This study aimed to identify factors predicting the probability of serious fetal acidemia at delivery in placental abruption. We identified 5769 women who delivered at >22 weeks’ gestation at two institutions in a tertiary referral unit specializing in neonatal infant care between January 2007 and December 2011. Ninety-one abruption cases were identified based on clinical and histological diagnoses. Serious fetal acidemia was defined as a pH < 7.0 in the umbilical arterial blood at delivery. Using a linear discriminant function, we calculated the score to determine the probability of serious fetal acidemia. Serious fetal acidemia was observed in 34 patients (37.4%). A logistic regression model showed that abnormal fetal heart rate patterns (bradycardia and late decelerations), uterine spasm, and maternal plasma concentration of fibrinogen less than 288 ng/dL were significantly associated with the occurrence of serious fetal acidemia. We suggest that the implementation of maternal fibrinogen in patients with placental abruption is a prognostic factor for serious fetal acidemia at delivery.
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http://dx.doi.org/10.3390/jcm11247504 | DOI Listing |
Am J Obstet Gynecol MFM
January 2025
The Josef Buchmann Gynecology and Maternity Center, Sheba Medical Center, Tel Hashomer, Israel; ARC Innovation Center, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; The Dina Recanati School of Medicine, Reichmann University, Herzliya, Israel.
Objective: Machine learning (ML), a subtype of artificial intelligence (AI), presents predictive modeling and dynamic diagnostic tools to facilitate early interventions and improve decision-making. Considering the global challenges of maternal, fetal, and neonatal morbidity and mortality, ML holds the potential to enable significant improvements in maternal and neonatal health outcomes. We aimed to conduct a comprehensive review of ML applications in peripartum care, summarizing the potential of these tools to enhance clinical decision-making and identifying emerging trends and research gaps.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2024
Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK; Saint Mary's Hospital, Manchester University NHS Foundation Trust, UK.
Introduction: Fetal scalp blood sampling (FSBS) can be used as an adjunctive test, in the presence of a pathological intrapartum fetal heart rate trace, to provide evidence of fetal acidaemia. The role of FSBS remains controversial, this study evaluates the diagnostic accuracy of FSBS at determining various adverse neonatal outcomes.
Method: A retrospective cohort analysis of FSBS undertaken < 1 h from birth in a single UK centre in 2016 and 2017.
PLoS One
January 2025
MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal.
Intrapartum asphyxia is responsible for approximately 900 000 deaths per year worldwide. These numbers show the urgency of investing in the quality of fetal health care. The heart rate signal is a complex signal and sometimes behaves unpredictably.
View Article and Find Full Text PDFJ Obstet Gynaecol Res
January 2025
Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Yamagata, Japan.
Aim: In Japan, the fetal heart rate pattern on cardiotocography is usually categorized into five levels for intrapartum management; however, studies on the 5-tier cardiotocography classification are limited. This study aimed to determine the correlation between 5-tier cardiotocography levels at delivery, neonatal Apgar scores and perinatal prognosis using a perinatal registry database.
Methods: This retrospective study used the 2018 Perinatal Registry Database of the Japan Society of Obstetrics and Gynecology.
Am J Obstet Gynecol
December 2024
Catholic University of Sacred Heart, Department of Women and Child Health, Fondazione Policlinico Gemelli IRCCS, Rome, Italy. Electronic address:
Background: Occiput posterior position is associated with labor arrest, need for operative delivery, and failed instrumental vaginal delivery, with resulting adverse peripartum outcomes. Vacuum extraction is the most commonly performed type of instrumental delivery worldwide.
Objective: This study aimed to investigate the outcome of vacuum extraction in fetuses with sonographically confirmed occiput posterior position before the procedure.
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