of FHRP A as compared to FHRP B. However, this difference disappeared, when the influence of FHR was taken into account by normalising all PIs to a standard heart rate level of 140 bpm. One should perform the umbilical artery blood flow measurements in absence of fetal breathing--(causing irregularity of the FVW) and body movements (because of accompanying FHR accelerations) and FHR should be taken into account when evaluating the FVWs.

Blood Flow Velocity↗

Relation between fetal heart rate accelerations, fetal movements, and fetal breathing movements.

The presence of fetal heart rate (FHR) accelerations is considered a sign of fetal well-being. Fetal body and breathing movements, as visualized by real-time ultrasound, were correlated to FHR accelerations in 16 high-risk pregnancies. The association between FHR accelerations (greater than 15 beats/min lasting 15 sec or more) and the different fetal behavioral states is described.

Female↗