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[PMID]:29325264
[Au] Autor:Xiong Y; Xia HX; Wang YS; Lin XL; Zhu TT; Zhao Y; Li XT
[Ad] Endereço:Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China.
[Ti] Título:[High risk factors analysis of stillbirth].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(12):811-817, 2017 Dec 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the high risk factors of stillbirth. 176 cases of stillbirth were collected in the Obstetrics and Gynecology Hospital of Fudan University from January 1(st), 2010 to December 31(st), 2016. All cases were analyzed retrospectively, including general profile, high risk factors of stillbirth in different years and pregnancy periods. (1) The incidence of stillbirth was 0.178%(176/98 785). Stillbirth occured mostly at 28-28(+6) gestational weeks (10.8%,19/176), and the second peak was 29-29(+6) weeks(10.2%,18/176), while the third common period was 37-37(+6) weeks (9.1%,16/176). After 39 weeks, it maintained at a low level. (2) The top 5 high risk factors of stillbirth were infection (18.2%,32/176), unexplained (13.6%,24/176), hypertention disorders in pregnancy (13.1%, 23/176), umbilical cord torsion (12.5%, 22/176) and fetal malformations (10.2%, 18/176). (3) From 2010 to 2012, the top 3 high risk factors were unexplained, the umbilical cord torsion and infection, while hypertention in pregnancy, infection and fetal malformation became the top 3 high risk factors after 2013. (4) Early stillbirth (20-27(+6) weeks) accounted for 21.6%(38/176); and unexplained (47.4%, 18/38), fetal edema (13.2%, 5/38),infection (13.2%, 5/38), umbilical cord torsion (5.3%, 2/38) were the top 4 high risk factors. Late stillbirth (≥28 weeks) accounted for 78.4%(138/176), with infection (19.6%,27/138), hypertention in pregnancy (15.9%,22/138), umbilical cord torsion (14.5%,20/138) and fetal malformation(12.3%,17/138)being the top 4 high risk factors. More attention should be paid to maternal complications, especially infection and hypertension in pregnancy. Antenatal fetal monitoring, timely termination of pregnancy, standard management of stillbirth and looking for the causes may help reduce the incidence of stillbirth.
[Mh] Termos MeSH primário: Morte Fetal/etiologia
Monitorização Fetal
Hipertensão/epidemiologia
Natimorto/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Idade Gestacional
Hospitais
Seres Humanos
Incidência
Gravidez
Estudos Retrospectivos
Fatores de Risco
Natimorto/etnologia
Cordão Umbilical
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567x.2017.12.004


  2 / 6807 MEDLINE  
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[PMID]:29444884
[Au] Autor:Sholapurkar SL
[Ad] Endereço:Royal United Hospital, Bath BA1 3NG, UK.
[Ti] Título:Intrapartum cardiotocography and pattern recognition.
[So] Source:BMJ;360:k664, 2018 02 14.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Cardiotocografia
Monitorização Fetal
[Mh] Termos MeSH secundário: Eletrocardiografia
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k664


  3 / 6807 MEDLINE  
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[PMID]:27775930
[Au] Autor:Biglari H; Sameni R
[Ad] Endereço:School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran.
[Ti] Título:Fetal motion estimation from noninvasive cardiac signal recordings.
[So] Source:Physiol Meas;37(11):2003-2023, 2016 Nov.
[Is] ISSN:1361-6579
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Fetal motility is a widely accepted indicator of the well-being of a fetus. In previous research, it has be shown that fetal motion (FM) is coherent with fetal heart rate accelerations and an indicator for active/rest cycles of the fetus. The most common approach for FM and fetal heart rate (FHR) assessment is by Doppler ultrasound (DUS). While DUS is the most common approach for studying the mechanical activities of the heart, noninvasive fetal electrocardiogram (ECG) and magnetocardiogram (MCG) recording and processing techniques have been considered as a possible competitor (or complement) for the DUS. In this study, a fully automatic and robust framework is proposed for the extraction, ranking and alignment of fetal QRS-complexes from noninvasive fetal ECG/MCG. Using notions from subspace tracking, two measures, namely the actogram and rotatogram, are defined for fetal motion tracking. The method is applied to four fetal ECG/MCG databases, including twin MCG recordings. By defining a novel measure of causality, it is shown that there is significant coherency and causal relationship between the actogram/rotatogram and FHR accelerations/decelerations. Using this measure, it is shown that in many cases, the actogram and rotatogram precede the FHR variations, which supports the idea of motion-induced FHR accelerations/decelerations for these cases and raises attention for the non-motion-induced FHR variations, which can be associated to the fetal central nervous system developments. The results of this study can lead to novel perspectives of the fetal sympathetic and parasympathetic brain systems and future requirements of fetal cardiac monitoring.
[Mh] Termos MeSH primário: Eletrocardiografia
Monitorização Fetal/métodos
Movimento Fetal
Magnetocardiografia
Processamento de Sinais Assistido por Computador
[Mh] Termos MeSH secundário: Artefatos
Bases de Dados Factuais
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161105
[St] Status:MEDLINE


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[PMID]:28613398
[Au] Autor:Alfirevic Z; Stampalija T; Dowswell T
[Ad] Endereço:Department of Women's and Children's Health, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, UK, L8 7SS.
[Ti] Título:Fetal and umbilical Doppler ultrasound in high-risk pregnancies.
[So] Source:Cochrane Database Syst Rev;6:CD007529, 2017 06 13.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. OBJECTIVES: The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes. SEARCH METHODS: We updated the search of Cochrane Pregnancy and Childbirth's Trials Register on 31 March 2017 and checked reference lists of retrieved studies. SELECTION CRITERIA: Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared with no Doppler ultrasound. Cluster-randomised trials were eligible for inclusion but none were identified. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. We assessed the quality of evidence using the GRADE approach. MAIN RESULTS: Nineteen trials involving 10,667 women were included. Risk of bias in trials was difficult to assess accurately due to incomplete reporting. None of the evidence relating to our main outcomes was graded as high quality. The quality of evidence was downgraded due to missing information on trial methods, imprecision in risk estimates and heterogeneity. Eighteen of these studies compared the use of Doppler ultrasound of the umbilical artery of the unborn baby with no Doppler or with cardiotocography (CTG). One more recent trial compared Doppler examination of other fetal blood vessels (ductus venosus) with computerised CTG.The use of Doppler ultrasound of the umbilical artery in high-risk pregnancy was associated with fewer perinatal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.52 to 0.98, 16 studies, 10,225 babies, 1.2% versus 1.7 %, number needed to treat (NNT) = 203; 95% CI 103 to 4352, evidence graded moderate). The results for stillbirths were consistent with the overall rate of perinatal deaths, although there was no clear difference between groups for this outcome (RR 0.65, 95% CI 0.41 to 1.04; 15 studies, 9560 babies, evidence graded low). Where Doppler ultrasound was used, there were fewer inductions of labour (average RR 0.89, 95% CI 0.80 to 0.99, 10 studies, 5633 women, random-effects, evidence graded moderate) and fewer caesarean sections (RR 0.90, 95% CI 0.84 to 0.97, 14 studies, 7918 women, evidence graded moderate). There was no comparative long-term follow-up of babies exposed to Doppler ultrasound in pregnancy in women at increased risk of complications.No difference was found in operative vaginal births (RR 0.95, 95% CI 0.80 to 1.14, four studies, 2813 women), nor in Apgar scores less than seven at five minutes (RR 0.92, 95% CI 0.69 to 1.24, seven studies, 6321 babies, evidence graded low). Data for serious neonatal morbidity were not pooled due to high heterogeneity between the three studies that reported it (1098 babies) (evidence graded very low).The use of Doppler to evaluate early and late changes in ductus venosus in early fetal growth restriction was not associated with significant differences in any perinatal death after randomisation. However, there was an improvement in long-term neurological outcome in the cohort of babies in whom the trigger for delivery was either late changes in ductus venosus or abnormalities seen on computerised CTG. AUTHORS' CONCLUSIONS: Current evidence suggests that the use of Doppler ultrasound on the umbilical artery in high-risk pregnancies reduces the risk of perinatal deaths and may result in fewer obstetric interventions. The results should be interpreted with caution, as the evidence is not of high quality. Serial monitoring of Doppler changes in ductus venosus may be beneficial, but more studies of high quality with follow-up including neurological development are needed for evidence to be conclusive.
[Mh] Termos MeSH primário: Monitorização Fetal/métodos
Gravidez de Alto Risco
Ultrassonografia Pré-Natal
Artérias Umbilicais/diagnóstico por imagem
Cordão Umbilical/diagnóstico por imagem
[Mh] Termos MeSH secundário: Cardiotocografia
Cesárea/utilização
Feminino
Seres Humanos
Trabalho de Parto Induzido/utilização
Mortalidade Perinatal
Gravidez
Ensaios Clínicos Controlados Aleatórios como Assunto
Natimorto/epidemiologia
Artérias Umbilicais/fisiopatologia
Cordão Umbilical/irrigação sanguínea
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD007529.pub4


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[PMID]:28594770
[Au] Autor:Taney J; Anastasio H; Paternostro A; Berghella V; Roman A
[Ad] Endereço:Icahn School of Medicine at Mount Sinai, New York, New York; and Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
[Ti] Título:Placental Abruption With Delayed Fetal Compromise in Maternal Acetaminophen Toxicity.
[So] Source:Obstet Gynecol;130(1):159-162, 2017 Jul.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: After maternal acetaminophen overdose, fetal fulminant liver failure, stillbirth, neonatal death, or preterm delivery may occur. CASE: A 27-year-old woman, gravida 2 para 1, presented at 28 weeks of gestation after unintentional acetaminophen overdose. Four days after ingestion, her laboratory values worsened, including serum aspartate aminotransferase of 5,460 units/L, alanine aminotransferase of 4,936 units/L, and international normalized ratio of 2.9. On day 6 after ingestion, fetal monitoring showed minimal variability with repetitive variable and late decelerations, which prompted cesarean delivery when a hematoma was noted on the maternal placental surface, consistent with placental abruption. The neonate showed no evidence of hepatic dysfunction. Review of the literature suggests that maternal acetaminophen overdose in the second and third trimester is associated with a 5% incidence of fetal compromise (mostly the result of nonreassuring fetal status leading to delivery or stillbirth) occurring within 6 days of ingestion. CONCLUSION: Maternal acetaminophen overdose can be associated with delayed fetal compromise, suggesting the importance of continued fetal surveillance several days after ingestion.
[Mh] Termos MeSH primário: Descolamento Prematuro da Placenta/diagnóstico
Acetaminofen/envenenamento
Analgésicos não Entorpecentes/envenenamento
Efeitos Tardios da Exposição Pré-Natal
[Mh] Termos MeSH secundário: Adulto
Cesárea
Diagnóstico Diferencial
Overdose de Drogas/sangue
Overdose de Drogas/diagnóstico
Feminino
Monitorização Fetal
Seres Humanos
Recém-Nascido
Gravidez
Terceiro Trimestre da Gravidez
Diagnóstico Pré-Natal
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 362O9ITL9D (Acetaminophen)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002089


  6 / 6807 MEDLINE  
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[PMID]:28438283
[Au] Autor:García González J; Ventura Miranda MI; Manchon García F; Pallarés Ruiz TI; Marin Gascón ML; Requena Mullor M; Alarcón Rodriguez R; Parron Carreño T
[Ad] Endereço:Nurse at Rafael Mendez Hospital, Lorca, Murcia, Spain; University of Lorca, Lorca, Murcia, Spain. Electronic address: jessyka_gg@hotmail.com.
[Ti] Título:Effects of prenatal music stimulation on fetal cardiac state, newborn anthropometric measurements and vital signs of pregnant women: A randomized controlled trial.
[So] Source:Complement Ther Clin Pract;27:61-67, 2017 May.
[Is] ISSN:1873-6947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Music has been used for medicinal purposes throughout history due to its variety of physiological, psychological and social effects. OBJECTIVE: To identify the effects of prenatal music stimulation on the vital signs of pregnant women at full term, on the modification of fetal cardiac status during a fetal monitoring cardiotocograph, and on anthropometric measurements of newborns taken after birth. MATERIAL AND METHOD: A randomized controlled trial was implemented. The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) during a fetal monitoring cardiotocograph. All of the pregnant women were evaluated by measuring fetal cardiac status (basal fetal heart rate and fetal reactivity), vital signs before and after a fetal monitoring cardiotocograph (maternal heart rate and systolic and diastolic blood pressure), and anthropometric measurements of the newborns were taken after birth (weight, height, head circumference and chest circumference). RESULTS: The strip charts showed a significantly increased basal fetal heart rate and higher fetal reactivity, with accelerations of fetal heart rate in pregnant women with music stimulation. After the fetal monitoring cardiotocograph, a statistically significant decrease in systolic blood pressure, diastolic blood pressure and heart rate in women receiving music stimulation was observed. CONCLUSION: Music can be used as a tool which improves the vital signs of pregnant women during the third trimester, and can influence the fetus by increasing fetal heart rate and fetal reactivity.
[Mh] Termos MeSH primário: Peso ao Nascer/fisiologia
Pressão Sanguínea/fisiologia
Frequência Cardíaca Fetal/fisiologia
Musicoterapia/métodos
[Mh] Termos MeSH secundário: Adulto
Índice de Apgar
Tamanho Corporal/fisiologia
Cardiotocografia
Feminino
Monitorização Fetal
Frequência Cardíaca/fisiologia
Seres Humanos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE


  7 / 6807 MEDLINE  
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[PMID]:28410419
[Au] Autor:Vullings R; Verdurmen KMJ; Hulsenboom ADJ; Scheffer S; de Lau H; Kwee A; Wijn PFF; Amer-Wåhlin I; van Laar JOEH; Oei SG
[Ad] Endereço:Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
[Ti] Título:The electrical heart axis and ST events in fetal monitoring: A post-hoc analysis following a multicentre randomised controlled trial.
[So] Source:PLoS One;12(4):e0175823, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Reducing perinatal morbidity and mortality is one of the major challenges in modern health care. Analysing the ST segment of the fetal electrocardiogram was thought to be the breakthrough in fetal monitoring during labour. However, its implementation in clinical practice yields many false alarms and ST monitoring is highly dependent on cardiotocogram assessment, limiting its value for the prediction of fetal distress during labour. This study aims to evaluate the relation between physiological variations in the orientation of the fetal electrical heart axis and the occurrence of ST events. METHODS: A post-hoc analysis was performed following a multicentre randomised controlled trial, including 1097 patients from two participating centres. All women were monitored with ST analysis during labour. Cases of fetal metabolic acidosis, poor signal quality, missing blood gas analysis, and congenital heart disease were excluded. The orientation of the fetal electrical heart axis affects the height of the initial T/QRS baseline, and therefore the incidence of ST events. We grouped tracings with the same initial baseline T/QRS value. We depicted the number of ST events as a function of the initial baseline T/QRS value with a linear regression model. RESULTS: A significant increment of ST events was observed with increasing height of the initial T/QRS baseline, irrespective of the fetal condition; correlation coefficient 0.63, p<0.001. The most frequent T/QRS baseline is 0.12. CONCLUSION: The orientation of the fetal electrical heart axis and accordingly the height of the initial T/QRS baseline should be taken into account in fetal monitoring with ST analysis.
[Mh] Termos MeSH primário: Monitorização Fetal
Frequência Cardíaca Fetal/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Cesárea
Eletrocardiografia
Feminino
Sangue Fetal/química
Doenças Fetais/fisiopatologia
Idade Gestacional
Seres Humanos
Concentração de Íons de Hidrogênio
Trabalho de Parto
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170504
[Lr] Data última revisão:
170504
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175823


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[PMID]:28335811
[Au] Autor:Vincent M; Benbrik N; Romefort B; Colombel A; Bézieau S; Isidor B
[Ad] Endereço:Service de Génétique Médicale, Hôpital Hôtel-Dieu, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France. marie.vincent@chu-nantes.fr.
[Ti] Título:Three patients presenting with severe macrosomia and congenital hypertrophic cardiomyopathy: a case series.
[So] Source:J Med Case Rep;11(1):78, 2017 Mar 24.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Macrosomia and hypertrophic cardiomyopathy are two features often associated in neonates of diabetic mothers. We report the cases of three patients with severe macrosomia and critical hypertrophic cardiomyopathy without severely unbalanced maternal diabetes. Only three patients with those two features and no uncontrolled maternal diabetes have been previously reported. CASE PRESENTATION: The first patient was a 39-week-old girl, the second patient was a 39-week-old girl, and the third patient was a 41-week-old boy. The two French girls and the French boy had severe macrosomia and hypertrophic cardiomyopathy, leading to the death of the boy. The outcome of the two girls was favorable, with a standardization of growth curves and ventricular hypertrophy. Their mothers presented with high body mass index but no severe documented maternal diabetes; glycemic imbalance was only suspected on postnatal analyses. There was no hydramnios during pregnancy and no other environmental factor, especially toxic exposure. Their parents are from Mayotte, Guadeloupe, and Guinea-Conakry. The usual genetics causes, Beckwith-Wiedemann syndrome, and chromosomal copy number variation, were also excluded. CONCLUSIONS: This report suggests the implication of other factors in addition to glycemic disorders, including genetic factors, in the occurrence of macrosomia and severe hypertrophic cardiomyopathy in neonates. These three original observations indicate that gynecologists and neonatologists should pay attention to neonates from mothers with a high body mass index and when maternal diabetes is not documented.
[Mh] Termos MeSH primário: Cardiomiopatia Hipertrófica/diagnóstico
Diabetes Gestacional/fisiopatologia
Macrossomia Fetal/diagnóstico
Hipoglicemia/complicações
Mães
Gravidez em Diabéticas/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Peso ao Nascer
Índice de Massa Corporal
Cardiomiopatia Hipertrófica/embriologia
Cardiomiopatia Hipertrófica/fisiopatologia
Variações do Número de Cópias de DNA
Diabetes Gestacional/sangue
Feminino
Macrossomia Fetal/fisiopatologia
Monitorização Fetal
Teste de Tolerância a Glucose
Seres Humanos
Lactente
Masculino
Gravidez
Resultado da Gravidez
Gravidez em Diabéticas/sangue
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1231-5


  9 / 6807 MEDLINE  
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[PMID]:28325438
[Au] Autor:Ahmadieh H; Asl BM
[Ad] Endereço:Department of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran.
[Ti] Título:Fetal ECG extraction via Type-2 adaptive neuro-fuzzy inference systems.
[So] Source:Comput Methods Programs Biomed;142:101-108, 2017 Apr.
[Is] ISSN:1872-7565
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: We proposed a noninvasive method for separating the fetal ECG (FECG) from maternal ECG (MECG) by using Type-2 adaptive neuro-fuzzy inference systems. METHODS: The method can extract FECG components from abdominal signal by using one abdominal channel, including maternal and fetal cardiac signals and other environmental noise signals, and one chest channel. The proposed algorithm detects the nonlinear dynamics of the mother's body. So, the components of the MECG are estimated from the abdominal signal. By subtracting estimated mother cardiac signal from abdominal signal, fetal cardiac signal can be extracted. This algorithm was applied on synthetic ECG signals generated based on the models developed by McSharry et al. and Behar et al. and also on DaISy real database. RESULTS: In environments with high uncertainty, our method performs better than the Type-1 fuzzy method. Specifically, in evaluation of the algorithm with the synthetic data based on McSharry model, for input signals with SNR of -5dB, the SNR of the extracted FECG was improved by 38.38% in comparison with the Type-1 fuzzy method. Also, the results show that increasing the uncertainty or decreasing the input SNR leads to increasing the percentage of the improvement in SNR of the extracted FECG. For instance, when the SNR of the input signal decreases to -30dB, our proposed algorithm improves the SNR of the extracted FECG by 71.06% with respect to the Type-1 fuzzy method. The same results were obtained on synthetic data based on Behar model. Our results on real database reflect the success of the proposed method to separate the maternal and fetal heart signals even if their waves overlap in time. Moreover, the proposed algorithm was applied to the simulated fetal ECG with ectopic beats and achieved good results in separating FECG from MECG. CONCLUSIONS: The results show the superiority of the proposed Type-2 neuro-fuzzy inference method over the Type-1 neuro-fuzzy inference and the polynomial networks methods, which is due to its capability to capture the nonlinearities of the model better.
[Mh] Termos MeSH primário: Eletrocardiografia/métodos
Monitorização Fetal/métodos
Processamento de Sinais Assistido por Computador
[Mh] Termos MeSH secundário: Algoritmos
Simulação por Computador
Feminino
Lógica Fuzzy
Frequência Cardíaca Fetal
Seres Humanos
Modelos Estatísticos
Gravidez
Razão Sinal-Ruído
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE


  10 / 6807 MEDLINE  
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[PMID]:28301889
[Au] Autor:Torossian A
[Ti] Título:Geburtshilfe: Anästhesie bei EXIT-Prozedur..
[So] Source:Anasthesiol Intensivmed Notfallmed Schmerzther;52(3):214-219, 2017 Mar.
[Is] ISSN:1439-1074
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:The ex utero intrapartum treatment (EXIT) procedure is performed as a part of an extended caesarean section for example to treat fetal airway disorders. For treatment, optimal uterine relaxation is necessary, however utero-placental supply of the fetus has to be guaranteed as well. "Balanced" anesthesia, tocolysis and tight maternal arterial blood pressure control are recommended. Standard fetal monitoring comprises pulse oxymetry and echocardiography. The article describes the physiology and anesthestic goals of the EXIT procedure, discusses alternative anesthesia techniques and gives an outlook on emerging progress.
[Mh] Termos MeSH primário: Analgesia Obstétrica/métodos
Anestesia Obstétrica/métodos
Cesárea/efeitos adversos
Cesárea/métodos
Dor do Parto/etiologia
Dor do Parto/terapia
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Feminino
Monitorização Fetal/métodos
Seres Humanos
Dor do Parto/diagnóstico
Monitorização Intraoperatória/métodos
Dor Pós-Operatória/etiologia
Gravidez
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-105986



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