Fetal Medicine - Science topic

Monozygotic twins will have the same blood type, with a few very rare exceptions.

vasculopathy due to DM

Welcome Dr Tanaka. Nice to see u there

It is best to avoid this situation, by carefully following the distracted labor process.

This is not an easy question, with a single correct answer as it depends on the situation very much.

Previous surgical history, BMI and gravidity of the mother, size of the baby, the duration of the impaction, the skill of the surgeon, the experience of the team all matters.

The time of the event is also important. Such cases tend to occur in very late at night or early in the morning where there is usually minimal help available.

You (and the baby and mother) would be very lucky if you have a "24 hour ready operation room" with good helping hands, doctors, assistants or midwives, around in a large hospital, with a transfusion center.

Sometimes a steady and gradual traction of the baby by the shoulders without squeezing the neck helps to slide and pull up the fetal head during cesarean. If you have an experienced helper with trained hands with good control and skills and reasonable movements, this person may help by simultaneously pushing the fetal head from below, while you do the controlled pulling from the above. However, uncontrolled power is not a real power, and can be dangerous. Sudden and jerky movements are very dangerous and not wanted. Pressing the anterior fontanel or depression fractures of the skull may occur with uncontrolled or untrained hands. These may cause injuries. Three or four fingers of the hand could be better to push the head by holding them in a triangular or quadrangular fashion, therefore the power of pushing could be distributed, rather than pushing from a single point.

Incision to the uterus must be very careful also because the lower segment would probably be extremely thinned. Uncontrolled extension of the incision to lateral or cutting the infant could be possible. Classical uterine incision may be an option in selected cases, however, there is a serious chance of atony after such a vigorous labor. The incision may still extend downwards. This is also hard to repair and still bleeds a lot even if there is no atony.

Neonatologist or a pediatrician is a wonderful help and should be available if possible. These babies may require active resuscitation.

Again:

It is best to avoid the situation with good labor management.

I found the service manual which also contains the electronic schemes along with very detailed information. 

What type of fetal heart rate export data are you trying to acquire? You may need additional electronic circuit if you are trying to acquire  fetal heart beat sound and turn it to momentary heart rate graphics as in a cardiotocogram.

DICOM interfaces may offer additional coupling possibilities.

I have not recognized an out signal port in the ultrasound systems I have used.

I hope I was of any help..

best regards.

I have not found women to be able to determine whether the fetus is breech vs vertex by where they feel fetal movement.  It is fairly reliable at term to ask if they have urinary urgency- because that means the head is down i.e. the fetus  is vertex.  I have not had women with breech babies feel strong urinary urgency in the last week, like the vertex babies cause.  

it would be interesting to determine if women feel less movement when the placenta is in the front vs.  in the back or on the side.     But fetal movement is very individual and really the results will reflect that every woman perceives it differently.  For a good example of different perceptions of fetal movement,    Quickening happens between 14 and 21 weeks- which reflects how  differently women perceive fetal movement .   And amazingly, another example of the variation in how women feel fetal movement is - the reason decreased fetal movement cannot be used as an indication of fetal distress, or fetal death,  is because in the research on TERM STILLBIRTH, 25% of women were still feeling  movement after the fetus had already died.     Well perhaps it does float around  or something but it is not moving its own body.  

So, ultimately, there cannot be objective research on this topic.  It would be like researching how different people perceive the color Yellow.     Cannot be done. 

no sufficient data are available, there's a large use in emergency ward (off label use)  . In Sweden a study on Data from the Swedish Medical Birth Register combined with the Swedish Register of Prescribed Drugs were used to identify 1349 infants born of women who had taken ondansetron in early pregnancy, 1998-2012 Reprod Toxicol. 2014 Dec;50:134-7. doi: 10.1016/j.reprotox.2014.10.017. Epub 2014 Oct 31,show interesting results. The answer is:  is not so safe, use it only if there's no alternatives o in emergency. no data show teratogenity (in rats and humans), but there's risk of birth defects .

At stage 3, the copper measurements of the donor are similar  to an iugr fetus while the recipient deals with volume overload. This means that the donor often starts with an increased PI in the umbilical artery followed by an abnormal blood flow in the ACM and in the ductus venous. The recipient often starts with an abnormal flow in the ductus venous. I hope this helps 

In my opinion DV is not helpfull as isolated Dopplerparameter. The old fashioned idea of an step to step change of UA > MCA > DV seems to be not true (Unterscheider J et al. AJOG 2013 539e1) . There are multiple combinations of changes in the Doppler Parameters and we have to check the follow up of all of them including growth, Amnion Fluid, BPP and the cerebro placental ratio.

DV is sometimes difficult to measure in a IUGR Fetus an there is a risk for a false positive "reversed flow" by measuring the liver vessels. You need training and supervison.