Is It Time to Redefine Fetal Decelerations in Cardiotocography?

Fetal monitoring technologies for the detection of intrapartum hypoxia - challenges and opportunities

Intrapartum fetal hypoxia is related to long-term morbidity and mortality of the fetus and the mother. Fetal surveillance is extremely important to minimize the adverse outcomes arising from fetal hypoxia during labour. Several methods have been used in current clinical practice to monitor fetal well-being. For instance, biophysical technologies including cardiotocography, ST-analysis adjunct to cardiotocography, and Doppler ultrasound are used for intrapartum fetal monitoring. However, these technologies result in a high false-positive rate and increased obstetric interventions during labour. Alternatively, biochemical-based technologies including fetal scalp blood sampling and fetal pulse oximetry are used to identify metabolic acidosis and oxygen deprivation resulting from fetal hypoxia. These technologies neither improve clinical outcomes nor reduce unnecessary interventions during labour. Also, there is a need to link the physiological changes during fetal hypoxia to fetal monitoring technologies. The objective of this article is to assess the clinical background of fetal hypoxia and to review existing monitoring technologies for the detection and monitoring of fetal hypoxia. A comprehensive review has been made to predict fetal hypoxia using computational and machine-learning algorithms. The detection of more specific biomarkers or new sensing technologies is also reviewed which may help in the enhancement of the reliability of continuous fetal monitoring and may result in the accurate detection of intrapartum fetal hypoxia.

Vitality in Newborn Farm Animals: Adverse Factors, Physiological Responses, Pharmacological Therapies, and Physical Methods to Increase Neonate Vigor

Vitality is the vigor newborn animals exhibit during the first hours of life. It can be assessed by a numerical score, in which variables, such as heart rate, respiratory rate, mucous membranes' coloration, time the offspring took to stand up, and meconium staining, are monitored. Vitality can be affected by several factors, and therapies are used to increase it. This manuscript aims to review and analyze pharmacological and physical therapies used to increase vitality in newborn farm animals, as well as to understand the factors affecting this vitality, such as hypoxia, depletion of glycogen, birth weight, dystocia, neurodevelopment, hypothermia, and finally, the physiological mechanism to achieve thermostability. It has been concluded that assessing vitality immediately after birth is essential to determine the newborn's health and identify those that need medical intervention to minimize the deleterious effect of intrapartum asphyxia. Vitality assessment should be conducted by trained personnel and adequate equipment. Evaluating vitality could reduce long-term neonatal morbidity and mortality in domestic animals, even if it is sometimes difficult with the current organization of some farms. This review highlights the importance of increasing the number of stock people during the expected days of parturitions to reduce long-term neonatal morbidity and mortality, and thus, improve the farm's performance.

Editorial: Precision Medicine in Obstetrics: Pregnancy Complication

Millions of women give birth every year worldwide [...].