The Experts below are selected from a list of 258 Experts worldwide ranked by ideXlab platform
Mark E. Vierhout - One of the best experts on this subject based on the ideXlab platform.
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A Fetal Scalp Electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixation
International Urogynecology Journal, 2011Co-Authors: Marieke P. G. Schoonenberg, Kirsten B. Kluivers, Mark E. VierhoutAbstract:A needle fragment was lost during a sacrospinous ligament fixation. This was recognized during the procedure, but could not be found at that moment. The patient complained of severe buttock pain postoperatively. The needle fragment was localized on CT scan of the pelvis. A Fetal Scalp Electrode helped as a search device to localize the needle on X-ray during the secondary surgery. The patient was operated successfully and was free of pain after 6 weeks.
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DOI 10.1007/s00192-010-1247-5
2010Co-Authors: Int Urogynecol J, Marieke P. G. Schoonenberg, Kirsten B. Kluivers, Mark E. VierhoutAbstract:A Fetal Scalp Electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixatio
Marieke P. G. Schoonenberg - One of the best experts on this subject based on the ideXlab platform.
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A Fetal Scalp Electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixation
International Urogynecology Journal, 2011Co-Authors: Marieke P. G. Schoonenberg, Kirsten B. Kluivers, Mark E. VierhoutAbstract:A needle fragment was lost during a sacrospinous ligament fixation. This was recognized during the procedure, but could not be found at that moment. The patient complained of severe buttock pain postoperatively. The needle fragment was localized on CT scan of the pelvis. A Fetal Scalp Electrode helped as a search device to localize the needle on X-ray during the secondary surgery. The patient was operated successfully and was free of pain after 6 weeks.
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DOI 10.1007/s00192-010-1247-5
2010Co-Authors: Int Urogynecol J, Marieke P. G. Schoonenberg, Kirsten B. Kluivers, Mark E. VierhoutAbstract:A Fetal Scalp Electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixatio
Robert Gagnon - One of the best experts on this subject based on the ideXlab platform.
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ST segment analysis of the Fetal electrocardiogram plus electronic Fetal heart rate monitoring in labor and its relationship to umbilical cord arterial blood gases.
American journal of obstetrics and gynecology, 2004Co-Authors: Kristina L. Dervaitis, Monica Poole, Gail Schmidt, Deborah Penava, Renato Natale, Robert GagnonAbstract:Objective This study was undertaken to determine the ability of intrapartum electronic Fetal heart rate monitoring (EFM) plus Fetal electrocardiogram (ECG) ST segment automated ANalysis (STAN, Neoventa Medical, Goteborg, Sweden) monitoring to predict metabolic acidemia (defined as an umbilical cord artery pH Study design Women with singleton, term pregnancies who had a clinical indication for internal EFM with a Fetal Scalp Electrode were included in the study. Attending physicians were blinded to the ST analysis information, only using available EFM as per current clinical practice. After delivery, 2 trained observers blinded to neonatal outcome and ST analysis information performed visual classification of the EFM tracing in 10-minute epochs according to FIGO guidelines. ST events automatically detected by the STAN S21 monitor (Neoventa Medical) were combined with the visual EFM classification as per STAN clinical guidelines (Neoventa Medical). Results When applying STAN clinical guidelines from a sample of 143 women, our data indicated a sensitivity of 43%, specificity of 74%, negative predictive value of 96%, and a positive predictive value of 8% for metabolic acidemia at birth. Poor ECG quality, despite good EFM tracings (ECG signal loss), occurred 11% of the tracing time. Conclusion The STAN clinical guidelines have a poor positive predictive value and a sensitivity of less than 50% for metabolic acidemia at birth.
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Intrapartum computerized Fetal heart rate parameters and metabolic acidosis at birth
Obstetrics and gynecology, 2003Co-Authors: Sumit K. Agrawal, Fred Doucette, Robert Gratton, Bryan S. Richardson, Robert GagnonAbstract:Abstract Objective To estimate to what extent computerized Fetal heart rate (FHR) parameters are affected by labor and to estimate the relationship between FHR parameters and the degree of Fetal metabolic acidosis in laboring patients at term. Methods Fifty-one women between 37 and 42 weeks' gestational age were recruited prospectively in the following groups: 1) nonlaboring women, and 2) laboring women requiring Fetal Scalp Electrode for continuous electronic FHR monitoring. Computerized FHR analysis was performed for 1 hour within 6 hours of delivery in the nonlaboring group and continuously throughout labor in the laboring group. Multiple linear regression analysis was used to determine the relationship between individual FHR parameters during the last hour before delivery and the degree of metabolic acidosis at birth. Results The umbilical cord artery base excess and pH did not show any significant correlation with any of the computer-derived FHR parameters studied. Both umbilical cord venous base excess and pH were inversely related to the number of large FHR decelerations (r = −.46, P Conclusion In term pregnant women with reassuring FHR tracing, labor causes an increase in both short- and long-term FHR variation, which was abolished in the presence of nonreassuring FHR tracing. Computer-derived FHR parameters studied during the last hour of labor were not correlated with the degree of metabolic acidosis as measured in the umbilical artery at birth.
Kirsten B. Kluivers - One of the best experts on this subject based on the ideXlab platform.
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A Fetal Scalp Electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixation
International Urogynecology Journal, 2011Co-Authors: Marieke P. G. Schoonenberg, Kirsten B. Kluivers, Mark E. VierhoutAbstract:A needle fragment was lost during a sacrospinous ligament fixation. This was recognized during the procedure, but could not be found at that moment. The patient complained of severe buttock pain postoperatively. The needle fragment was localized on CT scan of the pelvis. A Fetal Scalp Electrode helped as a search device to localize the needle on X-ray during the secondary surgery. The patient was operated successfully and was free of pain after 6 weeks.
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DOI 10.1007/s00192-010-1247-5
2010Co-Authors: Int Urogynecol J, Marieke P. G. Schoonenberg, Kirsten B. Kluivers, Mark E. VierhoutAbstract:A Fetal Scalp Electrode as a simple aid in the search for a lost needle fragment during sacrospinous ligament fixatio
Sabaratnam Arulkumaran - One of the best experts on this subject based on the ideXlab platform.
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Misidentification of maternal heart rate as Fetal on cardiotocography during the second stage of labor: the role of the Fetal electrocardiograph
Acta obstetricia et gynecologica Scandinavica, 2012Co-Authors: Raisha Nurani, Edwin Chandraharan, Virginia Lowe, Austin Ugwumadu, Sabaratnam ArulkumaranAbstract:Objective To identify the incidence of Fetal heart rate (FHR) accelerations in the second stage of labor and the role of Fetal electrocardiograph (ECG) in avoiding misidentification of maternal heart rate (MHR) as FHR. Design Retrospective observational study. Setting University hospital labor ward, London, UK. Sample Cardiotocograph (CTG) tracings of 100 fetuses monitored using external transducers and internal Scalp Electrodes. Methods CTG traces that fulfilled inclusion criteria were selected from an electronic FHR monitoring database. Main outcome measures Rate of accelerations during external and internal monitoring as well as decelerations for a period of 60 minutes prior to delivery were determined. The role of Fetal ECG in differentiating between MHR and FHR trace was explored. Results Decelerations occurred in 89% of CTG traces during the second stage of labor. Accelerations indicating possible recording of FHR or MHR were found in 28.1 and 10.9% of cases recorded by an external ultrasound transducer as well as internal Scalp Electrode, respectively. Accelerations coinciding with uterine contractions occurred only in 11.7 and 4% of external and internal recording of FHR, respectively. Absence of 'p-wave' of the ECG waveform was associated with MHR trace. Conclusion Decelerations were the commonest CTG feature during the second stage of labor. The incidence of accelerations coinciding with uterine contractions was less than half in fetuses monitored using a Fetal Scalp Electrode. Analysing the ECG waveform for the absence of 'p-wave' helps in differentiating MHR from FHR.
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ECG Waveform Analysis in Intrapartum Fetal Monitoring
Australian & New Zealand Journal of Obstetrics & Gynaecology, 1993Co-Authors: Sabaratnam ArulkumaranAbstract:Intrapartum cardiotocography (CTG) has a high false positive rate and, in the absence of facilities for Fetal Scalp blood sampling, is associated with increased operative deliveries for 'Fetal distress'. It is presently possible to obtain a representative Fetal ECG signal using the Fetal Scalp Electrode. There is renewed interest in Fetal ECG waveform analysis in the hope that it will improve the specificity of detecting intrapartum Fetal hypoxia when there is an abnormal Fetal heart rate pattern. Two portions of the Fetal ECG are potentially useful: the ST waveform (T/QRS ratio) and the PR interval correlated with the RR interval. Animal experiments suggest that changes in the ST waveform, increase in the T wave amplitude in particular, reflect myocardial anaerobic metabolism. Clinical studies have shown poor correlation between the T wave changes and Fetal heart rate changes. There is also concern that the sensitivity of the ST waveform changes for Fetal acidaemia may be poor. More information is required before its use is incorporated into routine clinical practice.