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  • 1. Amer-Wåhlin, Isis
    et al.
    Rosén, KG
    University of Borås, School of Engineering.
    ST-Analysis of the Fetal ECG2013In: Antenatal and Intrapartum fetal surveillance, Universities Press , 2013, p. 220-236Chapter in book (Other academic)
  • 2. Blad, Sofia
    et al.
    Larsson, David
    Outram, Nicolas
    Rosén, Karl G
    University of Borås, School of Engineering.
    Assessment of fetal reactivity biopatterns during labour by fetal ECG analysis2009Conference paper (Refereed)
    Abstract [en]

    Reactivity is the pattern of reactions associated with response to changes in the environment such as stress. Labour with uterine contractions hampering fetal and uterine blood flow provides significant stress and we need to improve our ability to assess fetal reactivity biopatterns during delivery. The study illustrates progress made with regard to detailed analysis of the fetal heart rate (FHR) and beat-to-beat variations (RR-intervals) as a clinical measure of fetal reactivity. A method, named residuals, is presented of using a small set of index cases to identify parameter settings which are then further evaluated in extensive database tests of 8100 cases.

  • 3. Kro, GA
    et al.
    Yli B, M
    Rasmussen, S
    Norèn, H
    Amer-Wåhlin, I
    Rosén, KG
    University of Borås, School of Engineering.
    Stray-Pedersen, B
    Saugstad, OD
    Association between umbilical cord artery pCO₂ and the Apgar score; elevated levels of pCO₂ may be beneficial for neonatal vitality after moderate acidemia.2013In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, no 6, p. 662-70Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine the association between 5-min Apgar score and umbilical cord artery carbon dioxide tension (pCO₂). DESIGN: Observational study. SETTING: European hospital labor wards. POPULATION: Data from 36,432 newborns ≥36 gestational weeks were obtained from three sources: two trials of monitoring with fetal electrocardiogram (the Swedish randomized controlled trial and the European Union Fetal ECG trial) and Mölndal Hospital data. After validation of the acid-base values, 25,806 5-min Apgar scores were available for analysis. METHODS: Validation of the umbilical cord acid-base values was performed to obtain reliable data. 5-min Apgar score was regressed against cord artery pCO₂ in a polynomial multilevel model. MAIN OUTCOME MEASURES: Five-min Apgar score, umbilical cord pCO₂, pH, and base deficit. RESULTS: Overall, a higher cord artery pCO₂ was found to be associated with lower 5-min Apgar scores. However, among newborns with moderate acidemia, lower umbilical cord artery pCO₂ (≤median pCO₂ for the specific cord artery pH) was associated with lower 5-min Apgar scores, with a relative risk of 2.0 (95% confidence interval: 1.4-2.8) for 5-min Apgar scores 0-6. CONCLUSIONS: Metabolic acidosis affects the newborn's vitality more than respiratory acidosis. In addition, elevated levels of pCO₂ may be beneficial for fetuses with moderate acidemia, and thus cord artery pCO₂ is a factor that should be considered when assessing the compromised newborn.

  • 4.
    Mollberg, Margareta
    University of Borås, School of Health Science.
    Comparison of infants with transient and persistent obstetric brachial plexus palsy: differences in obstetric management2007Conference paper (Refereed)
  • 5.
    Mollberg, Margareta
    University of Borås, School of Health Science.
    Obstetric Brachial Plexus Palsy2007Doctoral thesis, monograph (Other academic)
  • 6.
    Mollberg, Margareta
    University of Borås, School of Health Science.
    Obstetriska plexus brachialisskador i relation till den kliniska handläggningen2007Conference paper (Refereed)
  • 7. Nunes, I
    et al.
    Ayres-de-Campos, D
    Kwee, A
    Rosén, KG
    University of Borås, School of Engineering.
    Prolonged saltatory fetal heart rate pattern leading to newborn metabolic acidosis2014In: Clinical and Experimental Obstetrics and Gynecology, ISSN 0390-6663, Vol. 41, no 5, p. 507-11Article in journal (Refereed)
    Abstract [en]

    Purpose: The saltatory pattern, characterized by wide and rapid oscillations of the fetal heart rate (FHR), remains a controversial entity. The authors sought to evaluate whether it could be associated with an adverse fetal outcome. Material and Methods: The authors report a case series of four saltatory patterns occurring in the last 30 minutes before birth in association with cord artery metabolic acidosis, obtained from three large databases of internally acquired FHR tracings. The distinctive characteristics of this pattern were evaluated with the aid of a computer system. Results: All cases were recorded in uneventful pregnancies, with normal birth weight singletons, born vaginally at term. The saltatory pattern lasted between 23 and 44 minutes, exhibited a mean oscillatory amplitude of 45.9 to 80.0 beats per minute (bpm) and a frequency between four and eight cycles per minute. Conclusions: A saltatory pattern exceeding 20 minutes can be associated with the occurrence of fetal metabolic acidosis.

  • 8.
    Rosén, KG
    University of Borås, School of Engineering.
    ST analysis reviewed2013In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 209, no 4, p. 394-Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Comment on Effectiveness of electronic fetal monitoring with additional ST analysis in vertex singleton pregnancies at >36 weeks of gestation: an individual participant data metaanalysis

  • 9. Siira, Saila M.
    et al.
    Ojala, Tiina H.
    Vahlberg, Tero J.
    Rosén, Karl G.
    University of Borås, School of Engineering.
    Ekholm, Eeva M.
    Do spectral bands of fetal heart rate variability associate with concomitant fetal scalp pH?2013In: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 89, no 9, p. 739-742Article in journal (Refereed)
    Abstract [en]

    Background: Objective information on speci fi c fetal heart rate (FHR) parameters would be advantageous when assessing fetal responses to hypoxia. Small, visually undetectable changes in FHR variability can be quanti fi ed by power spectral analysis of FHR variability. Aims: To investigate the effect of intrapartum hypoxia and acidemia on spectral powers of FHR variability. Study design: This is a retrospective observational clinical study with data from an EU multicenter project. Subjects: We had 462 fetuses with a normal pH-value (pH > 7.20; controls) in fetal scalp blood sample (FBS) and 81 fetuses with a low scalp pH-value ( ≤ 7.20; low-FBS pH-fetuses). The low-FBS pH-fetuses were further divided into two subgroups according to the degree of acidemia: fetuses with FBS pH 7.11 – 7.20 (n = 58) and fetuses with FBS pH ≤ 7.10 (n = 23). Outcome measures: Spectral powers of FHR variability in relation to the concomitant FBS pH-value. Results: Fetuses with FBS pH ≤ 7.20 had increased spectral powers of FHR variability compared with controls (2.49 AU vs. 2.23 AU; p = 0.038). However, the subgroup of most affected fetuses (those with FBS pH ≤ 7.10) had signi fi cantly lower FHR variability spectral powers when compared to fetuses with FBS pH 7.11 – 7.20. Conclusions: This study shows that spectral powers of FHR variability change as a fetus becomes hypoxic, and that spectral powers decrease with deepening fetal acidemia.

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