INTRODUCTIONFetal distress is a result of acute or chronic disturbances in the system of "mother-placenta-fetus" in pre-eclampsia (PE). The aim of the investigation was to compare the accuracy of antenatal fetal distress diagnostics in cases of traditional cardiotocography (CTG) waveform evaluation and analysis of morphological non-invasive electrocardiogram (ECG) parameters in anterpartum patients with PE.

MATERIALS AND METHODSFetal non-invasive ECG antenatal recordings of 122 pregnant patients at 34 to 40 weeks of gestation were examined. In Group I, there were 32 women with physiological gestation and normal fetal condition according to haemodynamic Doppler values. Group II involved 48 patients with mild and moderate PE whom were performed Doppler investigation. In Group III, 42 patients with severe PE were monitored with haemodynamic Doppler.

RESULTSFetal autonomic tone was lower with the relative increase of low frequency (LF) branch in the patients of pre-eclamptic group. The increased value of the amplitude of mode (AMo) and stress index (SI) was associated with adrenergic overactivity. It has induced pQ and QT shortening, increased T/QRS ratio and decelerations appearance. The rate of antenatal fetal distress retrospectively was 31.1 % in PE. The traditional analysis of CTG parameters has showed sensitivity (72.7%) and specificity (87.1%). In addition to the conventional CTG analysis, evaluation of ECG parameters has contributed to better diagnostics of fetal distress. Sensitivity and specificity of non-invasive fetal ECG were absolutely equal in this study (100%).

CONCLUSIONThe results suggest that fetal non-invasive ECG monitoring is more objective than conventional CTG.

Cardiotocography ; methods ; Cross-Sectional Studies ; Electrocardiography ; methods ; Female ; Fetal Distress ; diagnosis ; physiopathology ; Fetal Monitoring ; Heart Rate, Fetal ; Humans ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Third ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Ultrasonography, Doppler ; Ultrasonography, Prenatal

PURPOSE: This study examined the effect on uterine contraction frequency (UCF), blood pressure (BP), heart rate (HR), fetal heart rate (FHR) patterns and psychophysical symptoms (physical discomfort, anxiety, and depression) of structured bed exercise (SBE) in hospitalized high-risk pregnant women prescribed bed rest. METHODS: Forty-five hospitalized high risk pregnant women at >24 weeks of pregnancy prescribed bed rest were randomly assigned to the experimental or control group. From January to May 2014, data were collected using electronic fetal monitoring and patient monitoring of UCF, BP, HR and FHR patterns, and psychophysical symptoms were measured using the antenatal physical discomfort scale, state-trait anxiety scale, and Edinburgh postnatal depression scale. RESULTS: UCF, BP, HR, and FHR patterns (rate, variability, acceleration, and deceleration) did not differ significantly between the experimental and control groups. The experimental group showed a significant increase in baseline FHR after SBE within the normal range, and after SBE, it reduced to the FHR before SBE. The variability, acceleration and deceleration of FHR before and after SBE did not differ significantly between two groups. Moreover, there was no statistically significant difference before and after SBE in the experimental group. Also, the experimental group showed statistically significant decreases in physical discomfort score. However, there were no significant differences in depression and anxiety score between two groups. CONCLUSIONS: SBE in hospitalized high-risk pregnant women under bed rest did not increase the risk to the fetus, and relieved physical discomfort and anxiety. Therefore, SBE should be considered as a nursing intervention in hospitalized high-risk pregnant women.
Acceleration ; Anxiety ; Bed Rest ; Blood Pressure ; Cardiotocography ; Deceleration ; Depression ; Depression, Postpartum ; Female ; Fetal Heart* ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Monitoring, Physiologic ; Nursing ; Pregnancy ; Pregnancy, High-Risk ; Pregnant Women* ; Reference Values ; Uterine Contraction*

In this paper, using ultrasonic doppler signal, we composed fetal heart sound / fetal movement diagnosis and web-based database server/client environment. Detecting fetal heart rate and movement at the same time, for the data loss-caused from telemetering-protection and the high speed diagnosis, we made two signals mix and transmit. For the better communication between obstetrician and remote woman/fetus, we proposed database table that could reflect the whole information about remote fetus and its mom. And we supported HL-7 format so that we might be compatible with other vendor product and easy to access web-based hospital computerization system. Applying doctor to web-based high level biosignal analysis algorithm and expert system, we offered remote fetal biosignal and diagnostic assistant data inducing fast diagnosis. We made web-based fetal diagnostic system and improved web system compatibility, fast diagnosis and minimum of the rate of misdiagnosis.
Commerce ; Diagnosis ; Diagnostic Errors ; Expert Systems ; Female ; Fetal Heart ; Fetal Monitoring* ; Fetal Movement ; Fetus ; Heart Rate, Fetal ; Pregnancy ; Ultrasonics

To analyze the effect of hypoxaemia on heart rate variability (HRV) in fetal lambs by means of power spectrum, the intrauterine surgical operations were performed at 116-125 gestational days in 7 lambs. Arterial catheter was inserted in the fetal femoral artery and sent to aorta abdominalis, and blood pressure was recorded continually on tape recorder. The microspheres were injected via the arterial catheter to block the micrangium of placenta, thus making an animal model of fetal hypoxaemia. The fetal blood sample was drawn through the catheter for blood gas analysis. In terms of the heart beat variability power spectral density, there were four consistent components, namely very low (VL, 0.01-0.025 cycle/beat), low (L, 0.025-0.125 cycle/beat), middle (M, 0.125-0.2 cycle/beat), and high (H, 0.2-0.5 cycle/beat). Integrated peaks in the power spectrum were compared before and after administration of microsphere. The spectral power in the L frequency components was significantly increased (0.07 +/- 0.01 vs. 0.21 +/- 0.03, P<0.01), and the spectral power in the H frequency components was significantly reduced (0.53 +/- 0.1 vs. 0.27 +/- 0.05, P<0.05). There was no significant difference in M and VL. The times of microsphere injection were related to fetal blood pH (r=0.585, p<0.01), PCO2 (r=0.5, p<0.05) and PO2 (r=0.75, P<0.01). The results clearly demonstrate the association between change of power spectrum of heart rate variability and the effect of hypoxia of the fetus in labour.
Animals ; Blood Gas Analysis ; Female ; Fetal Blood ; Fetal Hypoxia ; physiopathology ; Fetal Monitoring ; Heart Rate, Fetal ; physiology ; Pregnancy ; Sheep

PURPOSE: This study aimed to develop supplementary material about the electronic fetal monitoring for nursing students, and to test the effects on electronic fetal monitoring related knowledge and confidence on nursing performance in delivery room. METHODS: Totally 58 nursing students were recruited either experimental group (n=30) or a control group (n=28). A non-equivalent control group pretest-posttest design was employed to test the effects on fetal monitoring related knowledge and confidence on nursing performance in delivery room. The supplementary material about the electronic fetal monitoring was developed based on Analysis, Design, Development, Implement and Evaluation (ADDIE) model. Fetal monitoring related knowledge and confidence on nursing performance in delivery room were self-reported by the scales that author developed. Data were collected at pre-test and after the 6-week intervention. RESULTS: There was significant difference in confidence on nursing performance in delivery room between two groups after intervention. CONCLUSION: These findings suggest the importance of the supplementary material about the electronic fetal monitoring for nursing students to improve confidence on nursing performance in delivery room.
Delivery Rooms ; Fetal Monitoring* ; Humans ; Nursing* ; Students, Nursing* ; Weights and Measures

Monitoring fetal movement serves as an indirect rneasure of fetal well-being, especially for central nervous system integrity and function. Methods to monitor fetal movement vary from the simple approach of having the mother chart perceived movement to highly specialized methods. However there were no reliable objective monitoring methods in Korea. For development of objective method for evaluating fetal movement, during pregnancy, one-hundred and two pregnant patients were entered to this study. All patients were divided into following 3 groups and each type of monitoring methods were applied. Group 1(N=20): Type I using portable FHR Doppler unit(IFD-100 model, Intermed, Korea). Group 2(N=20): Type II using FHR Microphone(Prenatal Listening Kit, Model FS002, Unisar Inc., US). Group 3(N=62): Type III using conventional ultrasound transducer(Corometric 115 Model, US). In this study, accurate counting of the fetal movementutus were best performed using Type III, because of monitoring fetal movements has its greatest efficiency when using conventional ultrasound transducer of fetal monitor. It was also attractive to doctors and nurses as a convenient methods because it needed only single transducer when compared to Type I and II. Although monitoring fetal body movement permits a general assessment of well-being, no perfect technique is still reliable. Futher techniques would be developed using the results of this study for improvement of several factors such as accuracy and objectiveness
Central Nervous System ; Fetal Monitoring ; Fetal Movement* ; Humans ; Korea ; Mothers ; Pregnancy* ; Transducers ; Ultrasonography

INTRODUCTIONIntrapartum fetal monitoring is essential for the identification of fetal hypoxia to reduce perinatal morbidity and mortality. Cardiotocography is associated with low specificity for fetal acidosis and poor perinatal outcome leading to unnecessary operative deliveries. ST waveform analysis of the fetal electrocardiogram has been shown to be a promising adjunctive intrapartum assessment tool. We aim to present the pathophysiology, the role of intrapartum monitoring and the practical usage of this relatively new technology in our review.

METHODSAn electronic search of Medline and OVID was carried out, followed by a manual search of the references identified by the electronic search.

RESULTSThe incorporation of ST waveform analysis to cardiotocography has been shown to reduce the rates of neonatal metabolic acidosis, moderate and severe neonatal encephalopathy, thus improving perinatal outcome. The reduction in operative delivery rates due to fetal distress is also significant. The pathophysiology and practical usage of this technology were discussed.

CONCLUSIONSWith more accurate identification of fetal hypoxia and reduction of unnecessary intervention rates, incorporation of ST waveform analysis of fetal electrocardiography into cardiotocography can improve the standard of intrapartum fetal monitoring.

Electrocardiography ; utilization ; Female ; Fetal Hypoxia ; diagnosis ; Fetal Monitoring ; instrumentation ; methods ; Humans ; Pregnancy ; Singapore

The paper presents a novel fetal heart rate (FHR) detecting system which is a fuzzy counter using the auto-correlation and fuzzy mathematic algorithm. This system is able to deal with the increase and decrease phenomena of FHR, caused by the various interference and noises. It has a higher detection level than ever and a better robust system based on the DSP.
Algorithms ; Echocardiography, Doppler ; instrumentation ; Equipment Design ; Fetal Monitoring ; instrumentation ; Fuzzy Logic ; Heart Rate, Fetal

Fetal heart rate plays an essential role in maternal and fetal monitoring and fetal health detection. In this study, a method based on Poincare Plot and LSTM is proposed to realize the high performance classification of abnormal fetal heart rate. Firstly, the original fetal heart rate signal of CTU-UHB database is preprocessed via interpolation, then the sequential fetal heart rate signal is converted into Poincare Plot to obtain nonlinear characteristics of the signals, and then SquenzeNet is used to extract the features of Poincare Plot. Finally, the features extracted by SqueezeNet are classified by LSTM. And the accuracy, the true positive rate and the false positive rate are 98.00%, 100.00%, 92.30% respectively on 2 000 test set data. Compared with the traditional fetal heart rate classification method, all respects are improved. The method proposed in this study has good performance in CTU-UHB fetal monitoring database and has certain practical value in the clinical diagnosis of auxiliary fetal heart rate detection.
Databases, Factual ; Female ; Fetal Monitoring ; Fetus ; Heart Rate, Fetal ; Humans ; Pregnancy

OBJECTIVE: The purpose of this study was to evaluate the usefulness of approximate entropy on fetal heart rate variability of electronic fetal monitoring taken during antepartum and intrapartum periods as a new diagnostic method of fetal distress. METHODS: Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into 3 groups, i.e.; 36 into normal fetus group, 26 into presumed distress group and 14 into acidemic distress group. We performed a frequency analysis on time series of heart rate variability in three groups. In order to perform non-linear analysis on the raw data of the fetal heart rate, after resampling and low pass filtering, we investigated approximate entropy. RESULTS: The results of the approximate entropy showed that the value in normal fetus group was significantly high than the value in distress group. But in the distress group, ApEn value was not difference between acidemic and non-acidemic subgroup. ApEn of HRV was confirmed in nonlinear parameter without low pass filtering and resampling. CONCLUSION: The results show that the fetal heart rate variability has nonlinear characteristics and could distinguish normal fetal heart rate pattern and distress pattern numerically and objectively. And these ApEn value are useful for prediction and diagnosis of fetal distress in ante and prenatal periods.
Ants ; Diagnosis ; Entropy* ; Female ; Fetal Blood ; Fetal Distress* ; Fetal Heart* ; Fetal Monitoring ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Pregnancy ; Pregnant Women