Every year, about 85 percent of the approximately 5 million births in North America are evaluated with the electronic fetal monitoring (EFM). Clinicians use the EFM as a proxy to assess fetal oxygenation status, fetal well-being, and potential compromise. Despite the widespread use of this technology, neonatal hypoxia and acidosis continue to make up a high proportion of neonatal morbidity at term. Indeed, though the fetal heart rhythm is inextricably linked to fetal acid-base status, EFM has not been shown to reliably predict neonatal pH status nor has it reduced adverse maternal or neonatal outcomes. As a consequence, the high false-positive rate of EFM for predicting adverse neonatal outcomes has led to an increase in the rate of operative vaginal and cesarean delivery, with elevated rates of associated maternal and neonatal morbidity. This fact invariably leads to a paradox we have henceforth defined as the "obstetrical paradox." Herein, we explore the potential solutions to this paradox and introduce a novel noninvasive technique to assess fetal acid-base status in utero known as the "FETAL technique" (Fourier Evaluation of Tracings and Acidosis in Labour). The FETAL technique, currently under investigation, applies the discrete Fourier transformation to EFM tracings to determine the spectral frequency distribution of the fetal heart rate. These specific frequency distributions correlate with specific umbilical pH values and may provide the missing link between fetal heat rate patterns and acid-base status at birth. As we work toward realizing the full potential benefits of EFM, finding the best assessment strategies to evaluate fetal pH in real time remains a key goal in obstetrics.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031714 | PMC |
http://dx.doi.org/10.1155/2020/7801039 | DOI Listing |
JAMA Netw Open
December 2024
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Importance: Access to appropriate postpartum care is essential for improving maternal health outcomes and promoting maternal health equity.
Objective: To analyze the impact of the Nurse-Family Partnership (NFP) home visiting program on use of routine and emergency postpartum care.
Design, Setting, And Participants: This study was a secondary analysis of a randomized clinical trial that enrolled eligible participants between 2016 and 2020 to receive NFP or usual care from a South Carolina Medicaid program.
JAMA Pediatr
December 2024
Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Importance: Gestational exposure to nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of adverse fetal kidney outcomes. However, details regarding timing, specific NSAIDs, and long-term childhood kidney outcomes are limited.
Objective: To evaluate the association between gestational exposure to NSAIDs and the risk of chronic kidney disease (CKD) in childhood.
Anat Sci Int
December 2024
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece.
The cerebral arterial circle morphologic variability has been extensively studied. The posterior cerebral artery (PCA) variants are rarely identified, except from the first segment (P1) hypoplasia or absence. Due to its unique morphology, the computed tomography angiography (CTA) of a 34-year-old female patient was further investigated.
View Article and Find Full Text PDFSurg Radiol Anat
December 2024
Department of Anatomy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India.
Purpose: Anatomical research on fetal liver venous systems is scarce. This study presents variations, morphometric, and histogenesis data through cadaveric study which can aid prenatal radiological analysis.
Materials And Methods: 10% formalin embalmed 16 fetuses (8-second trimester, 8-third trimester) were utilized.
Microbiol Spectr
December 2024
Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, Shaanxi, China.
is one of the most common pathogens causing reproductive failure in ruminants (e.g., cattle and goats) worldwide.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!