Biomedical subjects

F C Christensen

Publications and source records attributed to F C Christensen.

3 recordsLinked to original sources

PubMed2003

Cross-over trial comparing maternal acceptance of two fetal movement charts.

OBJECTIVE: To compare two daily fetal movement charting techniques to determine which chart was preferred by patients and which promoted more patient adherence. METHODS: This randomized trial included patients with singleton gestations between 28 and 34 weeks' gestation, with intact membranes and not in labor. Consenting women were given a Hollister chart and a 'count to 10' chart in a cross-over manner over two consecutive 1-week periods. Each patient answered a questionnaire establishing which chart was preferred. All returned charts were evaluated for patient adherence. Data were analyzed using either the Yates-corrected chi2 test or Fisher's exact test when appropriate. RESULTS: Forty patients agreed to participate, and 31 completed and returned both charts. The 'count to 10' chart was clearly preferred over the Hollister chart (29 vs. 2; p = 0.002) because of the shorter recording period (median 23 min vs. 1 h; p < 0.01). The proportion of patients who fully completed the 'count to 10' chart during the week was significantly higher than the proportion completing the Hollister chart (68% vs. 26%; p < 0.001). CONCLUSION: The 'count to 10' fetal movement chart was clearly preferred and promoted a higher level of adherence.

Adult↗

PubMed2001

Mandated preterm delivery: its prevalence and impact at a tertiary referral center.

OBJECTIVE: To determine the prevalence and impact of mandated preterm deliveries at a tertiary referral center. METHODS: A chart review was conducted at our institution on all livebirths from 24 weeks to completion of 37 weeks' gestation between 1 January 1998 and 31 December 1999. Mandated delivery was defined as intentional intervention because of a deteriorating maternal or fetal condition. Reasons for intervention and intrapartum courses were compared with two other preterm groups (premature ruptured membranes, spontaneous labor) delivering during the same period. Statistical analyses included the Student t test, univariate ANOVA, X2 test and Mann-Whitney test. RESULTS: A total of 894 pregnancies delivered preterm, with 132 (14.8%) being mandated. Primary reasons for mandated delivery included severe pre-eclampsia (69.0%), vaginal bleeding (11.4%), deteriorating maternal illness (10.6%), worsening fetal growth restriction (6.1%) or major fetal malformation (3.0%). Delivery at less than 34 weeks was more common in the mandated group (68.9%) than in the ruptured membranes group (41.2%, p < 0.005) or in the spontaneous labor group (46.5%; p < 0.01). Cesarean section rates were higher in the mandated group (69.7%) than in the ruptured membranes group (18.3%; p <0.001) or in the spontaneous labor group (21.5%; p < 0.001). The presence of an unfavorable cervix, unsuccessful trial of labor, non-cephalic fetal presentation, or fetal intolerance of labor explained the high rate of surgery. CONCLUSIONS: Conditions mandating delivery accounted for 14.8% of all preterm births. Mandated delivery is associated with a greater need for delivery before 34 weeks, often by Cesarean section.

Analysis of Variance↗

PubMed1999

Fetal movement counts.

Monitoring fetal movement serves as an indirect measure of central nervous system integrity and function. The coordination of whole body movement in the fetus, which requires complex neurologic control, is similar to the coordination of movement in the preterm newborn infant. Short-term observations of the fetus are best performed using real-time ultrasound imaging or Doppler ultrasound. Daily fetal kick counting by the compliant gravida is a worthwhile adjunct in determining the need for fetal surveillance tests in the office and in predicting abnormal FHR patterns and perhaps impending stillbirth. Monitoring has its greatest value when placental insufficiency is long-standing; its routine role in low-risk pregnancies requires further clinical investigation. The presence of a vigorous fetus is reassuring. Perceived inactivity requires a reassessment of any underlying antepartum complication and a more precise evaluation by FHR testing or real-time ultrasonography before delivery is considered.

Cardiotocography↗