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Novel Insights In presence of cardiotocographic features suspected for hypoxic insult, intrapartum ultrasound in the hands of experienced operators can demonstrate cerebral edema as an indirect sign of fetal hypoxia affecting the fetal CNS and exclude non-hypoxic conditions potentially leading to abnormalities of the fetal heart rate. Introduction Hypoxic-ischemic encephalopathy is a syndrome involving the fetal central nervous system as the result of a perinatal hypoxic-ischemic injury. To date, transfontanellar ultrasound represents the first line exam in neonates with clinical suspicion of HIE as it allows to show features indicating acute hypoxic injury and exclude potential non-hypoxic determinants of HIE, however there is no report concerning the sonographic assessment of the brain during labor.
View Article and Find Full Text PDFThe fetal cerebral Doppler in the last weeks of pregnancy can select very small fetuses unlikely to present intrapartum compromise.
J Matern Fetal Neonatal Med
December 2025
Fetal Medicine Unit, St George's Hospital, London, UK.
Objective: To evaluate whether, in late pregnancy, the cerebral Doppler can identify very small fetuses that are less likely to experience intrapartum compromise (IC).
Material And Methods: This was a retrospective study of 282 singleton pregnancies that underwent an ultrasound scan at 32 + 0- 40 + 6 weeks and were delivered after induction, or spontaneous onset of labor. Very small fetuses were defined as fetuses with estimated weight less than the 3rd centile.
Factors contributing to visual intrapartum cardiotocograph interpretation variation among healthcare professionals: An integrative review.
PLoS One
January 2025
Faculty of Health Sciences, Department of Nursing Sciences, University of Pretoria, Pretoria, South Africa.
The reliability of cardiotocographs as diagnostic tools for fetal well-being is hampered by interpretational variations among healthcare professionals, contributing to high rates of cesarean sections and instrumental deliveries. While adjunct technologies may be used to confirm cases of fetal distress, those in resource constrained areas continue to rely on visual cardiotocograph interpretation to come up with the diagnosis of fetal hypoxia. This study investigated the factors contributing to variations in the visual interpretation of intrapartum cardiotocograph among healthcare professionals in the absence of adjunctive technologies.
View Article and Find Full Text PDFThe role of intrapartum ultrasound combined with free position delivery in the management of abnormal fetal positions during labor.
BMC Pregnancy Childbirth
January 2025
Medical Laboratory, Shidong Hospital, Affiliated to University of Shanghai for Science and Technology, 999 Shiguang Road, Yangpu District, Shanghai, 200438, China.
Objective: To investigate the effectiveness of combining intrapartum ultrasound with free maternal positions in managing abnormal labor, specifically focusing on its impact on delivery outcomes.
Methods: A retrospective cohort study was conducted on 176 cases of abnormal labor progression in women who attempted vaginal delivery at our hospital from June 2021 to May 2022. Among these, 88 cases were diagnosed with abnormal fetal positions using a combination of intrapartum ultrasound and vaginal examination, and these patients were guided to adopt free maternal positions (experimental group).
Risk factors for emergency department visits and readmissions for postpartum hypertension.
J Matern Fetal Neonatal Med
December 2025
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California (UCLA), Los Angeles, CA, USA.
Objective: Postpartum hypertension accounts for 15 to 20% of postpartum Emergency Department (ED) visits and readmissions in the United States. Postpartum readmission is a quality metric and target of quality improvement as it indicates poor control of hypertension and can portend increased morbidity. We aim to evaluate risk factors for postpartum ED visits and readmissions for hypertension.
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