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At least 19 recordsLinked to original sources
PubMedDate not supplied

Predictive values of umbilical artery waveforms and repeat cardiotocography in pregnancies complicated by nonreactive cardiotocography.

Fifty patients with a nonreactive nonstress cardiotocograph were studied. All had measurement of the A/B ratio of the umbilical artery Doppler waveform and 39 also had a repeat nonstress test. The positive and negative predictive values of the repeat nonstress test were 61% and 94%, respectively, and those of the A/B ratio were 67% and 83%. A repeat nonreactive nonstressed cardiotocograph appeared to be a test of high sensitivity (92%) and the A/B ratio a test of high specificity (83%). It is suggested that the combination of the two tests may prove a powerful predictor of adverse perinatal outcome.

Blood Flow Velocity↗
PubMed1992

Comparison of umbilical-artery velocimetry and cardiotocography for surveillance of small-for-gestational-age fetuses.

Intrauterine growth retardation is associated with an increased risk of fetal asphyxia as well as greater perinatal morbidity and mortality. Ultrasound fetometry enables detection of fetuses that are small for gestational age. Doppler velocimetry of the umbilical artery has good predictive ability for fetal distress, but it is not yet clear whether it could replace cardiotocography in antenatal surveillance of small-for-gestational-age fetuses. We have done a randomised comparison of the two methods. At four obstetric departments in Sweden, women with fetuses found to be small on ultrasound examination at 31 completed weeks of pregnancy or later were randomly assigned to antenatal surveillance with either doppler velocimetry (doppler; 214) or cardiotocography (CTG; 212). Pregnancies in the doppler group were managed according to a protocol based on blood-flow classes deriving from the semiquantitative evaluation of umbilical-artery velocity waveforms; unless the pregnancy was complicated by any other disorder, no antenatal cardiotocography was done. By comparison with the CTG group, the doppler group had fewer monitoring occasions (mean 4.1 [SD 3.1] vs 8.2 [6.2], p < 0.01), antenatal hospital admissions (68 [31.3%] vs 97 [45.8%], p < 0.01), inductions of labour (22 [10.3%] vs 46 [21.7%], p < 0.01), emergency caesarean sections for fetal distress (11 [5.1] vs 30 [14.2%], p < 0.01), and admissions to neonatal intensive care (76 [35.5%] vs 92 [43.4%], p = 0.10). The groups did not differ in gestational age at birth, birthweight, Apgar scores, or total number of caesarean deliveries. Umbilical-artery doppler velocimetry of small-for-gestational-age fetuses allows antenatal monitoring and obstetric interventions to be aimed more precisely than does cardiotocography.

Adolescent↗
PubMed1992

[Telemetric cardiotocography--clinical value and limits of the method in routine monitoring].

Cardiotocography by external telemetry and maternal ambulation has been compared to the usual recording in recumbent position. The visual interpretation extended to several items, such as technical quality, CTG scoring, contractions and foetal activity, which were interpreted for single groups of gestational age and diagnosis. A questionnaire of the patients joined with this study, referring to the acceptance of cardiotocography, definitely voted for the telemetrical method. As to the valuation of the cardiotocograms (CTGs), it was necessary to consider a slight restriction of the undulation of the foetal heart rate by telemetry. Referring to the technical quality of the CTGs, the telemetrical method was inferior in all points while recording in recumbent position. Problems appeared to occur especially with adipose gravidas. In patients with toxaemia, we noticed a tendency to increasing systolic blood pressure combined with growing restriction of foetal undulation by telemetrical recording. The use of external telemetry with maternal ambulation at other diagnostical situations should depend only on technical quality and maternal acceptance of telemetry, since there are no differences with respect to information.

Adolescent↗
PubMed1989

[Cardiotocography in intrauterine growth retardation].

Fifty seven cases of intrauterine growth retardation were analyzed at the Department of Perinatal Medicine, "Luis Castelazo Ayala" Hospital, IMSS. The main purpose of the study was to establish the usefulness of cardiotocography in the decision of pregnancy interruption. The patients were divided in three groups in relation to the last non stress test made before delivery (reactive, non reactive, non reactive, non reactive with declarations). It is concluded that cardiotocography is a useful procedure for the surveillance of these fetuses and it was found a good correlation between progressively ominous traces and fetal condition at birth.

Abortion, Induced↗
PubMedDate not supplied

[Significance of cardiotocography and amnioscopy in establishing indications for cesarean section].

In the period of 2 years (1974-1975), out of 11,672 deliveries, 398 (3.41%) were induced by cesarean section. An important role in inducing labour surgically was played by cardiotocography and amnioscopy (in addition to other methods), i.e. in 84.22% (366 cases). At present it appears necessary to use cardiotocography and aminiscopy both in the last trimester and during the labour itself, so as to facilitate the estimation of the degree of a possible danger for the foetus.

Cesarean Section↗
PubMed1992

Randomised trial of cardiotocography alone or with ST waveform analysis for intrapartum monitoring.

It is possible to record the fetal electrocardiographic waveform (ECG) from the scalp electrode used in labour for detection of fetal heart rate. Animal and observational studies of changes in the ST waveform of the ECG during hypoxia suggest that a combination of heart rate and ST waveform analysis might improve the predictive value of intrapartum monitoring. In a randomised trial, we have studied intervention rates and neonatal outcome for high-risk labours monitored either by conventional cardiotocography (CTG) or by ST waveform analysis plus CTG. 1200 women with pregnancy of at least 34 weeks' gestation were assigned to the groups when the decision to apply a fetal scalp electrode was made. Neonatal outcome was assessed by umbilical-cord blood gas analysis, Apgar scores, resuscitation needed, and postnatal course. All recordings were retrospectively viewed by an observer unaware of clinical details to check adherence to the trial protocol. The addition of ST waveform monitoring to CTG substantially reduced the proportion of deliveries for fetal distress (ST + CTG 27/615 vs CTG 58/606; p less than 0.001). The groups did not differ in rate of operative delivery for other reasons, incidence of asphyxia at birth, or neonatal outcome. Metabolic acidosis and low 5 min Apgar scores were less common in the ST + CTG than the CTG group, but not significantly so. The only case of birth asphyxia in the ST + CTG group was identified by both heart rate and ST changes. The review of recordings showed that the reduction in intervention rate was among cases with CTG patterns classified as normal or intermediate, whereas there was no difference in intervention rates among cases with abnormal recordings. Our findings confirm that ST waveform analysis discriminates CTG changes in labour and that our protocol for interpretation is safe. Further randomised studies are warranted.

Adult↗
PubMed1992

A simplified form of cardiotocography for antenatal fetal assessment.

Antenatal cardiotocography has become the primary method of evaluation of fetal wellbeing, and the relationship between the presence of fetal heart rate accelerations in response to fetal movement and subsequent good fetal outcome has been demonstrated. However, in areas where electronic monitors are few or not available it would be useful if such accelerations could be demonstrated using the Pinard stethoscope. A prospective study involving 200 women with a singleton pregnancy of more than 34 weeks gestation was performed at Harare Maternity Hospital, Harare, Zimbabwe, when a 6 min electronic trace using an external transducer was compared with simultaneously performed 6 min manual record using the Pinard stethoscope. The findings showed that the manual record has a sensitivity of 75% and although traces with excessive base line variability would show an acceleration on the manual record, in no case with a flat trace was an acceleration noted on the manual record. This acceptable degree of sensitivity would allow for a significant decrease in the number of women being referred for electronic tracing and would be a more appropriate use of limited resources in terms of manpower and equipment.

Auscultation↗
PubMed1991

Intrapartal cardiotocography in prediction of well-being of small for gestational age newborns.

An attempt to predict neonatal well-being in vaginal delivery was made in groups of 103 term small for gestational age (SGA) and 103 term adequate for gestational age (AGA) newborns, by assessing cardiotocography scores immediately before birth. For assessment, modified Fischer scores (from 0 to 10, normal greater than or equal to 8) and subjective visual scores (from 0 to 6, normal greater than or equal to 5) were used. Modified Fischer scores had a sensitivity of 25% in detecting acidosis (umbilical artery pH less than 7.20) in SGA cases; and of 50%, in AGA cases. Visual scores had a sensitivity of 75 and of 50%, respectively. Specificities in these groups were 64 and 65%, and 56 and 60%, respectively. The positive predictive values in all groups were below 10%. It is concluded that intrapartal cardiotocographic scoring is neither very sensitive nor specific in the prediction of neonatal condition in term vaginal SGA and AGA deliveries.

Acidosis↗
PubMed1989

Diagnostic potential of cardiotocography (CTG) for silent uterine rupture.

We report on 3 patients with silent rupture of previous uterine scars. Despite continuous monitoring by cardiotocography, diagnosis was not made until the time of surgery. The cesarean section was indicated by the obstetrical-clinical examination, while CTG offered no evidence of uterine rupture.

Adult↗
PubMed1991

[Diagnosis of disorders of the fetal status using computer-assisted cardiotocography].

The diagnostic system of cardiotocogram analysis in real time scale is described, and the diagnostic data of computer cardiotocography in various periods of os dilatation presented. Analysis of correlations and regressions of the parameters reflecting disorders of the fetal status has shown that the most significant parameter in the diagnosis of fetal status abnormalities is variability from beat to beat.

Adolescent↗
PubMed1978

Antepartum stress cardiotocography using buccal oxytocin.

The use of buccal pitocin in the performance of stressed antenatal cardiotocography was studied. Sixty-three tests were performed on 40 patients. All the patients were followed through labour and delivery. The results were evaluated and compared with those where an intravenous oxytocin infusion was used. Buccal pitocin produced comparable uterine contractions to those obtained by intravenous oxytocin, with similar test results. The avoidance of venepuncture and infusion was a positive advantage of this method of applying the stress.

Administration, Oral↗
PubMed1978

The evaluation of extended analysis of serum, amniotic fluid and cardiotocography in the management of pregnancy complicated by immunization in Rh or Kell antigens.

The estimation of protein and bilirubin concentration together with checking the activity of LDH, AspAT, AlAT and Ech in maternal serum and amniotic fluid was performed with intention to improve the accuracy of antenatal prediction in hemolytic disease of newborns. With the same intention, the cardiotocography was introduced. After study on forty-six pregnancies, the usefulness of estimation of optical density, protein and bilirubin concentration in amniotic fluid and calculation of bilirubin/protein ratio was confirmed. The other investigated methods appeared useless.

Amniotic Fluid↗
PubMed1979

Selection criteria for antenatal cardiotocography.

The present report considers two questions: 1) Which patients should be monitored routinely and 2) the interpretation of antenatal cardiotocography. During 26 months 812 patients with risk pregnancies were monitored with antenatal CTG. Most of them were daily registered. One hundred and seventeen (14.5%) showed pathological CTG changes. The CTG patterns were put into four classes according to the degree of seriousness. A comparison between high risk and low risk pregnancies showed that nearly all abnormal CTGs occurred in the high risk group. Within the high risk group, patients with essential hypertension and intrauterine growth retardation had pathological CTG changes in 20--30%. The study shows that high risk pregnancies should be monitored regularly at short intervals to allow early diagnosis of fetal distress. The value of routine CTG in low risk pregnancy can be questioned.

Echocardiography↗
PubMed1979

[Cardiotocography -- proposal of system solution (author's transl)].

A system solution with new technical details and new demands on space distribution is proposed for the use of antenatal cardiotocography and cardiotocographic monitoring of labour. Bedside equipment will be reduced and widely shifted to a centralised control room by introduction of the system. All installations are of high flexibility to leave room for future developments in medical engineering and for necessary services. -- Large-scale use of the new technique with capacity utilisation of the hardware involved will be ensured by appropriate upgrading of labour room personnel as well as by techno-organisational improvement of work and minimisation of expenses on diagnosis and monitoring. The measures proposed work according to expectation and lead to good perinatological results.

Female↗
PubMed1978

[Value of the abdominal electrocardiogram for cardiotocography (author's transl)].

The value of abdominal Electrocardiogram (abd. ECG) for cardiotocography has been studied prospectively in 183 ante- and 93 subpartum patients. The indications for using abd. ECG have been worked out and the influence of various factors on the quality of registration were tested. It was found that neither location of the placenta nor obesity nor the state of the membranes influenced the quality of abd. ECG-records. Furthermore abd. ECG was used successfully in cases with advanced labor.

Body Height↗