The Experts below are selected from a list of 3375 Experts worldwide ranked by ideXlab platform
Carl V Smith - One of the best experts on this subject based on the ideXlab platform.
-
clinical experience with the hewlett packard m 1350a Fetal Monitor correlation of doppler detected Fetal body movements with Fetal heart rate parameters and perinatal outcome
American Journal of Obstetrics and Gynecology, 1994Co-Authors: Lawrence D Devoe, Frank H Boehm, Richard J Paul, Fredric D Frigoletto, Christine Penso, Robert L Goldenberg, William F Rayburn, Carl V SmithAbstract:Abstract OBJECTIVE: Our purpose was to correlate measures of Doppler-detected Fetal movements with standard Fetal heart rate parameters and perinatal outcomes. STUDY DESIGN: This prospective, multiinstitutional trial used the Hewlett-Packard M1350A Monitor to record simultaneous Fetal heart rate baseline, variability, accelerations, decelerations, and number of Fetal movements, and duration and percent of total time. These data were compared at 10- and 30-minute intervals during nonstress tests and were correlated with Fetal heart rate baseline parameters and maternally perceived Fetal movements and with outcomes of infants delivered within 7 days of the last test. RESULTS: At six centers 1704 actocardiograms from 884 third-trimester patients were analyzed. Doppler-detected Fetal movement counts, durations, and percent of total time correlated weakly with all baseline Fetal heart rate parameters (all values CONCLUSIONS: Doppler actocardiography may help to discriminate Fetal states during antepartum testing. It may prevent inappropriate diagnosis of Fetal compromise when the nonstress test is nonreactive or nonreassuring. (AM J OBSTET GYNECOL 1994;170:650-5.)
-
characterization of Fetal body movement recorded by the hewlett packard m 1350 a Fetal Monitor
American Journal of Obstetrics and Gynecology, 1992Co-Authors: Terry D Melendez, William F Rayburn, Carl V SmithAbstract:OBJECTIVE: The purpose of this study was to evaluate the ability of a commercially available Monitor, the Hewlett-Packard M-1350-A Fetal Monitor, to record and discriminate between various Fetal body movements. STUDY DESIGN: Twenty-four patients between 29 and 42 weeks' gestation were Monitored over a 20 to 30 minute period simultaneously by the Hewlett-Packard instrument and ultrasonography. RESULTS: All 593 single or clustered Fetal movements recorded by the Monitor were seen ultrasonographically as being extremity movements that were either isolated or combined with trunk motion. Discriminating between these two types of movements was not possible on the basis of the duration of recorded movements. All adequate Fetal heart rate accelerations were attributed to combined trunk and extremity movements. Detection of Fetal hiccups was less exact, and recording of Fetal hand, mouth, breathing, and rapid eye movements was beyond the sensitivity of the Monitor. Signal artifacts were attributable to either motion of the maternal abdomen or Doppler transducer and became less of a problem with experience. CONCLUSION: Fetal extremity movements were recorded with accuracy by this new Fetal Monitor.
William F Rayburn - One of the best experts on this subject based on the ideXlab platform.
-
clinical experience with the hewlett packard m 1350a Fetal Monitor correlation of doppler detected Fetal body movements with Fetal heart rate parameters and perinatal outcome
American Journal of Obstetrics and Gynecology, 1994Co-Authors: Lawrence D Devoe, Frank H Boehm, Richard J Paul, Fredric D Frigoletto, Christine Penso, Robert L Goldenberg, William F Rayburn, Carl V SmithAbstract:Abstract OBJECTIVE: Our purpose was to correlate measures of Doppler-detected Fetal movements with standard Fetal heart rate parameters and perinatal outcomes. STUDY DESIGN: This prospective, multiinstitutional trial used the Hewlett-Packard M1350A Monitor to record simultaneous Fetal heart rate baseline, variability, accelerations, decelerations, and number of Fetal movements, and duration and percent of total time. These data were compared at 10- and 30-minute intervals during nonstress tests and were correlated with Fetal heart rate baseline parameters and maternally perceived Fetal movements and with outcomes of infants delivered within 7 days of the last test. RESULTS: At six centers 1704 actocardiograms from 884 third-trimester patients were analyzed. Doppler-detected Fetal movement counts, durations, and percent of total time correlated weakly with all baseline Fetal heart rate parameters (all values CONCLUSIONS: Doppler actocardiography may help to discriminate Fetal states during antepartum testing. It may prevent inappropriate diagnosis of Fetal compromise when the nonstress test is nonreactive or nonreassuring. (AM J OBSTET GYNECOL 1994;170:650-5.)
-
characterization of Fetal body movement recorded by the hewlett packard m 1350 a Fetal Monitor
American Journal of Obstetrics and Gynecology, 1992Co-Authors: Terry D Melendez, William F Rayburn, Carl V SmithAbstract:OBJECTIVE: The purpose of this study was to evaluate the ability of a commercially available Monitor, the Hewlett-Packard M-1350-A Fetal Monitor, to record and discriminate between various Fetal body movements. STUDY DESIGN: Twenty-four patients between 29 and 42 weeks' gestation were Monitored over a 20 to 30 minute period simultaneously by the Hewlett-Packard instrument and ultrasonography. RESULTS: All 593 single or clustered Fetal movements recorded by the Monitor were seen ultrasonographically as being extremity movements that were either isolated or combined with trunk motion. Discriminating between these two types of movements was not possible on the basis of the duration of recorded movements. All adequate Fetal heart rate accelerations were attributed to combined trunk and extremity movements. Detection of Fetal hiccups was less exact, and recording of Fetal hand, mouth, breathing, and rapid eye movements was beyond the sensitivity of the Monitor. Signal artifacts were attributable to either motion of the maternal abdomen or Doppler transducer and became less of a problem with experience. CONCLUSION: Fetal extremity movements were recorded with accuracy by this new Fetal Monitor.
Ken Bassett - One of the best experts on this subject based on the ideXlab platform.
-
defensive medicine during hospital obstetrical care a by product of the technological age
Social Science & Medicine, 2000Co-Authors: Ken Bassett, Nitya Iyer, Arminee KazanjianAbstract:This paper presents an alternative perspective on defensive medicine. Defensive medicine is usually understood as arising from the effect of law on medicine through fear of litigation. Of equal significance, however, is the complementary influence of medicine on law through technological innovation, and, more importantly, the way that medicine and law develop dialectically. Each shapes the other in establishing the standards of care central to both clinical medicine and to actual or potential legal action. Excessive testing owing to fear of litigation indicates that defensive medicine is being practised in a particular setting, but it does not explain why this is so. To understand why defensive medicine occurs and why it is so troubling to clinicians requires an understanding, not only of medical and legal developments, but of a political-economic system and the beliefs and values of a society. Defensive medicine is discussed in relation to hospital obstetrical scenarios commonly associated with fear of litigation: Fetal oxygen deprivation ("distress"), which is detected using an electronic Fetal Monitor, and prolonged labor, known as "dystocia". The material presented is taken from a medical anthropological study of obstetrical care in rural British Columbia, Canada. Litigation fears are shown to result less from rare, albeit often devastating, allegations of malpractice than from doctors adopting a role as "Fetal champions", together with the introduction of electronic Monitoring technology. The paper concludes by asserting that, rather than being in an adversarial relationship, medical practice and associated litigation primarily work together to reinforce each other, and the social conditions in which defensive medicine occurs.
-
anthropology clinical pathology and the electronic Fetal Monitor lessons from the heart
Social Science & Medicine, 1996Co-Authors: Ken BassettAbstract:Clinical pathology, the social process of applying disease categories and managing disease processes, is defined and its anthropological study described using examples from a study of Electronic Fetal Monitor (EFM) use during hospital obstetrical care in a rural Canadian village. Anthropological work on clinical pathology is shown to have helped doctors and nurses in this village to better understand both the cultural contingencies of their basic science knowledge and the historical contingencies of its application to the care of women during pregnancy and birth. It is argued that cultural anthropologists should study diagnostic and treatment activities, especially those involving sophisticated technology; their methods and theories make them ideally suited to this task.
Terry D Melendez - One of the best experts on this subject based on the ideXlab platform.
-
characterization of Fetal body movement recorded by the hewlett packard m 1350 a Fetal Monitor
American Journal of Obstetrics and Gynecology, 1992Co-Authors: Terry D Melendez, William F Rayburn, Carl V SmithAbstract:OBJECTIVE: The purpose of this study was to evaluate the ability of a commercially available Monitor, the Hewlett-Packard M-1350-A Fetal Monitor, to record and discriminate between various Fetal body movements. STUDY DESIGN: Twenty-four patients between 29 and 42 weeks' gestation were Monitored over a 20 to 30 minute period simultaneously by the Hewlett-Packard instrument and ultrasonography. RESULTS: All 593 single or clustered Fetal movements recorded by the Monitor were seen ultrasonographically as being extremity movements that were either isolated or combined with trunk motion. Discriminating between these two types of movements was not possible on the basis of the duration of recorded movements. All adequate Fetal heart rate accelerations were attributed to combined trunk and extremity movements. Detection of Fetal hiccups was less exact, and recording of Fetal hand, mouth, breathing, and rapid eye movements was beyond the sensitivity of the Monitor. Signal artifacts were attributable to either motion of the maternal abdomen or Doppler transducer and became less of a problem with experience. CONCLUSION: Fetal extremity movements were recorded with accuracy by this new Fetal Monitor.
M Bahar - One of the best experts on this subject based on the ideXlab platform.
-
characteristics of maternal heart rate patterns during labor and delivery
Obstetrics & Gynecology, 2002Co-Authors: Dan Sherman, Eugenia Frenkel, Yaffa Kurzweil, Anna Padua, Shlomo Arieli, M BaharAbstract:Abstract OBJECTIVE: To find patterns characteristic of maternal heart rates recorded by an electronic Fetal Monitor and compare them with concomitant Fetal heart rate (FHR) patterns. METHODS: Maternal heart rates and FHRs during active labor and delivery were simultaneously recorded in 26 parturients with singleton pregnancies in vertex presentation. The FHRs were obtained by an external ultrasound transducer or via a spiral scalp electrode and maternal heart rates by a triple-wire cable with electrocardiographic electrodes attached to the chest. Representative tracings of 30–60 minutes duration were selected from all stages of labor and after delivery of the placenta. Quantitative assessments were carried out under guidelines from the National Institute of Child Health and Human Development after blinding the source of these tracings. Patterns were compared by appropriate statistical analyses. RESULTS: Baseline maternal heart rates were significantly lower and their variability significantly higher than FHRs during all stages of labor. Maternal heart rates showed no decelerations; the proportion of tracings with accelerations increased as labor advanced, most of them coinciding with uterine contractions or bearing down efforts. The FHRs had both decelerations and accelerations. However, tracings with only accelerations (and no decelerations) were observed in decreasing frequency as labor advanced. Maternal accelerations had higher amplitudes and longer durations than Fetal accelerations, especially in the second stage of labor. CONCLUSION: Maternal heart rate patterns recorded by electronic Fetal Monitors closely resemble Fetal patterns. Baseline “Fetal bradycardia,” the absence of decelerations in the second stage of labor, and marked accelerations coinciding with uterine contractions may suggest a maternal heart rate rather than an FHR recording.