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At least 19 recordsLinked to original sources

The relationship between antepartum fetal heart rate, intrapartum fetal heart rate, and fetal acid-base status.

The relationships between antepartum baseline fetal heart rate, baseline variability, accelerations, decelerations, and fetal movement and intrapartum fetal heart rate, fetal acid-base assessment at delivery, and Apgar scores 1 and 5 minutes after delivery were studied in 290 mature pregnancies. There was a significant relationship between antepartum and intrapartum baseline fetal heart rate and baseline variability. There was no relationship between antepartum and intrapartum accelerations or decelerations. There was no correlation between antepartum fetal heart rate or fetal movement and fetal acid-base status at delivery or Apgar scores 1 and 5 minutes after delivery. There was a trend for decreased accelerations and decreased fetal movements to be associated with a low Apgar score 1 minute after delivery.

Acid-Base Equilibrium↗

Effect of epidural analgesia on the fetal heart rate.

Fetal heart rate (FHR) changes occasionally follow the use of labor epidurals. Most studies of the phenomenon have focused on specific techniques, but similar timing and appearance suggest a common cause. Induction of analgesia may transiently alter the balance between factors encouraging and inhibiting uterine contractions with subsequent changes of FHR patterns. Regardless the etiology, these changes are transient and do not produce maternal or fetal morbidity. However, they must be promptly recognized and treated if necessary.

Analgesics, Opioid↗

Fetal heart rate and fetal activity patterns after vibratory acoustic stimulation at thirty to thirty-two weeks' gestational age.

Twenty pregnant women between 30 and 32 weeks' gestational age were studied to examine the effects of a 5-second external vibratory acoustic stimulus on the fetal heart rate, fetal heart rate variability, and fetal activity patterns. There was an immediate significant increase in the basal fetal heart rate for 10 minutes compared with controls. There was also a significant increase in the mean duration of fetal heart rate accelerations without any change in the number of fetal heart rate accelerations. There were no changes in long-term fetal heart rate variability, fetal breathing, and gross fetal body movements.

Acoustic Stimulation↗

Effect of intravenous glucose injection on human maternal and fetal heart rate at term.

The effects of maternal intravenous glucose administration (25 gm) on maternal heart rate, fetal heart rate, gross fetal body movements, and fetal heart rate accelerations was measured in 11 healthy pregnant women at 38 to 40 weeks' gestational age. Mean maternal heart rate increased from 78.3 +/- 0.8 bpm during the control period to 82.7 +/- 0.5 bpm at 30 to 85 minutes following glucose injections (p less than 0.01). Mean fetal heart rate rose from 137.8 +/- 0.4 bpm to 142.4 +/- 0.3 bpm at 50 to 95 minutes following injections (p less than 0.001). The incidence of gross fetal body movements and the number, duration, and amplitude of fetal heart rate accelerations did not change following glucose injection. We conclude that maternal glucose administration near term results in a small but significant increase in the mean maternal heart rate and fetal heart rate and no change in the incidence of gross fetal body movements or in fetal heart rate accelerations.

Blood Glucose↗

Antepartum fetal heart rate testing. II. Intrapartum fetal heart rate observation and newborn outcome following a positive contraction stress test.

The positive contraction stress test (CST) has been looked upon as a predictor of fetal compromise. On this basis, some reports advise routine cesarean delivery on the assumption that the compromised fetus should not tolerate labor. Other authors advocate selective cesarean delivery, based on obstetrical factors such as the inducibility of the cervix and the practicality of fetal monitoring. Finally, an attempted trial of labor may be allowed on the basis of occurrence of fetal heart rate acceleration with fetal movement, or "reactivity." The occurrence of "false positive" tests is not infrequent (20 to 45 per cent). The definition of such is unclear and little quantitative information regarding intrapartum performance is available. In this series of 27 patients, a trial of labor was undertaken in 20. Vaginal delivery occurred in 11 (55 per cent) and cesarean section in nine (45 per cent). Fetal heart rate abnormalities thought to indicate "distress" occurred in five patients (25 per cent). The "positive" window or repetitive late deceleration as equivalent to the positive CST was seen in only three patients during labor. A trial of labor should be attempted in the face of a positive CST whenever obstetric factors are favorable and careful intrapartum monitoring can be performed.

Apgar Score↗

Intrapartum fetal heart rate monitoring. V. Fetal heart rate patterns in the second stage of labor.

A total of 1,755 fetal heart rate (FHR) tracings of the second stage of labor was analyzed. The FHR patterns were classified according to the behavior of the baseline FHR and are listed in decreasing order of benignity: normocardia, transitory bradycardia, tachycardia, persistent bradycardia, and progressive bradycardia. Each category was further subdivided into four groups on the basis of association or nonassociation with early, variable, or late decelerations. Cord compression pattern were noted in over 50% of the FHR tracings and account for the majority of low Apgar scores and fetal acidosis. FHR abnormalities occurred in 91% of second-stage labor patterns, and were mild in most cases or of too short duration to influence fetal outcome. An effort was made to establish therapeutic guidelines based on the morphologic features, prognostic grading, and the etiology of the FHR patterns in the second stage of labor.

Bradycardia↗

Antepartum fetal heart rate monitoring. III. Fetal movements and accelerations in fetal heart rate.

This third part of the paper deals with the study of the relationships between fetal movements, fetal heart rate accelerations associated with such movements, fetal heart rate instability and neonatal outcome. No correlations has been found between absence of fetal movements and neonatal distress. A correlation has been found between the lack of fetal heart rate accelerations, the flatness of the record and poor neonatal outcome. In extreme situations (i.e. flatness in less than 10% of the record or in more than 80%) the presence or absence of accelerations does not add further useful information. Such information, however, is gained in the intermediary situations (the 'combined' recordings) and particularly when the record is between 51 and 80% flat where there appears to be an 85.6% risk to the fetus. Consequently, when trying to analyse an antenatal record it seems advisable to take primarily into account the percentage of flat recordings (providing the records are numerous enough and of sufficient length). Then, in records between 10 and 50% flat, the presence or the lack of spontaneous decelerations requires consideration whereas, when the record is between 51 and 80% flat, it is the presence or absence of fetal heart rate accelerations which is important.

Apgar Score↗

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↗

Evaluation of fetal heart rate variability.

Fetal heart rate (FHR) variability appears to be an "early warning system" of fetal hypoxia. FHR variability has been utilized in clinical practice to examine fetal wellbeing. Since 1976 we have used a standardized scoring system to evaluate the cardiotocograph. To eliminate subjective aspects in FHR variability analysis we propose a programmable device utilizing a microprocessor. Preliminary results encourage us to continue this research.

Computers↗

The effect of maternal hypothermia on the fetal heart rate.

Fetal bradycardia is a recognized response to maternal hypothermia but has not previously been reported in conjunction with diabetes. A 30-year-old insulin-dependent diabetic was admitted at 35 weeks gestation for control of her diabetes. She developed maternal hypothermia and hypoglycemia and the fetal heart rate fell to 100 beats per minute (b.p.m.). However, the fetal heart rate gradually returned to normal after rewarming the patient.

Adult↗