External Uterine Contractions Signal Analysis

Labor dystocia is a major cause of operative delivery, which is associated with ncreased risks for both mother and fetus. We assessed linear and non-linear dynamics of external uterine contraction signals, in relation to labor progression and dystocia. Linear time domain, spectral and entropy methods were used to analyze external uterine contraction recordings obtained during the last two hours of labor, in 28 cases with normal and 27 cases with operative deliveries (forceps, vacuum or caesarean). Progression of labor was associated with a statistically significant increase in most linear time domain and spectral indices, both in normal and operative deliveries, whereas most entropy indices increased in normal deliveries, but did not change in operative deliveries. On the other hand, when compared with normal births, operative deliveries were associated with significantly increased entropy indices before the last hour of labor and significantly decreased (a probably associated) sympatho-vagal balance in the last hour of labor. Linear and non-linear analysis of external uterine contraction recordings may provide useful physiopathological and clinical information on the progression of labor and the diagnosis of dystocia.info:eu-repo/semantics/publishedVersio

Study of RFe12−xMox (R =Y, Ho) compounds by neutron powder diffraction, ac susceptibility and magnetization

Neutron powder diffraction, magnetization and ac susceptibility measurements were performed on compounds of the series RFe12−xMox (R D Y and Ho, x D 1, 2, 3). The influence of the Mo content on both structural and magnetic properties is discussed. Comparison with published data for different Mo concentrations is made. It is found that the effect of Mo substitution for Fe on structural and magnetic properties can be described by two regimes separated by a critical Mo content around x=2.Portuguese-French JNICT-CNRS collaboration

Longitudinal changes of cardiotocographic parameters throughout pregnancy: a prospective cohort study comparing small-for-gestational-age and normal fetuses from 24 to 40 weeks

Objective: To compare longitudinal trends of cardiotocographic (CTG) parameters between small-for-gestational-age (SGA) and normal fetuses, from 24 to 41 weeks of pregnancy. Methods: A prospective cohort study was carried out in singleton pregnancies without fetal malformations. At least one CTG was performed in each of the following intervals: 24-26 weeks+6 days, 27-29 weeks+6 days, 30-32 weeks+6 days, 33-35 weeks+6 days, 36-38 weeks+6 days and >= 39 weeks. Tracings were analyzed using the Omniview-SisPorto (R) 3.6 system. Cases with a normal - pregnancy outcome, including a birthweight >= 10th percentile for gestational age, were compared with two groups of SGA fetuses: with birthweight < 10th percentile (SGA < p10) and < 3rd percentile (SGA < p3; a subgroup of the latter). Generalized linear mixed-effects models were used for analysis. Results: A total of 176 fetuses (31 SGA) and 1256 tracings (207 from SGA fetuses) were evaluated. All CTG parameters changed significantly throughout pregnancy in the three groups, with a decreasing baseline and probability of decelerations, and an increasing average long-term variability (LTV), average short-term variability (STV) and accelerations. Baseline showed a more pronounced decrease (steeper slope) in SGA fetuses, being higher in these cases at earlier gestational ages and lower later in pregnancy. Average LTV was significantly lower in SGA < p3 fetuses, but a parallel increase occurred in all groups. There was a considerable inter-fetal variability within each group. Conclusion: A unique characterization of CTG trends throughout gestation in SGA fetuses was provided. A steeper descent of the baseline was reported for the first time. The findings raise the possibility of clinical application of computerized CTG analysis in screening and management of fetal growth restriction

Agreement and accuracy using the FIGO, ACOG and NICE cardiotocography interpretation guidelines.

INTRODUCTION: One of the limitations reported with cardiotocography (CTG) is the modest interobserver agreement observed in tracing interpretation. This study compared agreement, reliability and accuracy of CTG interpretation using the FIGO, ACOG and NICE guidelines. MATERIAL AND METHODS: A total of 151 tracings was evaluated by 27 clinicians from three centers where FIGO, ACOG and NICE guidelines were routinely used. Interobserver agreement was evaluated using the proportions of agreement (PA) and reliability with the kappa (k) statistic. The accuracy of tracings classified as "pathological/category III" was assessed for prediction of newborn acidemia. For all measures, 95% confidence intervals (95%CI) were calculated RESULTS: CTG classifications were more distributed with FIGO (9%, 52%, 39%) and NICE (30%, 33%, 37%) than with ACOG (13%, 81%, 6%). The category with the highest agreement was ACOG category II (PA=0.73 95%CI 0.70-76), and the ones with the lowest agreement were ACOG categories I and III. Reliability was significantly higher with FIGO (k=0.37, 95%CI 0.31-0.43), and NICE (k=0.33, 95%CI 0.28-0.39) than with ACOG (k= 0.15, 95%CI 0.10-0.21), however all represent only slight/fair reliability. FIGO and NICE showed a trend towards higher sensitivities in prediction of newborn acidemia (89% and 97% respectively) than ACOG (32%,), but the latter achieved a significantly higher specificity (95%) CONCLUSIONS: With ACOG guidelines there is high agreement in category II, low reliability, low sensitivity and high specificity in prediction of acidemia. With FIGO and NICE guidelines there is higher reliability, a trend towards higher sensitivity, and lower specificity in prediction of acidemia. This article is protected by copyright. All rights reserved

Sonographic knowledge of occiput position to decrease failed operative vaginal delivery: a systematic review and meta-analysis of randomized controlled trials

Objective: This study aimed to assess the efficacy of sonographic assessment of fetal occiput position before operative vaginal delivery to decrease the number of failed operative vaginal deliveries. Data Sources: The search was conducted in MEDLINE, Embase, Web of Science, Scopus, ClinicalTrial.gov, Ovid, and Cochrane Library as electronic databases from the inception of each database to April 2021. No restrictions for language or geographic location were applied. Study Eligibility Criteria: Selection criteria included randomized controlled trails of pregnant women randomized to either sonographic or clinical digital diagnosis of fetal occiput position during the second stage of labor before operative vaginal delivery. Methods: The primary outcome was failed operative vaginal delivery, defined as a failed fetal operative vaginal delivery (vacuum or forceps) extraction requiring a cesarean delivery or forceps after failed vacuum. The summary measures were reported as relative risks or as mean differences with 95% confidence intervals using the random effects model of DerSimonian and Laird. An I2 (Higgins I2) &gt;0% was used to identify heterogeneity. Results: A total of 4 randomized controlled trials including 1007 women with singleton, term, cephalic fetuses randomized to either the sonographic (n=484) or clinical digital (n=523) diagnosis of occiput position during the second stage of labor before operative vaginal delivery were included. Before operative vaginal delivery, fetal occiput position was diagnosed as anterior in 63.5% of the sonographic diagnosis group vs 69.5% in the clinical digital diagnosis group (P=.04). There was no significant difference in the rate of failed operative vaginal deliveries between the sonographic and clinical diagnosis of occiput position groups (9.9% vs 8.2%; relative risk, 1.14; 95% confidence interval, 0.77–1.68). Women randomized to sonographic diagnosis of occiput position had a significantly lower rate of occiput position discordance between the evaluation before operative vaginal delivery and the at birth evaluation when compared with those randomized to the clinical diagnosis group (2.3% vs 17.7%; relative risk, 0.16; 95% confidence interval, 0.04–0.74; P=.02). There were no significant differences in any of the other secondary obstetrical and perinatal outcomes assessed. Conclusion: Sonographic knowledge of occiput position before operative vaginal delivery does not seem to have an effect on the incidence of failed operative vaginal deliveries despite better sonographic accuracy in the occiput position diagnosis when compared with clinical assessment. Future studies should evaluate how a more accurate sonographic diagnosis of occiput position or other parameters can lead to a safer and more effective operative vaginal delivery technique

O impacto da pandemia na saúde sexual e reprodutiva das mulheres:realidade do Hospital Garcia de Orta, EPE

Introdução - Durante a pandemia 47 milhões de mulheres ficaram sem acesso a contracetivos, representando 1,4 milhões de gravidezes inesperadas e interrupções de gravidez, acentuando as desigualdades socioeconómicas. Embora o direito das mulheres à saúde sexual e reprodutiva seja considerada uma prioridade e um direito universal; as consequências decorrentes do elevado número de casos de infeção pelo vírus ao Sars-Cov2 conduziu à reorganização dos serviços de saúde na resposta ao doente respiratório e à vacinação em detrimento dos cuidados à saúde reprodutiva. Objetivo - Identificar as características sociodemográficas das mulheres que recorrem à consulta de IVG e o seu perfil contracetivo nos anos 2019, 2020 e primeiro semestre de 2021.N/

Wavelet transform selection method for biological signal treatment

This paper presents the development and evaluation of an algorithm for compressing fetal electrocardiographic signals, taken superficially on the mother’s abdomen. This method for acquiring ECG signals produces a great volumen of information that makes it difficult for the records to be stored and transmitted. The proposed algorithm aims for lossless compression of the signal by applying Wavelet Packet Transform to keep errors below the unit, with compression rates over 20:1 and with conserved energy in reconstruction as comparison parameter. For algorithm validation, the signal files provided by PhysioBank DataBase are used

Muonium in nano-crystalline II-VI semiconductors

http://www.sciencedirect.com/science/article/B6TVH-4V2NP2J-Y/2/3738c97c2d99528da5d86b486571793