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BACKGROUND Intrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related to fetal surveillance. Cardiotocographic (CTG) monitoring remains the basis of intrapartum surveillance, but its interpretation by healthcare professionals lacks reproducibility(More)
OBJECTIVE To assess whether intrapartum acidosis affects specific components of fetal heart rate variability. DESIGN Prospective clinical study. SETTING Twelve Nordic delivery units. SUBJECTS Fetal heart rate variability was studied in 334 fetuses divided into two groups according to cord pH value: the acidotic group (cord arterial pH < 7.05 at birth,(More)
This study examines a novel methodology for continuous fetal heart rate variability (FHRV) assessment in a non-stationary intrapartum fetal heart rate (FHR). The specific aim was to investigate simple statistics, dimension estimates and entropy estimates as methods to discriminate situations of low FHRV related to non-reassuring fetal status or as a(More)
Previous studies from this laboratory have demonstrated early and progressive alterations in the ST-T period of the fetal and neonatal electrocardiogram in relation to asphyxia. The aims of the present study were to investigate the metabolic background of these hypoxic ECG changes by means of serial myocardial biopsies in fetal lambs, relating these changes(More)
OBJECTIVES Infants who develop encephalopathy after perinatal asphyxia have an increased risk of death and adverse neurologic outcome. Conflicting results exist concerning outcome in healthy infants with metabolic acidosis at birth. The aim of the current study was to evaluate whether metabolic acidosis at birth in term infants who appear healthy is(More)
Progressive changes in the S-T interval of the fetal electrocardiogram (FECG) were studied in 14 lamb fetuses, acutely exteriorized and subjected to graded hypoxia. The aims of the study were to investigate whether beta-adrenoceptor stimulation and hypoxia exerted additive or potentiating effects on the FECG and several cardiovascular parameters and whether(More)
OBJECTIVE To identify the distribution of carbon dioxide tension (pCO(2) ) relative to pH in validated umbilical cord acid-base data. DESIGN Observational study. SETTING European hospital labour wards. POPULATION Data for 36,432 term newborns were obtained from three sources: two trials of fetal monitoring with electrocardiography (ECG; the Swedish(More)
Waveform analysis of the fetal ECG for fetal surveillance is regaining widespread interest. This paper presents our present knowledge on ST waveform analysis during human labour. A unipolar scalp lead with the maternal thigh as reference makes it possible to identify the T wave and at the same time decrease signal noise. The development of an ECG analyser(More)
OBJECTIVE To find whether low-to-high frequency (LF/HF) ratio of fetal heart rate (FHR) variability changes in relation to a significant ST-event during delivery, and if the change is predictive of metabolic acidosis of the newborn. DESIGN A case-control study. SETTING Data from a multicentre project. SUBJECTS Acidotic and control fetuses with(More)
The degree of metabolic acidosis at birth has been calculated in cord artery and vein samples from 21 term fetuses with cord artery pH less than 7.20. The aim of the study was to compare base deficit values calculated from either Siggaard-Andersen alignment nomogram (BD blood) or the Acid-Base chart (BD extra cellular fluid, BDecf). BDblood was found to be(More)