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Hantoushzadeh S, Gargari OK, Jamali M, Farrokh F, Eshraghi N, Asadi F, Mirzamoradi M, Razavi SJ, Ghaemi M, Aski SK, Panhi Z, Habibi GR. The association between increased fetal movements in the third trimester and perinatal outcomes; a systematic review and meta-analysis. BMC Pregnancy Childbirth 2024; 24:365. [PMID: 38750467 PMCID: PMC11095027 DOI: 10.1186/s12884-024-06547-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/28/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Fetal movement monitoring is one of the strategies used to assess the fetus's health. Until now, most studies focused on the decreased fetal movement and neonatal outcome, although this systematic review and meta-analysis is designed to assess the association between increased fetal movements (IFM) with perinatal outcomes. METHOD The electronic databases including PubMed, Scopus, Web of Science, and EMBASE were systematically searched for studies investigating the perinatal outcome of women with increased fetal movements from inception to July 2023. Following that, a random-effect meta-analysis model was used to obtain the combined diagnostic and predictive parameters including perinatal mortality (still birth and early neonatal mortality), operative delivery, Apgar score, neonatal resuscitation at birth and NICU Admission. RESULTS After the initial screening, seven studies examining the association between increased third trimester fetal movement and various perinatal outcomes were included. Meta-analysis revealed a significant reduction in the risk of cesarean delivery among patients with IFM compared to controls, suggesting a potential protective effect during childbirth. However, no statistically significant difference was observed in birth weight, small or large for gestational age births, neonatal intensive care unit admission, maternal age, umbilical cord around the neck, gestational diabetes mellitus, and hypertension, indicating that IFM may not be a major predictor of adverse perinatal outcomes or maternal conditions. Notably, IFM was significantly associated with a higher likelihood of labor induction. CONCLUSION The findings suggest that IFM may have a protective effect against cesarean delivery. Additionally, IFM does not appear to be significantly associated with maternal age, umbilical cord around the neck, gestational diabetes mellitus and hypertension. However, the observed significant association with labor induction warrants further investigation.
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Affiliation(s)
- Sedigheh Hantoushzadeh
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Omid Kohandel Gargari
- Gene Therapy Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Jamali
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Farrokh
- Department of Gynecology and Obstetrics, Mahdiyeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Eshraghi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Asadi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Masoumeh Mirzamoradi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Jafar Razavi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Marjan Ghaemi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | - Sudabeh Kazemi Aski
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Zahra Panhi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Gholam Reza Habibi
- Student Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
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Luo S, Chen Y, Zhou W, Canavese F, Li L. Pioneering a chick embryo model to explore the intrauterine etiology of developmental dysplasia of the hip in oligohydramnios conditions. Osteoarthritis Cartilage 2024:S1063-4584(24)01148-8. [PMID: 38588889 DOI: 10.1016/j.joca.2024.03.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To explore the impact of oligohydramnios on fetal movement and hip development, given its association with developmental dysplasia of the hip (DDH) but unclear mechanisms. METHODS Chick embryos were divided into four groups based on the severity of oligohydramnios induced by amniotic fluid aspiration (control, 0.2 mL, 0.4 mL, 0.6 mL). Fetal movement was assessed by detection of movement and quantification of residual amniotic fluid volume. Hip joint development was assessed by gross anatomic analysis, micro-computed tomography (micro-CT) for cartilage assessment, and histologic observation at multiple time points. In addition, a subset of embryos from the 0.4 mL aspirated group underwent saline reinfusion and subsequent evaluation. RESULTS Increasing volumes of aspirated amniotic fluid resulted in worsening of fetal movement restrictions (e.g., 0.4 mL aspirated and control group at E10: frequency difference -7.765 [95% CI: -9.125, -6.404]; amplitude difference -0.343 [95% CI: -0.588, -0.097]). The 0.4 mL aspirated group had significantly smaller hip measurements compared to controls, with reduced acetabular length (-0.418 [95% CI: -0.575, -0.261]) and width (-0.304 [95% CI: -0.491, -0.117]) at day E14.5. Histological analysis revealed a smaller femoral head (1.084 ± 0.264 cm) and shallower acetabulum (0.380 ± 0.106 cm) in the 0.4 mL group. Micro-CT showed cartilage matrix degeneration (13.6% [95% CI: 0.6%, 26.7%], P = 0.043 on E14.5). Saline reinfusion resulted in significant improvements in the femoral head to greater trochanter (0.578 [95% CI: 0.323, 0.833], P = 0.001). CONCLUSIONS Oligohydramnios can cause DDH by restricting fetal movement and disrupting hip morphogenesis in a time-dependent manner. Timely reversal of oligohydramnios during the fetal period may prevent DDH.
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Affiliation(s)
- Shaoting Luo
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China
| | - Yufan Chen
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China
| | - Weizheng Zhou
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China
| | - Federico Canavese
- Department of Pediatric Orthopedic Surgery, Lille University Centre, Jeanne de Flandre Hospital, 59000 Lille, France
| | - Lianyong Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China.
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Fredriksson L, Tidholm Qvist E, Sirotkina M, Pettersson K, Papadogiannakis N. Placental pathology in a large (Swedish) cohort of SARS-CoV-2 infected mothers. Placenta 2024; 145:100-106. [PMID: 38118226 DOI: 10.1016/j.placenta.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 12/04/2023] [Accepted: 12/09/2023] [Indexed: 12/22/2023]
Abstract
INTRODUCTION SARS-CoV-2 placentitis is associated with placental destruction and insufficiency and can affect perinatal outcome. The aim of the current study was to contribute with increased knowledge regarding placental histology in maternal SARS-CoV-2 infection during the pregnancy, as well as the correlation to the severity of maternal SARS-CoV-2 infection. MATERIAL AND METHODS This retrospective observational study included 116 women who had a verified SARS-CoV-2 infection during pregnancy and gave birth between April 2020 and February 2022 in the Stockholm region, Sweden. Placental tissue was evaluated regarding several histopathological parameters, amongst them detection of the triad of characteristics of placental SARS-CoV-2 infection: chronic histiocytic intervillositis, fibrin deposition and villous trophoblast necrosis, and immunohistochemistry for ORF-3 protein expression was used for confirmation. Medical records were reviewed for maternal characteristics and neonatal outcome. RESULTS SARS-CoV-2 placentitis was present in one-fifth of the examined placentas admitted to the institute due to maternal SARS-CoV-2 infection, out of which 86,4 % were delivered by acute caesarian section (ACS), all on fetal indication, and one pregnancy ended in stillbirth. Half of the cases without placentitis were delivered by ACS, out of which 50 % were on fetal indication. There was a clear tendency of a shorter time gap between confirmed maternal SARS-CoV-2 infection and delivery in the placentitis group. DISCUSSION The presence of SARS-CoV-2 placentitis does not seem to correlate with maternal factors or the severity of infection. It does correlate with development of placental dysfunction of acute/subacute onset and is often manifested as reduced fetal movements.
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Affiliation(s)
- Lisa Fredriksson
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Evelina Tidholm Qvist
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Meeli Sirotkina
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Pettersson
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Nikos Papadogiannakis
- Department of Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden; Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden.
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Andrén A, Akselsson A, Rådestad I, Ali SB, Lindgren H, Osman HM, Erlandsson K. Miscommunication influences how women act when fetal movements decrease an interview study with Swedish Somali migrant women. Midwifery 2023; 126:103796. [PMID: 37672854 DOI: 10.1016/j.midw.2023.103796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE To explore how Swedish Somali migrant women perceive fetal movements, process information about fetal movements, and take actions if decreased fetal activity occurs. DESIGN A qualitative study based on individual semi-structured interviews. The interviews were analysed using content analysis. SETTING The study was conducted in Sweden. PARTICIPANTS Swedish Somali migrant women (n=15) pregnant in their third trimester or recently given birth. FINDINGS The analysis led to the main category: tailored information about fetal movements enhances the possibility to seek care if the movements decrease. The results are described in the generic categories: explanatory models determine action; and understand and interpret information. KEY CONCLUSIONS Miscommunication on fetal movements can be a hurdle for Swedish Somali migrant women that may have impact on stillbirth prevention and the quality of care. Improved communication and information tailored to individual needs is essential to achieve equality for women and their newborns. IMPLICATIONS FOR PRACTICE The midwife can be used as a hub for reassuring that adequate information about fetal movements reaches each individual woman in antenatal care. Individualised information on fetal movements based on the women's own understanding is suggested to increase the possibility that the pregnant woman will seek care if the movements decrease. Somali women's verbal communication can be used to spread accurate information in the Somali community on the importance of seeking care if fetal movements decrease.
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Affiliation(s)
| | | | | | - Salma Burhan Ali
- Region Uppsala, Enköping Hospital, Department of Gynecology, Sweden
| | - Helena Lindgren
- Sophiahemmet University, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Sweden
| | - Hodan Mohamoud Osman
- College of Health Science and Medicine, Faculty of Nursing and Midwifery, Hargeisa University, Somaliland
| | - Kerstin Erlandsson
- Department of Women's and Children's Health, Karolinska Institutet, Sweden; School of Health and Welfare, Dalarna University, Sweden
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Vasung L, Xu J, Abaci-Turk E, Zhou C, Holland E, Barth WH, Barnewolt C, Connolly S, Estroff J, Golland P, Feldman HA, Adalsteinsson E, Grant PE. Cross-Sectional Observational Study of Typical in utero Fetal Movements Using Machine Learning. Dev Neurosci 2022; 45:105-114. [PMID: 36538911 PMCID: PMC10233700 DOI: 10.1159/000528757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
Early variations of fetal movements are the hallmark of a healthy developing central nervous system. However, there are no automatic methods to quantify the complex 3D motion of the developing fetus in utero. The aim of this prospective study was to use machine learning (ML) on in utero MRI to perform quantitative kinematic analysis of fetal limb movement, assessing the impact of maternal, placental, and fetal factors. In this cross-sectional, observational study, we used 76 sets of fetal (24-40 gestational weeks [GW]) blood oxygenation level-dependent (BOLD) MRI scans of 52 women (18-45 years old) during typical pregnancies. Pregnant women were scanned for 5-10 min while breathing room air (21% O2) and for 5-10 min while breathing 100% FiO2 in supine and/or lateral position. BOLD acquisition time was 20 min in total with effective temporal resolution approximately 3 s. To quantify upper and lower limb kinematics, we used a 3D convolutional neural network previously trained to track fetal key points (wrists, elbows, shoulders, ankles, knees, hips) on similar BOLD time series. Tracking was visually assessed, errors were manually corrected, and the absolute movement time (AMT) for each joint was calculated. To identify variables that had a significant association with AMT, we constructed a mixed-model ANOVA with interaction terms. Fetuses showed significantly longer duration of limb movements during maternal hyperoxia. We also found a significant centrifugal increase of AMT across limbs and significantly longer AMT of upper extremities <31 GW and longer AMT of lower extremities >35 GW. In conclusion, using ML we successfully quantified complex 3D fetal limb motion in utero and across gestation, showing maternal factors (hyperoxia) and fetal factors (gestational age, joint) that impact movement. Quantification of fetal motion on MRI is a potential new biomarker of fetal health and neuromuscular development.
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Affiliation(s)
- Lana Vasung
- Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Junshen Xu
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, Massachusetts, USA
| | - Esra Abaci-Turk
- Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Cindy Zhou
- Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth Holland
- Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - William H Barth
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Carol Barnewolt
- Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Connolly
- Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Judy Estroff
- Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Polina Golland
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, Massachusetts, USA
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, Massachusetts, USA
- Institute for Medical Engineering and Science, MIT, Cambridge, Massachusetts, USA
| | - Henry A Feldman
- Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Elfar Adalsteinsson
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, Massachusetts, USA
- Computer Science and Artificial Intelligence Laboratory, MIT, Cambridge, Massachusetts, USA
- Institute for Medical Engineering and Science, MIT, Cambridge, Massachusetts, USA
| | - P Ellen Grant
- Department of Pediatrics, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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Mesbah M, Khlif MS, Layeghy S, East CE, Dong S, Brodtmann A, Colditz PB, Boashash B. Automatic fetal movement recognition from multi-channel accelerometry data. Comput Methods Programs Biomed 2021; 210:106377. [PMID: 34517181 DOI: 10.1016/j.cmpb.2021.106377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Significant health care resources are allocated to monitoring high risk pregnancies to minimize growth compromise, reduce morbidity and prevent stillbirth. Fetal movement has been recognized as an important indicator of fetal health. Studies have shown that 25% of pregnancies with decreased fetal movement in the third trimester led to poor outcomes at birth. The studies have also shown that maternal perception of fetal movement is highly subjective and varies from person to person. A non-invasive system for fetal movement detection that can be used outside hospital would represent an advance in at-home monitoring of at-risk pregnancies. This is a challenging task that requires the use of advanced signal processing techniques to differentiate genuine fetal movements from contaminating artefacts. METHODS This manuscript proposes a novel algorithm for automatic fetal movement recognition using data collected from wearable tri-axial accelerometers strategically placed on the maternal abdomen. The novelty of the work resides in the efficient removal of artefacts and in distinctive feature extraction. The proposed algorithm used independent component analysis (ICA) for dimensionality reduction and artefact removal. A supplemental technique based on discrete wavelet transform (DWT) was also used to remove artefacts. RESULTS To identify fetal movements, 31 features were extracted from the acceleration data. Based on these features, several classifiers were used to distinguish fetal from non-fetal movements. Robustness of the classifiers was tested for various concentrations of artefacts in the classification data. The best performance was achieved by Bagging classifier algorithm, with random forest as its basis classifier, yielding an accuracy ranging from 87.6% to 95.8% depending on the artefact concentration level. CONCLUSIONS A high performance detection of fetal movements can be achieved using accelerometery-based systems suitable for long-term monitoring.
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Affiliation(s)
- Mostefa Mesbah
- Department of Electrical and Computer Engineering, Sultan Qaboos University, Muscat, Oman.
| | - Mohamed S Khlif
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Siamak Layeghy
- School of ITEE, The University of Queensland, Brisbane, Australia
| | - Christine E East
- Department of Obstetrics and Gynaecology, The University of Melbourne & Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, Australia; School of Nursing and Midwifery, Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Shiying Dong
- University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
| | - Paul B Colditz
- University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Boualem Boashash
- University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia
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He H, Huang J, Zhao X, Li Z. The effect of prenatal music therapy on fetal and neonatal status: A systematic review and meta-analysis. Complement Ther Med 2021; 60:102756. [PMID: 34175408 DOI: 10.1016/j.ctim.2021.102756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES This study aims to investigate the effects of prenatal music therapy on fetal and neonatal status. DESIGN AND SETTING A systematic review and meta-analysis of randomized controlled trials. INTERVENTIONS Ovid MEDLINE, Embase, Web of Science, Cochrane Library, and Chinese Biomedical Literature Database were searched for studies investigating the effects of prenatal music therapy. Two independent investigators carried out the literature selection, data analysis, and evidence quality assessment. Eligible studies were qualitatively described and synthesized using meta-analyses. MAIN OUTCOME MEASURES The outcomes included fetal or neonatal status. RESULTS After screening the 821 records yielded by the systematic search, we identified nine eligible studies involving 1419 pregnant women. Eight studies were included in the meta-analysis, and three outcomes were synthesized. Compared with no music therapy, prenatal music therapy did not change fetal heart rate (mean difference [95 % CI]: -0.28 [-3.75-3.20] beat/min, P = 0.88, moderate quality), number of fetal movements (mean difference [95 % CI]: 0.50 [-0.79-1.78] time/min, P = 0.45, low quality), or number of accelerations (mean difference [95 % CI]: 0.16 [-0.87-1.19] time/min, P = 0.76, low quality). This result did not change when two studies with a high risk of bias were excluded. Subgroup analysis showed that prenatal music therapy did not change fetal heart rate, number of fetal movements, or number of accelerations in different intervention phases. CONCLUSIONS Prenatal music therapy might not change fetal and neonatal status. However, more systematic strategies of prenatal music therapy deserve further exploration.
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Affiliation(s)
- Hui He
- Music College of Changsha University, Changsha, Hunan Province, China.
| | - Jian Huang
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
| | - Xu Zhao
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
| | - Zhijian Li
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
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Yatsuki K, Ryo E, Morita M, Seto M, Kamata H, Yonaga Y. Correlation between newborn size and gross fetal movement as counted by a fetal movement acceleration measurement recorder. J Dev Orig Health Dis 2021; 12:452-5. [PMID: 32662381 DOI: 10.1017/S2040174420000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The development of the fetal movement acceleration measurement (FMAM) recorder has enabled the accurate counting of gross fetal movements. The aim of the study was to investigate whether gross fetal movement is related to a newborn's size. A total of 90 pregnant women who delivered singleton infant at term were recruited. Gross fetal movements were counted using an FMAM recorder during maternal sleep. The ratio of movement positive 10-s epochs to all epochs during one night was calculated as an index of fetal movement. Independent explanatory variables for the fetal movement index were selected from eight possibilities, that is, maternal age, gestational week, and the six physical measures of the newborn (height, weight, head circumference, chest circumference, Kaup index, and the ratio of head to chest circumference) with the stepwise regression procedure. The selected physical variables and the fetal movement index were analyzed using multiple regression analysis. A total of 2812.95 h from 423 night records were available. Gestational weeks and weight of the newborn were selected as the significant independent variables. Multiple regression analysis revealed that newborn weight had a positive correlation with the fetal movement index (p < 0.0001). The multiple regression equation was "The fetal movement index (%) = 34.9989-0.9088 × gestational weeks + 0.0033 × newborn weight (g)." A person's physical ability and lifetime activity level may originate from fetal health. This study may provide a new way of looking at the Developmental Origins of Health and Disease theory.
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Tobias JH, Sayers A, Deere KC, Heazell AEP, Lawlor DA, Ireland A. Breech presentation is associated with lower adolescent tibial bone strength. Osteoporos Int 2019; 30:1423-1432. [PMID: 31020365 DOI: 10.1007/s00198-019-04945-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/18/2019] [Indexed: 12/28/2022]
Abstract
We compared bone outcomes in adolescents with breech and cephalic presentation. Tibia bone mineral content, density, periosteal circumference, and cross-sectional moment of inertia were lower in breech presentation, and females with breech presentation had lower hip CSA. These findings suggest that prenatal loading may exert long-lasting influences on skeletal development. INTRODUCTION Breech position during pregnancy is associated with reduced range of fetal movement, and with lower limb joint stresses. Breech presentation at birth is associated with lower neonatal bone mineral content (BMC) and area, but it is unknown whether these associations persist into later life. METHODS We examined associations between presentation at onset of labor, and tibia and hip bone outcomes at age 17 years in 1971 participants (1062 females) from a UK prospective birth cohort that recruited > 15,000 pregnant women in 1991-1992. Cortical BMC, cross-sectional area (CSA) and bone mineral density (BMD), periosteal circumference, and cross-sectional moment of inertia (CSMI) were measured by peripheral quantitative computed tomography (pQCT) at 50% tibia length. Total hip BMC, bone area, BMD, and CSMI were measured by dual-energy X-ray absorptiometry (DXA). RESULTS In models adjusted for sex, age, maternal education, smoking, parity, and age, singleton/multiple births, breech presentation (n = 102) was associated with lower tibial cortical BMC (- 0.14SD, 95% CI - 0.29 to 0.00), CSA (- 0.12SD, - 0.26 to 0.02), BMD (- 0.16SD, - 0.31 to - 0.01), periosteal circumference (- 0.14SD, - 0.27 to - 0.01), and CSMI (- 0.11SD, - 0.24 to 0.01). In females only, breech presentation was associated with lower hip CSA (- 0.24SD, - 0.43 to 0.00) but not with other hip outcomes. Additional adjustment for potential mediators (delivery method, birthweight, gestational age, childhood motor competence and adolescent height and body composition) did not substantially affect associations with either tibia or hip outcomes. CONCLUSIONS These findings suggest that prenatal skeletal loading may exert long-lasting influences on skeletal size and strength but require replication.
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Affiliation(s)
- J H Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A Sayers
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - K C Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A E P Heazell
- Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - D A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, Bristol University, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - A Ireland
- School of Healthcare Science, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD, UK.
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Ryo E, Kamata H, Seto M, Morita M, Yatsuki K. Correlation between umbilical cord length and gross fetal movement as counted by a fetal movement acceleration measurement recorder. Eur J Obstet Gynecol Reprod Biol X 2019; 1:100003. [PMID: 31396590 PMCID: PMC6683969 DOI: 10.1016/j.eurox.2019.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/19/2018] [Accepted: 12/27/2018] [Indexed: 10/31/2022] Open
Abstract
Introduction The fetal movement acceleration measurement (FMAM) recorder has made it possible to count gross fetal movements over many hours. Our purpose was to examine the relationship between umbilical cord length and fetal movements as counted by the FMAM recorder. Methods Sixty-two pregnant women recorded fetal movements weekly from 28 weeks to term. The ratio of 10-s periods in which movement occurred to total time was calculated as a movement index. Umbilical cord length was measured at delivery. (1) Multiple linear regression analyses were conducted with six explanatory variables (primipara / multipara, anterior / posterior located placenta, placental weight, the mean movement index of 28-31, 32-35, and 36-39 week) and a response valuable (umbilical cord length). (2) All women were divided into groups of shorter, middle, and longer cord length, specifically less than 50 cm, between 50 and 60 cm, and more than 60 cm. The movement index was compared among the three groups at 28-31, 32-35, and 36-39 weeks. Results A total of 2355.6 h from 368 night records were available. (1) There were no relationships between the cord length and the movement index of 28-31, 32-35, and 36-39 weeks (p = 0.090, 0.235, 0.129, respectively). (2) There were no differences in the movement index among the three groups at 28-31 and 32-35 gestational weeks (p = 0.096, and 0.465, respectively); however, the longer cord group had a greater movement index than the other two groups at 36-39 weeks (p = 0.0008). Discussion This study suggested that fetal movement near term is an important factor in determining whether cord length becomes relatively longer in normal pregnancies.
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Affiliation(s)
- Eiji Ryo
- Department of Obstetrics and Gynecology, Teikyo University, School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8606, Japan
| | - Hideo Kamata
- Department of Obstetrics and Gynecology, Teikyo University, School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8606, Japan
| | - Michiharu Seto
- Department of Obstetrics and Gynecology, Teikyo University, School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8606, Japan
| | - Masayoshi Morita
- Department of Obstetrics and Gynecology, Teikyo University, School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8606, Japan
| | - Keita Yatsuki
- Department of Obstetrics and Gynecology, Teikyo University, School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8606, Japan
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11
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Akkaya H, Büke B. A frequently asked question: Is it normal not to feel my baby's movements yet? J Chin Med Assoc 2018; 81:742-746. [PMID: 29079116 DOI: 10.1016/j.jcma.2017.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/21/2017] [Accepted: 07/31/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study aims to investigate average gestational week in which mothers feel their baby's movements for the first time, and the maternal-fetal factors affecting this time. METHODS A total of 423 pregnant women between 11 and 25 weeks of gestation were included in this prospective study. The patient cohort was divided into three subgroups according to the gestational week in which fetal movements were felt for the first time by the pregnant women. The women who felt the first movement before 25th percentile value constituted Group 1; between 25th and 75th percentile value constituted Group 2; and beyond 75th percentile value constituted Group 3. These three groups were then compared in terms of maternal age, parity, body mass index (BMI), tea and coffee consumption during pregnancy, smoking, educational status, accordance of mother to regular pregnancy follow-ups, placental site, and gender of the baby. RESULTS These three groups were statistically and significantly different regarding the above mentioned determinants except for mothers' tea and coffee consumption, smoking, and gender of the baby (p < 0.05). CONCLUSION This study revealed factors that affect maternal perception of first fetal movements in both a positive and negative manner. Although it is hard to define an exact time for each individual, an approximate time according to our data can be given to a mother, which considers an affecting factor on the basis of average gestational week.
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Affiliation(s)
- Hatice Akkaya
- Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri, Turkey.
| | - Barış Büke
- Department of Obstetrics and Gynecology, Kayseri Training and Research Hospital, Kayseri, Turkey
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12
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Abstract
This Viewpoint examines recent developments in the quantitative characterization of fetal movements via kinematical analysis. We contend that fetal kinematics represents a powerful tool to investigate prenatal cognition and the prepostnatal continuity of cognitive development. The potential benefits of increased investigation into the kinematics of fetal movement are manifold, and apply to diverse fields including pediatric medicine and developmental biology.
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Affiliation(s)
- Umberto Castiello
- Department
of General Psychology, University of Padova, 35122 Padova, Italy
| | - Valentina Parma
- International School for Advanced Studies (SISSA), 34136 Trieste, Italy
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13
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Heazell AEP, Warland J, Stacey T, Coomarasamy C, Budd J, Mitchell EA, O'Brien LM. Stillbirth is associated with perceived alterations in fetal activity - findings from an international case control study. BMC Pregnancy Childbirth 2017; 17:369. [PMID: 29132322 PMCID: PMC5683455 DOI: 10.1186/s12884-017-1555-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 10/31/2017] [Indexed: 11/16/2022] Open
Abstract
Background Stillbirth after 28 weeks gestation affects between 1.3–8.8 per 1000 births in high-income countries. The majority of stillbirths in this setting occur in women without established risk factors. Identification of risk factors which could be identified and managed in pregnancy is a priority in stillbirth prevention research. This study aimed to evaluate women’s experiences of fetal movements and how these relate to stillbirth. Methods An international internet-based case–control study of women who had a stillbirth ≥28 weeks’ gestation within 30 days prior to completing the survey (n = 153) and women with an ongoing pregnancy or a live born child (n = 480). The online questionnaire was developed with parent stakeholder organizations using a mixture of categorical and open–ended responses and Likert scales. Univariate and multiple logistic regression was used to determine crude (unadjusted) and adjusted odds ratios (aOR) with 95% confidence intervals (CI). Summative content analysis was used to analyse free text responses. Results Women whose pregnancy ended in stillbirth were less likely to check fetal movements (aOR 0.54, 95% CI 0.35–0.83) and were less likely to be told to do so by a health professional (aOR 0.55, 95% CI 0.36–0.86). Pregnancies ending in stillbirth were more frequently associated with significant abnormalities in fetal movements in the preceding two weeks; this included a significant reduction in fetal activity (aOR 14.1, 95% CI 7.27–27.45) or sudden single episode of excessive fetal activity (aOR 4.30, 95% CI 2.25–8.24). Cases described their perception of changes in fetal activity differently to healthy controls e.g. vigorous activity was described as “frantic”, “wild” or “crazy” compared to “powerful” or “strong”. Conclusions Alterations in fetal activity are associated with increased risk of stillbirth. Pregnant women should be educated about awareness of fetal activity and reporting abnormal activity to health professionals. Electronic supplementary material The online version of this article (10.1186/s12884-017-1555-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander E P Heazell
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9WL, Manchester, UK. .,Maternal and Fetal Health Research Centre, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Jane Warland
- Mother's Babies and Families Research Group, School of Nursing and Midwifery, University of South Australia, Adelaide, Australia
| | | | - Christin Coomarasamy
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Jayne Budd
- St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9WL, Manchester, UK
| | - Edwin A Mitchell
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Louise M O'Brien
- Sleep Disorders Center and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
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Yee C, Choi SJ, Oh SY, Ki CS, Roh CR, Kim JH. Clinical characteristics of pregnancies complicated by congenital myotonic dystrophy. Obstet Gynecol Sci 2017; 60:323-8. [PMID: 28791262 DOI: 10.5468/ogs.2017.60.4.323] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/25/2016] [Accepted: 12/05/2016] [Indexed: 11/23/2022] Open
Abstract
Objective Although the conventional prevalence of myotonic dystrophy is 1:8,000, the prevalence in Korean population was recently reported as 1:1,245. With higher domestic result than expected, we aimed to investigate the clinical characteristics of pregnancies complicated by congenital myotonic dystrophy in our institution. Methods We have reviewed 11 paired cases of neonates diagnosed with congenital myotonic dystrophy and their mothers between July 2004 and May 2014, with clinical features including maternal history of infertility, prenatal ultrasonographic findings, and neonatal outcomes. Cytosine-thymine-guanine (CTG) repeat expansion in the myotonic dystrophy protein kinase gene of both neonates and their mothers was also examined. Results None of mother was aware of their myotonic dystrophy traits before pregnancy. History of infertility followed by assisted reproductive technology accounted for 57.1% (4/7). Distinctive prenatal ultrasonographic finding was severe idiopathic polyhydramnios (66.7%, 4/6) with median amniotic fluid index of 43 (range, 37 to 66). In 37.5% (3/8) cases, decreased fetal movement was evident during prenatal ultrasound examination. For neonatal outcomes, more than half (6/11) were complicated with preterm birth and the proportion of 1-minute Apgar score <4 and 5-minute Apgar score <7 was 44.4% (4/9) and 66.7% (6/9), respectively. Most of neonates were admitted to the neonatal intensive care unit (9/10) because of hypotonia with respiratory problems and there was one infant death. Median number of cytosine-thymine-guanine repeats in mothers and neonates was 400 (range, 166 to 1,000) and 1,300 (range, 700 to 2,000), respectively. Conclusion Our data suggest that severe idiopathic polyhydramnios with decreased fetal movement in pregnant women, especially with a history of infertility, requires differential diagnosis of congenital myotonic dystrophy.
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Abstract
BACKGROUND The perception of reduced fetal movement (RFM) is an important marker of fetal wellbeing and is associated with poor perinatal outcome (such as intra-uterine death). METHODS We conducted a prospective study of women presenting with RFM over 28 weeks' gestation to a tertiary-level maternity hospital. We examined pregnancy outcomes and compared them to a retrospectively collected control group delivering contemporaneously. RESULTS In total, 275 presentations were analysed in the RFM group, with 264 in the control group. Women with RFM were more likely to be nulliparous (p = 0.002) and have an induction of labour (p = 0.0011). 26.5 % (n = 73) of cases were admitted following presentation with RFM, and 79.4 % (n = 58) delivered on primary presentation. Overall, 15.2 % (n = 42) women were induced for RFM specifically. CONCLUSION This prospective study shows the increased burden of care required by those with RFM, including increased neonatal unit admission rates, increased induction rates and higher surveillance demands, demonstrating the need for increased attention to this area of practice.
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Affiliation(s)
- Claire M. McCarthy
- />Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Wilton, Cork, Ireland
| | - S. Meaney
- />National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland
| | - K. O’Donoghue
- />Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, University College Cork, Wilton, Cork, Ireland
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16
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Abstract
Arthrogryposis by definition has multiple congenital contractures. All types of arthrogryposis have decreased in utero fetal movement. Because so many things are involved in normal fetal movement, there are many causes and processes that can go awry. In this era of molecular genetics, we have tried to place the known mutated genes seen in genetic forms of arthrogryposis into biological processes or cellular functions as defined by gene ontology. We hope this leads to better identification of all interacting pathways and processes involved in the development of fetal movement in order to improve diagnosis of the genetic forms of arthrogryposis, to lead to the development of molecular therapies, and to help better define the natural history of various types of arthrogryposis.
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Affiliation(s)
- Judith G Hall
- Departments of a Medical Genetics, University of British Columbia and BC Children's Hospital, Vancouver, B.C., Canada; Departments of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, B.C., Canada
| | - Jeff Kiefer
- Translational Genomics Research Institute (TGen), Phoenix, Ariz., USA
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17
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Linde A, Georgsson S, Pettersson K, Holmström S, Norberg E, Rådestad I. Fetal movement in late pregnancy - a content analysis of women's experiences of how their unborn baby moved less or differently. BMC Pregnancy Childbirth 2016; 16:127. [PMID: 27245990 PMCID: PMC4888620 DOI: 10.1186/s12884-016-0922-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/25/2016] [Indexed: 01/18/2023] Open
Abstract
Background Pregnant women sometimes worry about their unborn baby’s health, often due to decreased fetal movements. The aim of this study was to examine how women, who consulted health care due to decreased fetal movements, describe how the baby had moved less or differently. Methods Women were recruited from all seven delivery wards in Stockholm, Sweden, during 1/1 – 31/12 2014. The women completed a questionnaire after it was verified that the pregnancy was viable. A modified content analysis was used to analyse 876 questionnaires with the women’s responses to, “Try to describe how your baby has moved less or had changes in movement”. Results Four categories and six subcategories were identified: “Frequency” (decreased frequency, absence of kicks and movement), “Intensity” (weaker fetal movements, indistinct fetal movements), “Character” (changed pattern of movements, slower movements) and “Duration”. In addition to the responses categorised in accordance with the question, the women also mentioned how they had tried to stimulate the fetus to move and that they had difficulty in distinguishing fetal movements from contractions. Further, they described worry due to incidents related to changed pattern of fetal movements. Conclusion Women reported changes in fetal movement concerning frequency, intensity, character and duration. The challenge from a clinical perspective is to inform pregnant women about fetal movements with the goal of minimizing unnecessary consultations whilst at the same time diminishing the length of pre-hospital delay if the fetus is at risk of fetal compromise. Trial registration Not applicable. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0922-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anders Linde
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. .,Sophiahemmet University, PB 5605, S-114 86, Stockholm, Sweden.
| | - Susanne Georgsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Sophiahemmet University, PB 5605, S-114 86, Stockholm, Sweden
| | - Karin Pettersson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Sofia Holmström
- Sophiahemmet University, PB 5605, S-114 86, Stockholm, Sweden
| | - Emma Norberg
- Sophiahemmet University, PB 5605, S-114 86, Stockholm, Sweden
| | - Ingela Rådestad
- Sophiahemmet University, PB 5605, S-114 86, Stockholm, Sweden
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18
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Vairavan S, Ulusar UD, Eswaran H, Preissl H, Wilson JD, Mckelvey SS, Lowery CL, Govindan RB. A computer-aided approach to detect the fetal behavioral states using multi-sensor Magnetocardiographic recordings. Comput Biol Med 2015; 69:44-51. [PMID: 26717240 DOI: 10.1016/j.compbiomed.2015.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 11/26/2015] [Accepted: 11/28/2015] [Indexed: 11/26/2022]
Abstract
We propose a novel computational approach to automatically identify the fetal heart rate patterns (fHRPs), which are reflective of sleep/awake states. By combining these patterns with presence or absence of movements, a fetal behavioral state (fBS) was determined. The expert scores were used as the gold standard and objective thresholds for the detection procedure were obtained using Receiver Operating Characteristics (ROC) analysis. To assess the performance, intraclass correlation was computed between the proposed approach and the mutually agreed expert scores. The detected fHRPs were then associated to their corresponding fBS based on the fetal movement obtained from fetal magnetocardiogaphic (fMCG) signals. This approach may aid clinicians in objectively assessing the fBS and monitoring fetal wellbeing.
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Affiliation(s)
- S Vairavan
- Graduate Institute of Technology, University of Arkansas at Little Rock, AR, USA
| | - U D Ulusar
- Computer Engineering Department, Akdeniz University, Antalya, Turkey
| | - H Eswaran
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, AR, USA; Division of Biomedical Informatics, University of Arkansas for Medical Sciences, AR, USA
| | - H Preissl
- Division of Biomedical Informatics, University of Arkansas for Medical Sciences, AR, USA; MEG Center, University of Tubingen, Tubingen, Germany
| | - J D Wilson
- Graduate Institute of Technology, University of Arkansas at Little Rock, AR, USA
| | - S S Mckelvey
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, AR, USA
| | - C L Lowery
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, AR, USA
| | - R B Govindan
- Division of Fetal and Transitional Medicine, Fetal Medicine Institute, Children׳s National Health System, 111 Michigan Ave, NW Washington, DC 20010, USA.
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19
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Ribes S, Girault JM, Perrotin F, Kouamé D. Multidimensional Ultrasound Doppler Signal Analysis for Fetal Activity Monitoring. Ultrasound Med Biol 2015; 41:3172-3181. [PMID: 26365925 DOI: 10.1016/j.ultrasmedbio.2015.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 07/22/2015] [Accepted: 07/27/2015] [Indexed: 06/05/2023]
Abstract
Fetal activity parameters such as movements, heart rate and the related parameters are essential indicators of fetal wellbeing, and no device provides simultaneous access to and sufficient estimation of all of these parameters to evaluate fetal health. This work was aimed at collecting these parameters to automatically separate healthy from compromised fetuses. To achieve this goal, we first developed a multi-sensor-multi-gate Doppler system. Then we recorded multidimensional Doppler signals and estimated the fetal activity parameters via dedicated signal processing techniques. Finally, we combined these parameters into four sets of parameters (or four hyper-parameters) to determine the set of parameters that is able to separate healthy from other fetuses. To validate our system, a data set consisting of two groups of fetal signals (normal and compromised) was established and provided by physicians. From the estimated parameters, an instantaneous Manning-like score, referred to as the ultrasonic score, was calculated and was used together with movements, heart rate and the associated parameters in a classification process employing the support vector machine method. We investigated the influence of the sets of parameters and evaluated the performance of the support vector machine using the computation of sensibility, specificity, percentage of support vectors and total classification error. The sensitivity of the four sets ranged from 79% to 100%. Specificity was 100% for all sets. The total classification error ranged from 0% to 20%. The percentage of support vectors ranged from 33% to 49%. Overall, the best results were obtained with the set of parameters consisting of fetal movement, short-term variability, long-term variability, deceleration and ultrasound score. The sensitivity, specificity, percentage of support vectors and total classification error of this set were respectively 100%, 100%, 35% and 0%. This indicated our ability to separate the data into two sets (normal fetuses and pathologic fetuses), and the results highlight the excellent match with the clinical classification performed by the physicians. This work indicates the feasibility of detecting compromised fetuses and also represents an interesting method of close fetal monitoring during the entire pregnancy.
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Affiliation(s)
- Sophie Ribes
- University of Toulouse III, IRIT UMR CNRS 5505, Toulouse, France
| | | | - Franck Perrotin
- CHU Bretonneau, Tours, service de Gynecologie Obstétrique, INSERM U930, Tours, France
| | - Denis Kouamé
- University of Toulouse III, IRIT UMR CNRS 5505, Toulouse, France.
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20
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Bellinger SA, Lucas D, Kleven GA. An ecologically relevant guinea pig model of fetal behavior. Behav Brain Res 2015; 283:175-83. [PMID: 25655512 DOI: 10.1016/j.bbr.2015.01.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/01/2015] [Accepted: 01/26/2015] [Indexed: 11/16/2022]
Abstract
The laboratory guinea pig, Cavia porcellus, shares with humans many similarities during pregnancy and prenatal development, including precocial offspring and social dependence. These similarities suggest the guinea pig as a promising model of fetal behavioral development as well. Using innovative methods of behavioral acclimation, fetal offspring of female IAF hairless guinea pigs time mated to NIH multicolored Hartley males were observed longitudinally without restraint using noninvasive ultrasound at weekly intervals across the 10 week gestation. To ensure that the ultrasound procedure did not cause significant stress, salivary cortisol was collected both before and after each observation. Measures of fetal spontaneous movement and behavioral state were quantified from video recordings from week 3 through the last week before birth. Results from prenatal quantification of Interlimb Movement Synchrony and state organization reveal guinea pig fetal development to be strikingly similar to that previously reported for other rodents and preterm human infants. Salivary cortisol readings taken before and after sonography did not differ at any observation time point. These results suggest this model holds translational promise for studying the prenatal mechanisms of neurobehavioral development, including those that may result from adverse events. Because the guinea pig is a highly social mammal with a wide range of socially oriented vocalizations, this model may also have utility for studying the prenatal origins and trajectories of developmental disabilities with social-emotional components, such as autism.
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Affiliation(s)
- S A Bellinger
- Department of Psychology, Wright State University, Dayton, OH 45435, United States; Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, United States
| | - D Lucas
- Department of Psychology, Wright State University, Dayton, OH 45435, United States; Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, United States
| | - G A Kleven
- Department of Psychology, Wright State University, Dayton, OH 45435, United States.
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21
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Voegtline KM, Costigan KA, Pater HA, DiPietro JA. Near-term fetal response to maternal spoken voice. Infant Behav Dev 2013; 36:526-33. [PMID: 23748167 PMCID: PMC3858412 DOI: 10.1016/j.infbeh.2013.05.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 03/26/2013] [Accepted: 05/02/2013] [Indexed: 10/26/2022]
Abstract
Knowledge about prenatal learning has been largely predicated on the observation that newborns appear to recognize the maternal voice. Few studies have examined the process underlying this phenomenon; that is, whether and how the fetus responds to maternal voice in situ. Fetal heart rate and motor activity were recorded at 36 weeks gestation (n = 69) while pregnant women read aloud from a neutral passage. Compared to a baseline period, fetuses responded with a decrease in motor activity in the 10 s following onset of maternal speech and a trend level decelerative heart rate response, consistent with an orienting response. Subsequent analyses revealed that the fetal response was modified by both maternal and fetal factors. Fetuses of women who were previously awake and talking (n = 40) showed an orienting response to onset of maternal reading aloud, while fetuses of mothers who had previously been resting and silent (n = 29) responded with elevated heart rate and increased movement. The magnitude of the fetal response was further dependent on baseline fetal heart rate variability such that largest response was demonstrated by fetuses with low variability of mothers who were previously resting and silent. Results indicate that fetal responsivity is affected by both maternal and fetal state and have implications for understanding fetal learning of the maternal voice under naturalistic conditions.
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Affiliation(s)
- Kristin M Voegtline
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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22
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DiPietro JA, Voegtline KM, Costigan KA, Aguirre F, Kivlighan K, Chen P. Physiological reactivity of pregnant women to evoked fetal startle. J Psychosom Res 2013; 75:321-6. [PMID: 24119937 PMCID: PMC3796734 DOI: 10.1016/j.jpsychores.2013.07.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 07/11/2013] [Accepted: 07/14/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The bidirectional nature of mother-child interaction is widely acknowledged during infancy and childhood. Prevailing models during pregnancy focus on unidirectional influences exerted by the pregnant woman on the developing fetus. Prior work has indicated that the fetus also affects the pregnant woman. Our objective was to determine whether a maternal psychophysiological response to stimulation of the fetus could be isolated. METHODS Using a longitudinal design, an airborne auditory stimulus was used to elicit a fetal heart rate and motor response at 24 (n=47) and 36 weeks (n=45) of gestation. Women were blind to condition (stimulus versus sham). Maternal parameters included cardiac (heart rate) and electrodermal (skin conductance) responses. Multilevel modeling of repeated measures with 5 data points per second was used to examine fetal and maternal responses. RESULTS As expected, compared to a sham condition, the stimulus generated a fetal motor response at both gestational ages, consistent with a mild fetal startle. Fetal stimulation was associated with significant, transient slowing of maternal heart rate coupled with increased skin conductance within 10s of the stimulus at both gestational ages. Nulliparous women showed greater electrodermal responsiveness. The magnitude of the fetal motor response significantly corresponded to the maternal skin conductance response at 5, 10, 15, and 30s following stimulation. CONCLUSION Elicited fetal movement exerts an independent influence on the maternal autonomic nervous system. This finding contributes to current models of the dyadic relationship during pregnancy between fetus and pregnant woman.
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Affiliation(s)
- Janet A. DiPietro
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Kristin M. Voegtline
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Kathleen A. Costigan
- Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frank Aguirre
- Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katie Kivlighan
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Ping Chen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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