Objective: This study aimed to determine the effect of fetal movements on the MCA pulsatility index (PI) and quantify the fall of MCA PI after initiation of fetal movements and/or breathing, and the time taken to reco...Objective: This study aimed to determine the effect of fetal movements on the MCA pulsatility index (PI) and quantify the fall of MCA PI after initiation of fetal movements and/or breathing, and the time taken to recover from a fall below the 5th percentile. Methods: 16 women with appropriate for gestational age (AGA) fetuses and 16 women with small for gestational age (SGA) fetuses were recruited. MCA PI during “no movement” state was compared with MCA PI values during fetal body movements and breathing movements. Results: MCA PI measurements with body or breathing movements were significantly (p 0.005) lower as compared to that observed without movements. MCA PI started rising immediately after cessation of body movements and/or breathing movements. Conclusions: MCA PI with fetal body or breathing movements is significantly lower as compared to that observed in the quiet state. If MCA PI measurement is below 5th centile, it should be measured again up to 90 seconds after cessation of fetal body and/or breathing movements in order to minimize false positive diagnosis of cerebral sparing effect in SGA as well as AGA fetuses.展开更多
Fetal heart rate(FHR)monitoring is one of the central parts of obstetric care.Ultrasound-based technologies such as cardiotocography(CTG)remain the most common method for FHR monitoring.The CTG’s limitations,includin...Fetal heart rate(FHR)monitoring is one of the central parts of obstetric care.Ultrasound-based technologies such as cardiotocography(CTG)remain the most common method for FHR monitoring.The CTG’s limitations,including subjective interpretation,high interobserver variability,and the need for skilled professionals,led to the development of computerized CTG(cCTG).While cCTG demonstrated advantages,its superiority over visual interpretation remains inconclusive.This has prompted the exploration of alternatives like noninvasive fetal electrocardiography(NIFECG).This review explores the landscape of antenatal FHR monitoring and the need for remote FHR monitoring in a patient-centered care model.Additionally,FHR monitoring needs to evolve from the traditional approach to incorporate artificial intelligence and machine learning.The review underscores the importance of aligning fetal monitoring with modern healthcare,leveraging artificial intelligence algorithms for accurate assessments,and enhancing patient engagement.The physiology of FHR variability(FHRV)is explained emphasizing its significance in assessing fetal well-being.Other measures of FHRV and their relevance are described.It delves into the promising realm of NIFECG,detailing its history and recent technological advancements.The potential advantages of NIFECG are objective FHR assessment,beat-to-beat variability,patient comfort,remote prolonged use,and less signal loss with increased maternal body mass index.Despite its promise,challenges such as signal loss must be addressed.The clinical application of NIFECG,its correlation with cCTG measures,and ongoing technological advancements are discussed.In conclusion,this review explores the evolution of antenatal FHR monitoring,emphasizing the potential of NIFECG in providing reliable,home-based monitoring solutions.Future research directions are outlined,urging longitudinal studies and evidence generation to establish NIFECG’s role in enhancing fetal well-being assessments during pregnancy.展开更多
文摘Objective: This study aimed to determine the effect of fetal movements on the MCA pulsatility index (PI) and quantify the fall of MCA PI after initiation of fetal movements and/or breathing, and the time taken to recover from a fall below the 5th percentile. Methods: 16 women with appropriate for gestational age (AGA) fetuses and 16 women with small for gestational age (SGA) fetuses were recruited. MCA PI during “no movement” state was compared with MCA PI values during fetal body movements and breathing movements. Results: MCA PI measurements with body or breathing movements were significantly (p 0.005) lower as compared to that observed without movements. MCA PI started rising immediately after cessation of body movements and/or breathing movements. Conclusions: MCA PI with fetal body or breathing movements is significantly lower as compared to that observed in the quiet state. If MCA PI measurement is below 5th centile, it should be measured again up to 90 seconds after cessation of fetal body and/or breathing movements in order to minimize false positive diagnosis of cerebral sparing effect in SGA as well as AGA fetuses.
文摘Fetal heart rate(FHR)monitoring is one of the central parts of obstetric care.Ultrasound-based technologies such as cardiotocography(CTG)remain the most common method for FHR monitoring.The CTG’s limitations,including subjective interpretation,high interobserver variability,and the need for skilled professionals,led to the development of computerized CTG(cCTG).While cCTG demonstrated advantages,its superiority over visual interpretation remains inconclusive.This has prompted the exploration of alternatives like noninvasive fetal electrocardiography(NIFECG).This review explores the landscape of antenatal FHR monitoring and the need for remote FHR monitoring in a patient-centered care model.Additionally,FHR monitoring needs to evolve from the traditional approach to incorporate artificial intelligence and machine learning.The review underscores the importance of aligning fetal monitoring with modern healthcare,leveraging artificial intelligence algorithms for accurate assessments,and enhancing patient engagement.The physiology of FHR variability(FHRV)is explained emphasizing its significance in assessing fetal well-being.Other measures of FHRV and their relevance are described.It delves into the promising realm of NIFECG,detailing its history and recent technological advancements.The potential advantages of NIFECG are objective FHR assessment,beat-to-beat variability,patient comfort,remote prolonged use,and less signal loss with increased maternal body mass index.Despite its promise,challenges such as signal loss must be addressed.The clinical application of NIFECG,its correlation with cCTG measures,and ongoing technological advancements are discussed.In conclusion,this review explores the evolution of antenatal FHR monitoring,emphasizing the potential of NIFECG in providing reliable,home-based monitoring solutions.Future research directions are outlined,urging longitudinal studies and evidence generation to establish NIFECG’s role in enhancing fetal well-being assessments during pregnancy.
