Abstract:
BACKGROUND:Sub partu foetal heart-rate (FHR) patterns are difficult to evaluate. Until now we have no numerical criteria to reliably define what is a non-reassuring or even a 'pathological' FHR tracing. Computer-aided FHR analysis using the new WAS score offers the unique opportunity to assess numerical boundaries for these definitions. METHODS:Direct FHR tracings of 475 foetuses, all delivered by the vaginal route, were recorded electronically and the last 30 min of each tracing were used for computation of the WAS score. The WAS score refers to FHR frequency, microfluctuation, and oscillation amplitude per minute. Acid-base and blood-gas analyses were performed in blood of the umbilical artery (UA) and vein (UV) immediately post partum. pH (UA) and the WAS score were correlated (r) and the 4 variables sensitivity, specificity, the false positive rate (FPR) and the false negative rate (FNR) were determined. ROC plots for different threshold pH (UA) values were performed. RESULTS:pH (UA) and the WAS score are normally distributed: mean pH (UA)=7.263+/-0.064 and mean WAS score 2.78+/-0.81, respectively. The correlation coefficient, r amounts to 0.657, P<10(-4). Using the mean pH (UA) and the mean WAS score leads to a sensitivity and specificity both of 72% with an FPR and FNR both of 28%. Using a WAS score of 1.816 and the threshold pH (UA) of 7.122 sensitivity becomes the first time 100% (FNR=0%) and FPR decreases to 10.7%. These 2 values are chosen to separate a normal (score >1.816) from an abnormal (non-reassuring) CTG (score < or =1.816). According to this definition newborns with a reassuring (normal) FHR tracing (N=417) have a pH (UA)=7.275+/-0.055, pCO (2)=52.3+/-7.9, BE (Ecf,oxy.)=-3.0+/-2.3, sO (2)=24.9+/-12.3 with an acidotic risk (pH (UA) <7.100) of 0% and APGAR 1 min <7=0.96%, respectively. Neonates with an abnormal (non-reassuring) FHR tracing (N=58) present a mean pH (UA)=7.178+/-0.066, pCO (2)=62.6+/-9.6, BE (Ecf,oxy.)=-5.4+/-2.6, sO (2)=18.3+/-12.0 and an acidotic risk of 6.9%. No neonate in this group was severely depressed (APGAR 1 min < or =3). Separation of the true positive (pH (UA) <7.122) from the false positive (pH (UA) > or =7.122) cases yields 10 babies with a mean pH (UA)=7.084+/-0.053, pCO (2)=71.8+/-10.7, BE (Ecf,oxy.)=-8.4+/-2.0, sO (2)=20.2+/-14.5 and an acidotic risk of 44.4%; in this group also not one baby was severely depressed (APGAR 1 min < or =3) but 3 were already moderately affected (<7 after 1 min). No infant scored <7 after 5 min. There must be a lower limit for the definition of a true 'pathological' FHR tracing; this boundary should not be identical with the threshold pH value where hypoxic injuries in term infants usually commence. For FHF this is a WAS score of 0.630 and a threshold pH (UA) of 7.075. CONCLUSION:Using sensitivity, specificity, FPR and FNR of the FHR sub partu, it is possible to discriminate online a normal (reassuring) from an abnormal (non-reassuring) FHR tracing by a simple computer-aided procedure which we call WAS scoring.
journal_name
Z Geburtshilfe Neonatoljournal_title
Zeitschrift fur Geburtshilfe und Neonatologieauthors
Roemer VMdoi
10.1055/s-0030-1261962subject
Has Abstractpub_date
2010-08-01 00:00:00pages
151-60issue
4eissn
0948-2393issn
1439-1651journal_volume
214pub_type
杂志文章abstract::The delivery of a 23 para I who was born herself with a sacrococcygeal teratoma of the type II is reported. After the extirpation of the tumor and of the coccyx an anomaly of the pelvis is found in the sense of a pygopagic pelvis (stretching and bending of the sacrum towards the dorsum). This anomaly and the scars in ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::The present study discusses problems of maternal infection with hepatitis C virus in pregnancy with respect to the recent publications on this subject. In particular, questions of vertical transmission during pregnancy and fetal infection sub partu are discussed using three cases as an example. It was shown that recen...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:
更新日期:1996-11-01 00:00:00
abstract::Ante- and postpartum noninvasive 24-hour ambulatory blood pressure measurements were performed in 18 normotensive pregnants and 36 patients with mild (n = 16) or severe preeclampsia (n = 12) or HELLP-syndrome (n = 8). In contrast to normotensive pregnancy (n = 18) displaying a decline of systolic and diastolic blood p...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract::The cesarean section rate and the associated complications are still rising in Germany. An important indication is term breech in singletons. Not significant data concerning a higher morbidity or mortality in vaginal breech birth indicate the cesarean but a deficit in education and experience. ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0032-1309052
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Twin pregnancies and gestations after assisted reproductive therapy (ART) are of special obstetric significance with regard to their associated risks. However, little is known about preventive approaches specifically evaluated for these constellations. METHODS:A selective literature search was conducted to ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0029-1241846
更新日期:2009-12-01 00:00:00
abstract::Several prospective clinical trials have indicated an association between maternal periodontal status and adverse pregnancy outcome, e.g., low birth weight, pre-term birth and pre-eclampsia. However, the translation of these findings into clinical care and decision making is still a matter of debate. Gynecologists and...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1385859
更新日期:2014-12-01 00:00:00
abstract::Periventricular leucomalacia (PVL) is the most common form of hypoxemic brain damage in infants. In PVL, there is usually a preceding history of asphyxia or hypoxia. This results in hypoxic-ischaemic damage to the region of the brain around the lateral ventricles, a particularly vulnerable area as it is in a border zo...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 00:00:00
abstract::Cytotrophoblast cells were isolated from human term placenta after cesarean section by fragmentation of villous tissue with trypsin and DNAse I. Trophoblast cells fuse in vitro to syncytiotrophoblast cells and progesteron is released. Placental Protein 14 (PP14) was incubated (300 micrograms/ml PP14 in 6 ml solution (...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::The breastfeeding behavior of women is influenced by social, demographic and cultural factors, yet little is known about the influence of migration and acculturation. A systematic search using the electronic databases LIVIVO and MEDLINE (PubMed) was conducted followed by a manual search in the bibliographies of all se...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/a-0821-6070
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:This study aimed to evaluate the incidence of knee pain or the intensification of knee-related problems during pregnancy. We hypothesised that the occurrence of knee problems correlates with an increase in body weight during pregnancy. METHODS:A total of 326 women (30(th)-40(th) week of pregnancy) were involve...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0034-1395536
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:During pregnancy about 30 grams of calcium are transferred to a full-term neonate. The enormous demand for calcium can be regulated by compensatory mechanisms in the maternal metabolism such as elevated steroid hormone levels, increased intestinal absorption of dietary calcium, and renal conservation, but als...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2006-951742
更新日期:2006-10-01 00:00:00
abstract::Within a group of preeclamptic women we found severe histologic placental pathology with functional relevance when both the uteroplacental and fetoplacental flow velocity waveforms showed elevated resistance indices. These pathological findings were a reduced decidual area, infarction and villus maturation failures wi...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::Progressive systemic sclerosis is a connective tissue disease with inflammation and fibrosis. Pregnant women with progressive systemic sclerosis have an increased risk for preterm births and probably for small-for-date babies. We report the case of a 28-year-old II G O P suffering from progressive systemic sclerosis w...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2005-916247
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:This study examines the recommendations of international guidelines on the use of antepartum and intrapartum cardiotocography. MATERIAL AND METHODS:The guidelines of Germany, Canada, UK, USA, Sri Lanka, Australia as well as FIGO have been compared. The recommendations on the use of cardiotocography were sepa...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0043-122945
更新日期:2018-04-01 00:00:00
abstract::Supine sleeping is recommended to prevent the sudden infant death syndrome (SIDS). Low birth weight infants are at increased risk for SIDS, which is increased further if they are placed prone. Prone sleeping, however, also has advantages for preterm infants, such as a reduced apnoea rate, an increased lung volume and ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1004610
更新日期:2008-02-01 00:00:00
abstract::Neonatal mysthenia gravis (NMG) is a rare cause of arthrogryposis multiplex congenita (AMC) due to diaplacental transfer of maternal acetylcholine receptors (AChR) antibodies. 2 cases of severe NMG complicated by chronic lung disease and pulmonary arterial hypertension are reported. With respect to the severe course o...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0033-1349888
更新日期:2013-08-01 00:00:00
abstract:INTRODUCTION:Therapeutic hypothermia (TH) improves the outcome in newborns with hypoxic-ischemic encephalopathy (HIE) and should be used in case of perinatal asphyxia and signs of moderate/severe HIE. MATERIAL/METHODS:Frequency of HIE and the application of TH were extracted from the neonatal survey, a registry that c...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/a-1164-7174
更新日期:2020-12-01 00:00:00
abstract::Introduction: It is estimated that after premature rupture of membranes (PROM) at term, 60% of all women go into labour within 48 h, 95% within 72 h. Often labour is induced after 24 h because the risk of maternal and neonatal infection rises. The majority of clinicians advise hospital care to allow monitoring and det...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0042-115035
更新日期:2016-10-01 00:00:00
abstract::The finding of absent or reverse end-diastolic flow velocities (AREDV) in the umbilical artery already prior to viability corresponds to the most severe end of the clinical spectrum of placental insufficiency. However, there is little or no experience or published literature with regard to perinatal outcome. We report...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0034-1394388
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Associations between the size of the placenta and birth weight have been described before. This connection has also been found in (sonographically estimated) second trimester placental size. The aim of this study was to find out if there are any differences in first trimester placental volume between vario...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2002-33671
更新日期:2002-07-01 00:00:00
abstract::A few years ago recombinant human erythropoietin (rh-EPO) has been introduced for the prophylaxis of anaemia of prematurity. Aim of this controlled study was a cost-effectiveness analysis of the prophylaxis with rh-EPO versus sole transfusion with packed red blood cells. In the study group 33 infants (gestational age ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 临床试验,杂志文章
doi:
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:As with all new diagnostic options in medicine, great hope was placed in the introduction of high-resolution prenatal sonography. Progress tends to carry with it a demanding attitude of higher expectations. Patients and doctors alike may initially overestimate the possibilities of medical advances. QUESTION...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-2001-14551
更新日期:2001-01-01 00:00:00
abstract::Disorders of laterality and heterotaxy syndromes are rare diseases with an incidence of 1-1.5/10,000 live births. They are associated with numerous viscerocardiac anomalies and malformations. In particular, heterotaxy syndromes are associated with complex cardiac and extracardiac malformations that have an important i...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1314808
更新日期:2012-06-01 00:00:00
abstract::Among the very rare intracerebral lipomas, those of the corpus callosum are the most frequent. Due to the advanced technology and the frequent use of ultrasonography these lesions are diagnosed more and more often. A female neonate was admitted to our hospital because of a progressive thrombocytopenia. Pregnancy was c...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::To date there has not been a systematic analysis of pregnant patients with an immigrant background and gestational diabetes in Germany, even though the number of these patients has been rising continuously since the 1980s. METHODS:The case number estimate for this prospective study targeted 160 patients with gestatio...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/a-1270-8258
更新日期:2020-11-02 00:00:00
abstract::Ever since the first report on fetal magnetocardiography by Kariniemi in 1974 numerous studies have examined cardiac activity in healthy fetuses using this technique. Recently there has been an increase in reports on the identification of fetal pathological states, in particular in the diagnosis of fetal arrhythmias, ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-2005-837799
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To assess neonatal outcome and delivery mode in dichorionic twin delivery at term with a cephalic-presenting first twin. METHODS:A retrospective cohort study of 308 twin deliveries after 37 completed weeks of gestation with a cephalic-presenting first twin undertaken in one perinatal center with active manag...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0030-1267218
更新日期:2010-10-01 00:00:00
abstract::The objective of this study was to analyze ST segment analyses (STAN) using simultaneous traditional - gold standard invasive (fetal scalp electrode) and newly available non-invasive abdominal fetal electrocardiography (fECG) during delivery.This was a prospective observational study of non-invasive fetal ECG using 5 ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/s-0034-1375606
更新日期:2014-06-01 00:00:00
abstract::With regard to the question of the liability of a locum, the contractual general conditions are important above all others for the locum. The false opinion of some physicians that one is not liable because one is on holiday - or at least was not concretely involved in the incident - can, from case to case, be misleadi...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1287859
更新日期:2011-12-01 00:00:00
abstract::An inverted uterus is defined as the eversion of the uterus into the vagina. It is a very rare event but has to be treated as an emergency. A woman with an inverted uterus is in serious danger of developing atony with high blood loss in a short time. This can lead to hypovolemic shock and circulatory failure. Therapy ...
journal_title:Zeitschrift fur Geburtshilfe und Neonatologie
pub_type: 杂志文章
doi:10.1055/a-0828-8696
更新日期:2020-02-01 00:00:00