Identifying the level of fetal risk during labor
First Claim
1. An apparatus for identifying the level of fetal risk during labor, comprising:
- at least one computer operative to receive input signals indicative of at least fetal heart rate (“
FHR”
) and maternal uterine activity in a patient, the at least one computer further operative (i) to determine from the FHR at least baseline FHR variability, FHR accelerations, and FHR decelerations, and (ii) to determine when each of at least (a) FHR, (b) baseline FHR variability, (c) FHR accelerations, (d) FHR decelerations, and (e) maternal uterine activity exhibit at least one non-reassuring characteristic from among a plurality of pre-defined non-reassuring characteristics for at least the parameters (a) through (e); and
wherein the at least one computer is further operative to (iii) receive user-inputs indicative of the presence in the patient of one or more antecedent clinical parameters which elevate the level of fetal risk during labor, and (iv) to determine at a given point in time during labor a present level of risk to the fetus which takes into account only;
the total number of the one or more antecedent clinical parameters which elevate the level of fetal risk during labor; and
the total number of the parameters (a) through (e) that each simultaneously, independently exhibit at least one of the non-reassuring characteristics at the given point in time during labor;
wherein the at least one computer is further operative to indicate a predetermined action to be taken in response to the present level of risk to the fetus, and wherein further the indicated predetermined action is intervention in labor when the present level of risk to the fetus for an adverse outcome is at a predetermined level; and
at least one output operatively connected to the at least one computer, the at least one output indicating the determined present level of risk to the fetus and the predetermined action to be taken in response to the indicated present level of risk to the fetus.
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Abstract
A method for identifying the level of fetal risk during labor comprises monitoring at least each of the concurrent clinical parameters of (a) FHR, (b) baseline FHR variability, (c) FHR accelerations, (d) FHR decelerations, and (e) maternal uterine activity, to determine whether each parameter independently exhibits at least one non-reassuring characteristic, and indicating a present level of risk to the fetus corresponding to the number of the concurrent clinical parameters (a) through (e) that are simultaneously, independently non-reassuring. An apparatus for implementing the method comprises at least one computer operative to receive input signals indicative of at least FHR and maternal uterine activity in a patient. The computer is operative to determine from the FHR baseline FHR variability, FHR accelerations, and FHR decelerations, to determine when any one or more of the parameters (a) through (e) each exhibit at least one non-reassuring characteristic, and to determine a present level of risk to the fetus corresponding to the number of the parameters (a) through (e) that are simultaneously, independently non-reassuring. At least one output operatively connected to the at least one computer indicates the determined present level of risk to the fetus.
33 Citations
25 Claims
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1. An apparatus for identifying the level of fetal risk during labor, comprising:
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at least one computer operative to receive input signals indicative of at least fetal heart rate (“
FHR”
) and maternal uterine activity in a patient, the at least one computer further operative (i) to determine from the FHR at least baseline FHR variability, FHR accelerations, and FHR decelerations, and (ii) to determine when each of at least (a) FHR, (b) baseline FHR variability, (c) FHR accelerations, (d) FHR decelerations, and (e) maternal uterine activity exhibit at least one non-reassuring characteristic from among a plurality of pre-defined non-reassuring characteristics for at least the parameters (a) through (e); andwherein the at least one computer is further operative to (iii) receive user-inputs indicative of the presence in the patient of one or more antecedent clinical parameters which elevate the level of fetal risk during labor, and (iv) to determine at a given point in time during labor a present level of risk to the fetus which takes into account only; the total number of the one or more antecedent clinical parameters which elevate the level of fetal risk during labor; and the total number of the parameters (a) through (e) that each simultaneously, independently exhibit at least one of the non-reassuring characteristics at the given point in time during labor; wherein the at least one computer is further operative to indicate a predetermined action to be taken in response to the present level of risk to the fetus, and wherein further the indicated predetermined action is intervention in labor when the present level of risk to the fetus for an adverse outcome is at a predetermined level; and at least one output operatively connected to the at least one computer, the at least one output indicating the determined present level of risk to the fetus and the predetermined action to be taken in response to the indicated present level of risk to the fetus. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An apparatus for identifying the level of fetal risk during labor, comprising:
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at least one computer operative to receive input signals indicative of at least fetal heart rate (“
FHR”
) and maternal uterine activity in a patient, the at least one computer further operative (i) to determine from the FHR at least baseline FHR variability, FHR accelerations, and FHR decelerations, and (ii) to determine when each of at least (a) FHR, (b) baseline FHR variability, (c) FHR accelerations, (d) FHR decelerations, and (e) maternal uterine activity exhibit at least one non-reassuring characteristic from among a plurality of pre-defined non-reassuring characteristics for at least the parameters (a) through (e); andwherein the at least one computer is further operative to (iii) to receive user-inputs indicative of the presence in the patient of the concurrent clinical parameters of (f) prolonged latent phase, (g) arrest and protraction of the active phase, (h) failed descent of the presenting part, (i) arrested descent of the presenting part, and (j) protracted descent of the presenting part, and (iv) to determine at a given point in time during labor a present level of risk to the fetus which takes into account only; the total of the number of the parameters (a) through (e) that each simultaneously, independently exhibit at least one of the non-reassuring characteristics at the given point in time during labor; and the number of the concurrent clinical parameters (f) through (j) that are simultaneously present; wherein the at least one computer is further operative to indicate a predetermined action to be taken in response to the present level of risk to the fetus, and wherein further the indicated predetermined action is intervention in labor when the present level of risk to the fetus for an adverse outcome is at a predetermined level; and at least one output operatively connected to the at least one computer, the at least one output indicating the determined present level of risk to the fetus and the predetermined action to be taken in response to the indicated present level of risk to the fetus. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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25. An apparatus for identifying the level of fetal risk during labor, comprising:
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at least one computer operative to receive input signals indicative of at least fetal heart rate (“
FHR”
) and maternal uterine activity in a patient, the at least one computer further operative;(i) to determine from the FHR at least baseline FHR variability, FHR accelerations, and FHR decelerations; (ii) to determine when each of at least (a) FHR, (b) baseline FHR variability, (c) FHR accelerations, (d) FHR decelerations, and (e) maternal uterine activity exhibit at least one non-reassuring characteristic from among a plurality of pre-defined non-reassuring characteristics for at least the parameters (a) through (e), and to assign a pre-defined value to each of said parameters (a) through (e) that simultaneously, independently exhibit at least one of the non-reassuring characteristics; and (iii) to determine, at a given point in time during labor, a present level of risk to the fetus corresponding only to the total of the values assigned to each of said parameters (a) through (e) at the given point in time; and wherein the at least one computer is further operative to indicate a predetermined action to be taken in response to the present level of risk to the fetus, and wherein further the indicated predetermined action is intervention in labor when the present level of risk to the fetus for an adverse outcome is at a predetermined level; and at least one output operatively connected to the at least one computer, the at least one output indicating the determined present level of risk to the fetus and the predetermined action to be taken in response to the indicated present level of risk to the fetus.
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Specification