BACKGROUND Continuous electronic foetal monitoring is presumably a superior method of screening for foetal hypoxia as it detects subtle changes in the foetal heart, which can be missed on auscultation. However, in developing countries like India, with limited number of cardiotocography machines available, it was endeavoured to find out if after an initial 20 minutes electronic recording of the foetal heart auscultation could be substituted for electronic foetal monitoring for intrapartum foetal surveillance even in women with category II admission test who were considered to be at high risk for intrapartum foetal hypoxia. Aim: To comparatively study, in women with category II admission test, the neonatal outcome with electronic foetal monitoring and intermittent auscultation. MATERIALS AND METHODS 42 women with category II admission test were randomly divided into two groups: Group I was monitored with intermittent auscultation and Group II received continuous electronic foetal monitoring. RESULTS Operative vaginal delivery for foetal distress was used in 14.28% cases in Group I as compared to 19% in Group II, but the difference was not statistically significant (p= 0.67). Caesarean section for the indication of foetal distress was performed in 47.62% cases in the intermittent auscultation group and 52.38% cases in Group II (p= 0.54). There was no statistically significant difference in the neonatal morbidity and mortality in the two groups. CONCLUSION An admission test followed by intermittent auscultation with stethoscope during and after uterine contractions should be the mainstay of foetal monitoring in labour and is the best way of using the limited number of foetal monitors available in developing countries with economic constraints.
Background One of the common practices in modern obstetrical care is labour induction when foetal and maternal complications arise. We endeavoured to compare the efficacy and safety of the inexpensive mechanical method of induction Foley’s catheter to the more established pharmacological agent Intracervical Prostaglandin E2 gel Method The present prospective randomised control study was carried out on 200 women with a term singleton pregnancy in cephalic presentation, with an unfavourable cervix and a valid indication for induction of labour. The patients were randomly allocated using the chit method to either Foley’s catheter [group A, n=100] or PGE2 gel [group B, n=100] . Augmentation with oxytocin was done if required and labor was closely monitored till delivery and the perinatal outcome and maternal side effects was recorded Quantitative variables were compared using unpaired t-test/Mann-Whitney Test and qualitative variables were compared using Chi-Square test /Fisher’s exact test. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0 RESULTThe caesarean section rate did not show a significant difference between the Foley’s group(18%) and PGE2 group(11%) The incidence of fetal distress, Meconium stained liquor and APGAR score <7 at 5 minutes was significantly with PGE2 as compared to group A. (P<.05) Incidence of hyperstimulation of uterus was reported in 6% women who received PGE2 as compared to none in Foley’s group. The induction delivery interval did not show any significant difference between the two groups. CONCLUSION In women undergoing induction of labour at term in resource constraint set ups like ours, Foley catheter is a good alternative to the more established prostaglandin E2 gel, with good efficacy and better neonatal and maternal safety profile. Keywords: cervical ripening; dinoprostone; obstetric labor, induced
Objectives: Expanding from our previous work, this study aimed to investigate the correlation, precision, mean percentage difference (MPD) and 95% limits of agreement (LOA) between cardiac indices measured by USCOM-1A against NICOM and 2D transthoracic echocardiography (2D-TTE) across pregnancy in Chinese women. Methods: It was a prospective longitudinal study performed in singleton pregnancy at 11-14 +6 (n = 109), 19-24 +6 (n = 56), 30-34 +6 (n = 57), and 35-37 +6 (n = 44) weeks. Cardiac indices were obtained by USCOM-1A ® , which uses continuous wave Doppler, NICOM, which uses thoracic bioreactance, and 2D-TTE. Cardiac index (CI) and stroke volume index (SVI) were calculated from cardiac output (CO) and stroke volume (SV) adjusted for body surface area. SV, CO, SVI, and CI were assessed by calculating correlation, bias, precision, MPD and LOA. Results: Comparing cardiac indices by USCOM-1A and 2D-TTE, SV, but not SVI, showed significant moderate correlation except for 30-34 +6 weeks (r = 0.25-0.41; p < 0.05); CO, but not CI, showed significant moderate correlation at all 4 timepoints (r = 0.31-0.38; p < 0.05). Overall, SV and CO obtained by USCOM-1A relative to that obtained by 2D-TTE had a bias of 4.87mL (95% LOA: -45.2-35.5) and 0.41L/min (95% LOA: -3.75-2.93), respectively. Comparing cardiac indices by USCOM-1A and NICOM, SV and CO measurements showed significant moderate correlation only at 11-13 +6 weeks (r = 0.31;0.32; p < 0.05). Overall, SV and CO obtained by USCOM-1A relative to that obtained by NICOM had a bias of 15.1mL (95% LOA: -49.2-19.1) and 0.76 L/min (95% LOA: -3.72-2.20), respectively. MPD for all cardiac indices at 4 timepoints were > 30%. Conclusions: In Chinese pregnant women, USCOM-1A has on average higher values of cardiac indices compared to the measurements by 2D-TTE and NICOM. MPD for all cardiac indices are > 30%, which are higher than clinically acceptable limit. Future research is needed to focus on optimising the non-invasive automated devices to improve the agreement of measurements with 2D-TTE.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.