Intrapartum fetal heart rate monitoring (FHR) was introduced in the 1970's in this country for the hope of preventing intrapartum hypoxic fetal events. The proper interpretation and the following management of intrapartum FHR are among the items that the obstetricians should be well informed of. This review summarizes the standardized FHR monitoring definition and interpretation based on the report from National Institute of Child Health and Human Development in 2008 and offers updated guidelines suggested by American College of Obstetrics and Gynecology in 2010. This review also details on the intrauterine resuscitation and finally demonstrates recent evidences about the impact of standardization of intrapartum management on adverse perinatal outcomes.
Female ; Fetal Heart ; Gynecology ; Heart Rate, Fetal ; National Institute of Child Health and Human Development (U.S.) ; Obstetrics ; Pregnancy ; Resuscitation ; Child Health

In 1969, the International Conference proposed a definition of sudden infant death syndrome (SIDS): the sudden death of any infant or young child which is unexpected by history and in whom a thorough necropsy fails to demonstrate an adequate cause of death. The National Institute of Child Health and Human Development redefined SIDS in 1989, requiring death scene investigation with age restriction under 12 months. These definitions, however, are not adequate for the countries having under-organized medico-legal system. In South Korea, no mandatory or customary complete medico-legal investigation is not performed in the sudden child death cases, including autopsy. As a consequence, SIDS can be diagnosed as 'unknown 'by non-pathologists. Even in autopsy cases, the pathologists can not collect proper medical history by themselves. Furthermore, scene investigation is just performed by police or omitted. Age in SIDS is a controversial problem in both upper and lower limit. So the authors concluded that the above two definitions of SIDS are not agreeable with the country such as South Korea. We proposed a new concept of sudden child death syndrome (SCDS), which means 'the sudden death of any infant including neonate with good condition after birth, or young child which reveals no definite cause of death by inspection or autopsy ', for the purpose of not unreasonable diagnosis and adequate research in the countries having under-developed postmortem investigation system.
Autopsy ; Cause of Death ; Child* ; Death, Sudden ; Diagnosis ; Humans ; Infant ; Infant, Newborn ; Korea ; National Institute of Child Health and Human Development (U.S.) ; Parturition ; Police ; Sudden Infant Death*

PURPOSE: There has recently been improvement in treatment skills and outcomes of patients in neonatal intensive care units (NICUs) of Korea. According to several studies, such results of very to extremely low birth weight infants were markedly improved in comparison to that of Japan or USA. In speculation, the authors reviewed the survival outcomes by gestational age from 2002 to 2009. METHODS: We extracted the survival outcomes of NICU patients by gestational age from the data of previous studies. Data from Japanese Perinatal Care Center Research Network and NICHD Neonatal Research Network of US were used for comparison. RESULTS: The survival rates by gestational age are as follows (2002, 2007, and 2009 respectively): 22-23 weeks (3.4, 19.0, 28.6%), 24 weeks (21.3, 44.0, 59.3%), 26 weeks (59.4,77.8, 78.0%), 28 weeks (79.0, 88.0, 91.2%), 30 weeks (93.8, 95.3, 93.6%), 32 weeks (95.3, 97.1, 98.2%), 34 weeks (98.8, 99.0, 99.0%), 36 weeks (99.2, 99.1, 99.2%), 38 weeks (99.7, 99.5, 99.2%), 40 weeks (99.7, 99.4, 99.2%), longer than 42 weeks (100.0, 96.3, 94.7%). For infants with a gestational age lesser than 28 weeks, the survival rates of Korea (2009), Japan (2009), and US (2003-2007) were 77.5, 89.0 and 71.6% respectively. The statistics of Korea ranked between those of Japan, USA. CONCLUSION: The survival rate of neonates admitted to NICU in Korea markedly improved from 2002 to 2009. The present study is the first report of survival rate by gestational age in Korea and will become a fundamental basis for further improvement in neonatal care.
Asian Continental Ancestry Group ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Japan ; Korea ; National Institute of Child Health and Human Development (U.S.) ; Perinatal Care ; Survival Rate