PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Cardiotocography”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources
PubMed1992

Prospective study of the quality of survival of infants with critical fetal reserve detected by antenatal cardiotocography.

From 1981 to 1986 antenatal cardiotocographic monitoring was performed on 9,992 high-risk pregnancies selected from a total obstetrical population of 31,518 patients (31.7%). A critical fetal reserve pattern was detected in 89 patients (0.9%) whose pregnancies resulted in 68 surviving infants, 19 perinatal deaths and 2 sudden infant deaths. Since 47.4% of the infants who died in the perinatal period did so because of a related congenital malformation, such a defect should be excluded in the fetus with critical fetal reserve, by ultrasonography, before delivery (there is usually insufficient time for fetal karyotyping). Sixty-three (92.6%) of the surviving children were assessed at our Growth and Developmental Clinic and disabilities were detected in 16 (25.4%); however, the disability was major in only 5, including 2 children with Down syndrome. The quality of survival of infants born from pregnancies complicated by critical fetal reserve was satisfactory as 60 of 63 children (95.2%) had neither a major disability related to intrauterine hypoxia identified by the cardiotocographic pattern, or had one likely to significantly interfere with their quality of life. Our results suggest that pregnancies can be continued until the cardiotocographic pattern becomes critical in order to gain fetal maturity, without compromise to the fetal brain.

Cardiotocography↗
PubMed1994

Intrapartum cardiotocography and the expert witness.

Fetal heart rate changes occur in the majority of labours and correlate poorly with perinatal outcome and subsequent neurological development. Obstetricians giving expert evidence related to the interpretation of intrapartum cardiotocographs are advised to exercise caution when expressing their opinions.

Cardiotocography↗
PubMed1998

Computerized cardiotocography following vibroacoustic stimulation of premature fetuses.

OBJECTIVE: The purpose of this study was to examine the effect of vibroacoustic stimulation (VAS) on the fetal heart rates (FHRs) in a group of premature fetuses. STUDY DESIGN: The FHRs were analyzed using the Oxford Sonicaid Computer System 8000, 30 min preceding and then 3 times following VAS. RESULTS: The changes of the mean FHR after VAS in the premature group and the control group of term fetuses occurred in the first 10 min after VAS. The greatest increase in the number of accelerations occurred in both groups during the 11-20 min following VAS. The long-term variability increased significantly in all 3 study periods in premature fetuses and only in the periods of 0-10 and 11-20 min in the control group. The increase in short-term variability was similar in both groups and it was greatest in the period of 11-20 min. CONCLUSION: Most of the heart rate changes of premature fetuses occur between 11 and 20 min following VAS.

Acoustic Stimulation↗
PubMed2006

Massive feto-maternal hemorrhage: diagnosis by cardiotocography, Doppler ultrasonography and ST waveform analysis of fetal electrocardiography.

A 34-year-old healthy gravida 2 para 1 presented after an uncomplicated pregnancy at term with a 2-day history of diminished fetal movements. Fetal anemia was suspected by fetal heart rate monitoring and Doppler estimation of the fetal peak blood flow velocity of the middle cerebral artery. We were also fortunate to register pathological ST waveform changes of the fetal ECG indicating fetal hypoxia. The diagnosis of a massive feto-maternal hemorrhage was confirmed by an extremely high fraction of erythrocytes containing fetal hemoglobin in maternal blood and, after delivery, by placental histology.

Adult↗
PubMed2000

Using telemedicine to facilitate training in cardiotocography (CTG) interpretation.

Electronic fetal monitoring is a controversial practice in modern obstetric care and is frequently an aspect of medicolegal cases involving the management of labour and delivery. The interpretation of the cardiotocograph (CTG) produced by such monitors is a skill required by those caring for the pregnant woman. Studies have shown that most 'experts' do not interpret CTGs in a consistent manner, when compared with either other experts or themselves. However, it has also been shown that consistency can be improved with training. Telemedicine has been used to advantage in the training of obstetrics and gynaecology registrars in CTG interpretation.

Cardiotocography↗
PubMed2006

Four years' experience with antepartum cardiotocography using telemedicine.

We reviewed the first four years of experience with telemonitoring of patients with high-risk pregnancies. Nine peripheral units (eight in Campania, a region of south Italy, and one in Hungary) recorded cardiotocographic traces and transmitted them via modem to an operations centre at the University 'Federico II' in Naples, where the computerized analysis was performed. The medical report was returned to the peripheral unit via fax or email. Four thousand and twenty one traces were recorded: 2674 (67%) from 764 high-risk patients and 1347 (34%) from 499 patients at apparent low risk. The neonatal outcome was good overall. Questionnaires were sent to the operators working at the peripheral units to evaluate the acquisition of specific skills and their level of satisfaction. Sixty-six questionnaires about cardiotocographic trace interpretation were collected. The number of correct answers increased during the study. A total of 33 questionnaires about job satisfaction were collected. The answers showed that the operators gradually overcame their scepticism during the study. A total of 1098 questionnaires were answered by the patients. Their answers showed a moderate level of satisfaction. Telecardiotocography allowed the decentralization of prenatal surveillance.

Cardiotocography↗
PubMed2004

Computerized cardiotocography parameters in pregnant women affected by pregestational diabetes mellitus.

AIM: To evaluate whether computerized CTG (cCTG) is a reliable method of predicting neonatal outcome in pregnancies complicated by pregestational diabetes at term. PATIENTS AND METHODS: We considered 27 pregnant women affected by pregestational diabetes and 46 normal pregnancies as controls that fulfilled the following criteria: singleton, Caucasian, euglycemic pregnancies at term (>37 weeks gestational age). All women delivered by cesarean section (CS), with an antepartum cCTG performed within one hour before the CS and an UBGA available at birth. No patient was in labor during FHR monitoring. RESULTS: Among cCTG parameters, accelerations 15 bpm, HV min, HV ms and STV were significantly lower in comparison to controls. We observed that in the diabetic pregnant women the parameter STV was not able to predict or to linearly regress with the most important UBGA parameters: pH and pCO2. Contrarily, in normal pregnancies, the STV linearly regressed with both the pH (p < 0.03) and pCO2 (p<0.04). CONCLUSIONS: Computerized FHR criteria may not be applicable to fetuses in pregestational diabetic pregnancies at term. Therefore some criteria should perhaps be modified for a correct interpretation of cCTG in these pregnancies.

Acidosis↗
PubMed2006

Intrapartum cardiotocography -- the dilemma of interpretational variation.

OBJECTIVE: To evaluate and compare interobserver variation in interpretation of intrapartum cardiotocograms. SUBJECTS: Fifteen senior (experience >4 years) and 16 junior (experience < or =4 years) obstetricians from 10 delivery units. DESIGN: Thirty-one obstetricians interpreted intrapartum cardiotocographic (CTG) readings from 22 parturients. METHODS: Inter-observer agreement in CTG interpretation and decision-making was assessed via proportions of agreement (Pa), with 95% confidence intervals (CI). MAIN OUTCOME MEASURES: The level of inter-observer agreement was analyzed by calculating Pa values for CTG baseline, variability, early, variable and late decelerations, uterine tonus, power of contractions, hypertonus and clinical decision. RESULTS: In assessments of normal cases the Pa were acceptable or good (0.63-0.82) as regards all CTG interpretation elements except for the power of contractions (0.24), but in assessments of abnormal cases the Pa values were lower (0.18-0.60). As regards clinical decisions, a higher Pa was found in cases without recommendation for intervention (0.63, 95% CI 0.62-0.64) than in cases with such recommendation (0.55, 95% CI 0.54-0.56). The Pa in the abnormal cases was better among senior than among junior obstetricians. CONCLUSIONS: Inter-observer variation in interpretation of abnormal CTG readings and recommendations for intervention is relatively wide. To improve reliability, uniform classification and standardized training in CTG interpretation are needed, as well as increased use of computerized CTG.

Cardiotocography↗
PubMed1988

Sub partu monitoring of the fetus by cardiotocography and fetal blood analysis.

A retrospective study to determine how well cardiotocogram (CTG) and micro blood analysis (FBA) results correspond to each other was made on 200 deliveries which had been monitored sub partu by these techniques. FBA was performed 306 times. CTG results were analysed according to Hammacher's method and the scores compared with the FBA results. In 40 cases with a normal Hammacher score, a normal FBA-pH value, as expected, was also found. In a total of 266 observations with a CTG score greater than two, there were simultaneously 10 times (scarcely 4%) found when there was a FBA value under 7.20. Of the 200 infants involved, 25 had a cord arterial pH value under 7.20. Ten minutes after birth, all of these infants were doing fine, with an Apgar score of at least seven. Statistically, sub partu CTG analysis according to Hammacher's method is highly sensitive, yet not very specific, when compared to the corresponding FBA-pH value.

Adult↗
PubMed1992

Computerised cardiotocography following vibro-acoustic stimulation.

To study the effect of vibro-acoustic stimulation (VAS) to the mean fetal heart rate (FHR), period of high and low FHR variation, overall variation (msec and bpm) and short term variation (msec). In a prospective study 17 pregnant women between 34-42 weeks gestation admitted to antenatal ward for obstetric complications two 60 min FHR recording was carried out with an interval of 30 min in between recordings. On a random basis the fetus was stimulated by a vibro-acoustic stimulator for 5 sec at the beginning of one of the two 60 min FHR recordings. Automated analysis of the FHR, tocodynamometry, and maternal perception of fetal movements was done by a commercially available computerized programme (System 8000). It was possible to obtain the two 60 min recordings with signal loss of < 10% in 12 out of 17 patients. No changes were observed when the FHR parameters for 60 min after VAS was compared with the control period. When analyzed in segments of 0 to 10, 11 to 20, 20 to 40 and 41 to 60 min the mean baseline FHR was significantly higher after VAS during the first 10 minutes compared with any 10 or 20 min segment of the control period or any such segments 10 min after VAS. Concomitantly the overall variation and short-term variation was significantly lower during the first 10 minutes following VAS (p < 0.05) compared with the parameters in the corresponding periods during the control period.(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustic Stimulation↗
PubMed1996

Why has conventional intrapartum cardiotocography not given the expected results?

It is probable that conventional electronic fetal monitoring (EFM) has reduced the intrapartum death rate, but the expected dramatic reduction in neurological handicap has not occurred. There are two reasons for this: the majority of infants, who develop neurological problems have been harmed before the onset of labor, and the method of EFM has been more difficult to use in daily routine than expected. However, EFM is the best method we have to monitor high risk cases and the results can be improved by better training of the staff.

Brain Injuries↗