The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
C W Redman - One of the best experts on this subject based on the ideXlab platform.
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umbilical artery resistance index as a screening test for Fetal Well Being i prospective revealed evaluation
Obstetrics & Gynecology, 1991Co-Authors: R Pattinson, J Jennings, G Dawes, C W RedmanAbstract:Abnormalities of the human fetoplacental circulation, a common association with Fetal morbidity and mortality, can be detected by Doppler ultrasound examination of the umbilical arterial blood flow. The value of this procedure as a screening test was assessed in 369 women whose fetuses were evaluated on 1354 occasions using both computerized antenatal Fetal heart rate (FHR) analysis and continuous-wave Doppler ultrasound. The FHR analyses were used to guide management, but the results of the Doppler measurements were not made available to the clinical staff. The mean duration of each nonstress test (NST) was 27 minutes, compared with 6 minutes for the Doppler examination. Increased resistance indices in the umbilical artery identified those fetuses with an abnormal NST or a clinical diagnosis of antenatal distress with a high sensitivity and negative predictive value. The high rate of false-positive results with respect to these two end points was reduced when Fetal distress in labor was included as a third end point. The value of the Doppler examination in predicting Fetal distress was applicable to appropriately grown as Well as small for gestational age fetuses.
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Umbilical artery resistance index as a screening test for Fetal Well-Being. II: Randomized feasibility study.
Obstetrics and gynecology, 1991Co-Authors: G J Hofmeyr, R Pattinson, D Buckley, J Jennings, C W RedmanAbstract:To determine whether the time taken for Fetal assessment could safely be reduced by preliminary screening with Doppler ultrasound, 897 women having Fetal assessment in the high-risk unit of the John Radcliffe Hospital, Oxford, were randomly allocated to two groups. In the Doppler group, preliminary assessment was by umbilical artery resistance estimation, and in the Fetal heart rate (FHR) group by computerized FHR analysis. To minimize the risk of failing to recognize Fetal distress, the criteria for using the nonallocated method as Well were deliberately conservative. Thus, 66% of the 1869 Doppler studies done in the Doppler group and 39% of the 2069 FHR tests done in the FHR group needed to be followed by the nonallocated tests. Trained nursing staff performed the Doppler studies as part of their routine duties. Doppler studies were unsuccessful in obtaining a result on 26% of the occasions. Under the above clinical circumstances, preliminary Doppler screening did not reduce the time taken for Fetal assessment. There were no significant differences in perinatal outcome between the groups, except that emergency as opposed to elective cesareans were less frequent in the Doppler group. As this finding was not predicted by previous hypothesis, it needs to be confirmed.
Dena Abitz - One of the best experts on this subject based on the ideXlab platform.
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a randomized controlled trial of a new Fetal acoustic stimulation test for Fetal Well Being
American Journal of Obstetrics and Gynecology, 1997Co-Authors: David Marden, Robert S Mcduffie, Richard G Allen, Dena AbitzAbstract:Abstract OBJECTIVES: Our purpose was to determine (1) whether a Fetal acoustic stimulation test results in more palpable Fetal movement compared with a mock test (control) and (2) whether palpated Fetal movements after a Fetal acoustic stimulation test are accompanied by a reactive nonstress test. STUDY DESIGN: In a randomized controlled trial we studied women seen in the labor and delivery suite for various indications. Women were excluded for multiple gestation, 2 test. A p value RESULTS: We randomized 297 women to the test group and 280 women to the control (mock test) group. Of women tested with the Fetal acoustic stimulation test, 81% had Fetal movement by palpation or visualization (grades 2 or 3) compared with 19% of the control group ( p CONCLUSION: The Fetal acoustic stimulation test evokes significantly more palpated or visualized Fetal movement than in controls. Palpated or visualized Fetal movement after acoustic stimulation was almost always accompanied by a reactive nonstress test. (Am J Obstet Gynecol 1997;176:1386-8.)
R Pattinson - One of the best experts on this subject based on the ideXlab platform.
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umbilical artery resistance index as a screening test for Fetal Well Being i prospective revealed evaluation
Obstetrics & Gynecology, 1991Co-Authors: R Pattinson, J Jennings, G Dawes, C W RedmanAbstract:Abnormalities of the human fetoplacental circulation, a common association with Fetal morbidity and mortality, can be detected by Doppler ultrasound examination of the umbilical arterial blood flow. The value of this procedure as a screening test was assessed in 369 women whose fetuses were evaluated on 1354 occasions using both computerized antenatal Fetal heart rate (FHR) analysis and continuous-wave Doppler ultrasound. The FHR analyses were used to guide management, but the results of the Doppler measurements were not made available to the clinical staff. The mean duration of each nonstress test (NST) was 27 minutes, compared with 6 minutes for the Doppler examination. Increased resistance indices in the umbilical artery identified those fetuses with an abnormal NST or a clinical diagnosis of antenatal distress with a high sensitivity and negative predictive value. The high rate of false-positive results with respect to these two end points was reduced when Fetal distress in labor was included as a third end point. The value of the Doppler examination in predicting Fetal distress was applicable to appropriately grown as Well as small for gestational age fetuses.
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Umbilical artery resistance index as a screening test for Fetal Well-Being. II: Randomized feasibility study.
Obstetrics and gynecology, 1991Co-Authors: G J Hofmeyr, R Pattinson, D Buckley, J Jennings, C W RedmanAbstract:To determine whether the time taken for Fetal assessment could safely be reduced by preliminary screening with Doppler ultrasound, 897 women having Fetal assessment in the high-risk unit of the John Radcliffe Hospital, Oxford, were randomly allocated to two groups. In the Doppler group, preliminary assessment was by umbilical artery resistance estimation, and in the Fetal heart rate (FHR) group by computerized FHR analysis. To minimize the risk of failing to recognize Fetal distress, the criteria for using the nonallocated method as Well were deliberately conservative. Thus, 66% of the 1869 Doppler studies done in the Doppler group and 39% of the 2069 FHR tests done in the FHR group needed to be followed by the nonallocated tests. Trained nursing staff performed the Doppler studies as part of their routine duties. Doppler studies were unsuccessful in obtaining a result on 26% of the occasions. Under the above clinical circumstances, preliminary Doppler screening did not reduce the time taken for Fetal assessment. There were no significant differences in perinatal outcome between the groups, except that emergency as opposed to elective cesareans were less frequent in the Doppler group. As this finding was not predicted by previous hypothesis, it needs to be confirmed.
David Marden - One of the best experts on this subject based on the ideXlab platform.
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a randomized controlled trial of a new Fetal acoustic stimulation test for Fetal Well Being
American Journal of Obstetrics and Gynecology, 1997Co-Authors: David Marden, Robert S Mcduffie, Richard G Allen, Dena AbitzAbstract:Abstract OBJECTIVES: Our purpose was to determine (1) whether a Fetal acoustic stimulation test results in more palpable Fetal movement compared with a mock test (control) and (2) whether palpated Fetal movements after a Fetal acoustic stimulation test are accompanied by a reactive nonstress test. STUDY DESIGN: In a randomized controlled trial we studied women seen in the labor and delivery suite for various indications. Women were excluded for multiple gestation, 2 test. A p value RESULTS: We randomized 297 women to the test group and 280 women to the control (mock test) group. Of women tested with the Fetal acoustic stimulation test, 81% had Fetal movement by palpation or visualization (grades 2 or 3) compared with 19% of the control group ( p CONCLUSION: The Fetal acoustic stimulation test evokes significantly more palpated or visualized Fetal movement than in controls. Palpated or visualized Fetal movement after acoustic stimulation was almost always accompanied by a reactive nonstress test. (Am J Obstet Gynecol 1997;176:1386-8.)
Marcelo Zugaib - One of the best experts on this subject based on the ideXlab platform.
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asthma during pregnancy effects on Fetal Well Being and maternal and perinatal complications
Revista Da Associacao Medica Brasileira, 2013Co-Authors: Renata Franco Pimentel Mendes, Roseli Mieko Yamamoto Nomura, Cristiane Ortigosa, Rossana Pulcineli Vieira Francisco, Marcelo ZugaibAbstract:Objective: To assess the effects of maternal asthma on pregnancy, analyzing the conse‑ quences of the severity of the disease in the impairment of Fetal Well‑Being, as Well as the related maternal and perinatal complications. Methods: A retrospective study with 117 pregnancies complicated by maternal asthma and with no other comorbidities, in the period from January, 2005 to December, 2010. Inclusion criteria were as follows: singleton pregnancy; pregnant women diagnosed with asthma prior to pregnancy; initiation of prenatal care before the 28 th week of pregnancy; birth at this institution; newborn weighing over 500 g and gestational age at delivery of 22 weeks or more; absence of Fetal malformations or chromosomal abnormalities; absence of maternal comorbidities. Asthma was classified as intermittent, mild persistent, moderate persistent, or severe persistent. The results of Fetal biophysical profile and of Doppler velocimetry of the umbilical artery performed 14 days prior to birth were analyzed. Results: Of the total of 117 pregnant women with asthma, 41 (35.0%) had intermittent, 33 (28.2%) mild persistent, 21 (17.9%) moderate persistent, and 22 (18.8%) severe persistent asthma. There was no significant difference among the groups as to the type of birth: cesarean section was performed in 65.8% of the cases, maternal corticosteroid therapy was used at the moment of birth in 20.5%, the gestational age at birth averaged 38.6 weeks (SD 1.9 weeks), and birth weight averaged 3,056 g (SD 581g). The Fetal biophysical profile performed during the antepartum period (n = 90, 76.9%) showed a normal result (8 or 10) in 99% of the cases. Doppler velocimetry of the umbilical artery was assessed in 23.9% (n = 28) of the pregnant women, and delivered normal results in 100% of the cases. The use of systemic corticosteroid therapy was significantly (p < 0.001) different among the intermittent (4.9%), mild persistent (9.1%), moderate persistent (28.6%), and severe persistent (45.5%) groups. Regarding the beginning of birth, there was a higher proportion of elective cesarean section in the groups with moderate persistent asthma (52.5%) and severe persistent (54.6%) when compared to the intermittent (21.9%) and mild persistent (24.2%) groups (p = 0.039).
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Asma na gestação: efeitos na vitalidade Fetal, complicações maternas e perinatais Asthma during pregnancy: effects on Fetal Well-Being, and maternal and perinatal complications
Associação Médica Brasileira, 2013Co-Authors: Renata Franco Pimentel Mendes, Roseli Mieko Yamamoto Nomura, Cristiane Ortigosa, Rossana Pulcineli Vieira Francisco, Marcelo ZugaibAbstract:OBJETIVO: Avaliar os efeitos da asma materna sobre a gravidez, analisando as repercussões da gravidade da doença no comprometimento do bem-estar Fetal, bem como as complicações maternas e perinatais associadas. MÉTODOS: Foi realizado estudo retrospectivo de 117 gestações complicadas pela asma materna e sem outras comorbidades, no período de janeiro de 2005 a dezembro de 2010. Os critérios de inclusão foram: gestação única; diagnóstico de asma prévio à gestação; início do pré-natal antes da 28ª semana de gravidez; parto realizado na instituição; peso do recém-nascido acima de 500g e idade gestacional no parto acima de 22 semanas; ausência de malformações fetais ou anomalias cromossômicas; ausência de comorbidades maternas. A gravidade da asma foi classificada em intermitente, persistente leve, persistente moderada, persistente grave. Foram analisados os resultados do perfil biofísico Fetal e da dopplervelocimetria de artéria umbilical realizados até 14 dias antes do parto. RESULTADOS: Do total de 117 gestantes asmáticas analisadas: 41 (35,0%) eram intermitentes, 33 (28,2%) persistentes leves, 21 (17,9%) persistentes moderadas e 22 (18,8%) persistentes graves. Não houve diferença significativa entre os grupos quanto ao tipo de parto: a cesárea foi realizada em 65,8% dos casos, a corticoterapia materna no momento do parto em 20,5%, a idade gestacional no parto apresentou média de 38,6 semanas (DP 1,9 semanas) e o peso ao nascimento apresentou média de 3056 g (DP 581 g). O perfil biofísico Fetal realizado no período anteparto (n = 90, 76,9%) apresentou resultado normal (8 ou 10) em 99% dos casos. A dopplervelocimetria de artéria umbilical foi avaliada em 23,9% (n = 28) das gestantes, e apresentou-se normal em 100% dos casos. O uso de corticoterapia sistêmica foi significativamente (p< 0,001) diferente entre os grupos intermitente (4,9%) e persistente leve (9,1%), persistente moderada (28,6%), persistente grave (45,5%). quanto ao início do parto, houve maior proporção de cesárea eletiva no grupo com asma persistente moderada (52,5%) e persistente grave (54,6%) quando comparados aos grupos intermitente (21,9%) e persistente leve (24,2%) (p = 0,039). CONCLUSÃO: A gravidade da asma materna não parece influenciar diretamente os resultados perinatais e não compromete a vitalidade Fetal. A conduta ativa proporcionando melhor quadro clínico materno promove evolução favorável para a gestação complicada pela asma.OBJECTIVE: To assess the effects of maternal asthma on pregnancy, analyzing the consequences of the severity of the disease in the impairment of Fetal Well-Being, as Well as the related maternal and perinatal complications. METHODS: A retrospective study with 117 pregnancies complicated by maternal asthma and with no other comorbidities, in the period from January, 2005 to December, 2010. Inclusion criteriawere as follows: singleton pregnancy; pregnantwomen diagnosed with asthma prior to pregnancy; initiation of prenatal care before the 28th week of pregnancy; birth at this institution; newborn weighing over 500 g and gestational age at delivery of 22 weeks or more; absence of Fetal malformations or chromosomal abnormalities; absence of maternal comorbidities. Asthma was classified as intermittent, mild persistent, moderate persistent, or severe persistent. The results of Fetal biophysical profile and of Doppler velocimetry of the umbilical artery performed 14 days prior to birth were analyzed. RESULTS: Of the total of 117 pregnant women with asthma, 41 (35.0%) had intermittent, 33 (28.2%) mild persistent, 21 (17.9%) moderate persistent, and 22 (18.8%) severe persistent asthma. There was no significant difference among the groups as to the type of birth: cesarean section was performed in 65.8% of the cases, maternal corticosteroid therapy was used at the moment of birth in 20.5%, the gestational age at birth averaged 38.6 weeks (SD 1.9 weeks), and birth weight averaged 3,056 g (SD 581 g). The Fetal biophysical profile performed during the antepartum period (n = 90, 76.9%) showed a normal result (8 or 10) in 99% of the cases. Doppler velocimetry of the umbilical artery was assessed in 23.9% (n = 28) of the pregnant women, and delivered normal results in 100% of the cases. The use of systemic corticosteroid therapy was significantly (p < 0.001) different among the intermittent (4.9%), mild persistent (9.1%), moderate persistent (28.6%), and severe persistent (45.5%) groups. Regarding the beginning of birth, there was a higher proportion of elective cesarean section in the groups with moderate persistent asthma (52.5%) and severe persistent (54.6%) when compared to the intermittent (21.9%) and mild persistent (24.2%) groups (p = 0.039). CONCLUSION: The severity of maternal asthma does not appear to have any direct influence on perinatal outcomes, and does not compromise Fetal Well-Being. Active conduct to enable a better maternal clinical condition provides a favorable prognosis for pregnancy complicated by asthma
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Assessment of Fetal Well-Being in pregnancies complicated by maternal moderate to severe thrombocytopenia
Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 2011Co-Authors: Roseli Mieko Yamamoto Nomura, Ana Maria Kondo Igai, Verbênia Nunes Costa, Seizo Miyadahira, Marcelo ZugaibAbstract:PURPOSE: To analyze the results of assessment of Fetal Well-Being in pregnancies complicated by moderate or severe maternal thrombocytopenia. METHODS: Data from April 2001 to July 2011 of 96 women with a diagnosis of thrombocytopenia in pregnancy were retrospectively analyzed. We analyzed the following tests performed during the antepartum period for Fetal assessment: cardiotocography, Fetal biophysical profile, amniotic fluid index and umbilical artery Doppler velocimetry. RESULTS: A total of 96 pregnancies with the following diagnoses were analyzed: gestational thrombocytopenia (n=37, 38.5%) hypersplenism (n=32, 33.3%), immune thrombocytopenic purpura (ITP, n=14, 14.6%), secondary immune thrombocytopenia (n=6, 6.3%), bone marrow aplasia (n=3, 3.1%), and others (n=4, 4.1%). Cardiotocography showed normal results in 94% of cases, a Fetal biophysical profile with an index of 8 or 10 in 96.9% and an amniotic fluid index >5.0 cm in 89.6%. Doppler umbilical artery velocimetry showed normal results in 96.9% of cases. In the analysis of the major groups of thrombocytopenia, the diagnosis of oligohydramnios was found to be significantly more frequent in the group with ITP (28.6%) compared to the other groups (gestational thrombocytopenia: 5.4% and hypersplenism: 9.4%, p=0.04). CONCLUSIONS: This study indicates that in pregnancies complicated by moderate or severe maternal thrombocytopenia, even though the Fetal Well-Being remains preserved in most cases, Fetal surveillance is important in pregnant women with ITP, with emphasis on amniotic fluid volume evaluation due to its association with oligohydramnios.
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Avaliação da vitalidade Fetal em gestações complicadas pela plaquetopenia materna moderada ou grave Assessment of Fetal Well-Being in pregnancies complicated by maternal moderate to severe thrombocytopenia
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2011Co-Authors: Roseli Mieko Yamamoto Nomura, Ana Maria Kondo Igai, Verbênia Nunes Costa, Seizo Miyadahira, Marcelo ZugaibAbstract:OBJETIVO: Analisar os resultados da avaliação da vitalidade Fetal em gestações complicadas por plaquetopenia materna moderada ou grave. MÉTODOS: No período de abril de 2001 a julho de 2011, foram analisados, retrospectivamente, os dados de prontuários de 96 gestantes com diagnóstico de plaquetopenia na gestação. Foram analisados os seguintes exames de avaliação da vitalidade Fetal realizados no período anteparto: cardiotocografia, perfil biofísico Fetal, índice de líquido amniótico e doplervelocimetria das artérias umbilicais. RESULTADOS: Foram analisadas 96 gestações com os seguintes diagnósticos: plaquetopenia gestacional (n=37, 38,5%), hiperesplenismo (n=32, 33,3%), púrpura trombocitopenica imune (PTI, n=14, 14,6%), plaquetopenia imune secundária (n=6, 6,3%), aplasia medular (n=3, 3,1%) e outros (n=4, 4,1%). A cardiotocografia apresentou resultado normal em 94% dos casos, o perfil biofísico Fetal com índice 8 ou 10 em 96,9% e o índice de líquido amniótico >5,0 cm em 89,6%. A doplervelocimetria da artéria umbilical apresentou resultado normal em 96,9%. Na análise dos principais grupos de plaquetopenia, constatou-se que o diagnóstico de oligohidrâmnio foi significativamente mais frequente no grupo com PTI (28,6%) quando comparado aos demais (gestacional: 5,4% e hiperesplenismo: 9,4%, p=0,04). CONCLUSÕES: O presente estudo permitiu concluir que, nas gestações complicadas pela plaquetopenia materna moderada ou grave, apesar do bem-estar Fetal manter-se preservado na grande maioria dos casos, em gestantes com PTI é importante o seguimento da vitalidade Fetal com ênfase na avaliação do volume de líquido amniótico, devido à sua associação com a oligohidramnia.PURPOSE: To analyze the results of assessment of Fetal Well-Being in pregnancies complicated by moderate or severe maternal thrombocytopenia. METHODS: Data from April 2001 to July 2011 of 96 women with a diagnosis of thrombocytopenia in pregnancy were retrospectively analyzed. We analyzed the following tests performed during the antepartum period for Fetal assessment: cardiotocography, Fetal biophysical profile, amniotic fluid index and umbilical artery Doppler velocimetry. RESULTS: A total of 96 pregnancies with the following diagnoses were analyzed: gestational thrombocytopenia (n=37, 38.5%) hypersplenism (n=32, 33.3%), immune thrombocytopenic purpura (ITP, n=14, 14.6%), secondary immune thrombocytopenia (n=6, 6.3%), bone marrow aplasia (n=3, 3.1%), and others (n=4, 4.1%). Cardiotocography showed normal results in 94% of cases, a Fetal biophysical profile with an index of 8 or 10 in 96.9% and an amniotic fluid index >5.0 cm in 89.6%. Doppler umbilical artery velocimetry showed normal results in 96.9% of cases. In the analysis of the major groups of thrombocytopenia, the diagnosis of oligohydramnios was found to be significantly more frequent in the group with ITP (28.6%) compared to the other groups (gestational thrombocytopenia: 5.4% and hypersplenism: 9.4%, p=0.04). CONCLUSIONS: This study indicates that in pregnancies complicated by moderate or severe maternal thrombocytopenia, even though the Fetal Well-Being remains preserved in most cases, Fetal surveillance is important in pregnant women with ITP, with emphasis on amniotic fluid volume evaluation due to its association with oligohydramnios
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p86assessment of Fetal Well Being in patients with poor obstetric history comparison between cases of absent or reversed end diastolic velocity in the umbilical artery
Ultrasound in Obstetrics & Gynecology, 2000Co-Authors: R P V Francisco, Seizo Miyadahira, R M Yamamoto, C C Leite, Marcelo ZugaibAbstract:Background A study of the assessment of Fetal Well-Being and perinatal results in patients with poor obstetric history and absent or reversed end-diastolic velocity flow (AREDV). Methods Between 1997 and 2000, 36 high risk pregnant women with poor obstetric history and AREDV were followed by the Fetal Surveillance Unit. Ten cases presented reversed end-diastolic velocity waveforms. Results The results are shown in the table:1 Table 1. AEDV n = 26 REDV n = 10 P fhr with deceleration 13/19(68.4%) 5/7(71.4%) NS BPS below 6 1/26(3.8%) 5/7(71.4%) 0.004 Amniotic fluid index ≤ 5 6/26(23.1%) 7/10(70.0%) 0.025 MCA PI < 5th p 23/24(95.8%) 8/10(80.0%) NS Perinatal death 6/26(23.1%) 6/10(60.0%) 0.04 Birth weight < 1000g 10/26(36.5%) 6/10(60.0%) NS Conclusions The results show a higher incidence of abnormal BPS and AFI in red cases, with a high rate of perinatal death.