OBJECTIVE: An overwiev of the new diagnostic method of fetal wellbeing - fetal magnetocardiography (fMCG). DESIGN: A review article. SETTING: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic. METHODS: An analysis of the literature using database search engines PubMed, and SCOPE in field of fMCG. RESULTS: Fetal magnetocardiography is a non-invasive technique able to monitor the spontaneous electrophysiological activity of the fetal heart. Compared to cardiotocography and fetal electrocardiography, this is a more effective method with a higher resolution. The signal obtained from the fetal heart is sufficiently precise and the quality allows an assessment of PQRST complex alterations, and to detect fetal arrhythmia. Thanks to early diagnosis of fetal arrhythmia, there is the possibility for appropriate therapeutic intervention and the reduction of unexplained fetal death in late gestation. fMCG with high temporal resolution also increases the level of clinical trials which record fetal heart rate (FHR) variability. According to the latest theories, FHR variability is a possible indicator of fetal status and enables the study of the fetal autonomic nervous system indirectly. fMCG is an experimental method that requires expensive equipment. It is yet to be shown in the future, if this method will get any application in clinical practice.
- MeSH
- lidé MeSH
- magnetokardiografie metody MeSH
- monitorování plodu metody MeSH
- prediktivní hodnota testů MeSH
- prenatální diagnóza MeSH
- srdeční arytmie vrozené diagnóza MeSH
- srdeční frekvence plodu MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
OBJECTIVE: An overview of electronic fetal monitoring methods (EFM), and an analysis of their physical and technical limits. DESIGN: A review article. SETTING: Department of Gynecology and Obstetrics Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic. METHODS: An analysis of the literature using database search engines PubMed, and SCOPE in the years 2000 - 2013 in field of diagnostic methods of fetal status in utero. RESULTS: The essential aim of modern perinatology is the birth of a live and healthy newborn. This aim is strongly related to the abilities of the diagnostic methods to evaluate the intrauterine fetal status and with the professional skills of obstetricians to analyze these methods accurately. Nowadays, EFM is exposed to criticism, in spite of its widespread use. It is associated with some degree of failure in terms of an over-evaluation and under-evaluation. An over-evaluation of results can lead to unnecessary, often surgical, intervention. An under-evaluation of results can lead to an adverse fetal outcome with a neurologic handicap or intrauterine death. The long-term efforts currently underway to improve the reliability of EFM still remain to show any great progress. KEYWORDS: cardiotocography, intermittent auscultation, pulse oximetry, ST analysis, fetal electrocardiography.
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
OBJECTIVE: A retrospective analysis of medical records during years 2007-2011 considers maternal and fetal outcome in patients with breech presentation terminated by vaginal delivery versus caesarean section (CS). DESIGN: Retrospective analysis. SETTING: Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. METHODS: Authors devided patients with breech presentation of fetus (n = 299) to groups of single pregnancies terminated in term (n = 197), before term (n = 67) and to group of multiple pregnancies (n = 35). All groups were devided according to the way of termination of pregnancy by vaginal delivery, by acute CS and by planned CS. Main followed parameters: parity, gestational week, Apgar score, birth weight, birth length, fetal gender, indications for CS, mortality and neonatal morbidity, umbilical artery pH, convulsions, admit to neonatal intensive care unit, intubation of neonate, intracranial bleeding, cervical spine and peripheral nerve injuries. RESULTS: Total cohort of breech deliveries was 299. In the group of single pregnancies in term was 19.8% terminated by vaginal delivery (n = 39), 32.5% deliveries by acute CS (n = 64). The most common indication was fetal hypoxia (43.8%). By planned CS was terminated 47.7% deliveries (n = 94). The most common indication for CS was footling presentation (54.3%). Severe neonatal morbidity was rare and without significant difference according to the type of termination of pregnancy. Neonatal outcome was comparable in the group of preterm deliveries(n = 67) terminated by vaginal delivery or by CS. All neonatal deaths were associated with extreme prematurity and not with type of termination of gravidity. CONCLUSION: Clinical outcomes between vaginal breech deliveries and breech deliveries terminated by CS in term in singleton pregnancies were not significant different. Mortality of neonates delivered by preterm delivery was associated with severe prematurity.
- MeSH
- dospělí MeSH
- gestační stáří MeSH
- incidence MeSH
- lidé MeSH
- novorozenec nedonošený * MeSH
- novorozenec MeSH
- poloha plodu koncem pánevním epidemiologie MeSH
- předčasný porod epidemiologie etiologie MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
