home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-06 | 366.6 KB |
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MacOS 8.1
|
Win98
|
DOS
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| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
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|00000580| 39 39 00 00 00 01 90 af | 05 00 d2 0a 00 00 00 00 |99......|........|
|00000590| 00 00 00 00 62 ba 05 00 | 00 00 00 00 24 55 6e 69 |....b...|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 31 31 35 30 30 7d |que_ID{Y|RB11500}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 55 6d 62 69 6c 69 63 |..$Title|{Umbilic|
|000005c0| 61 6c 20 41 72 74 65 72 | 79 20 42 6c 6f 6f 64 20 |al Arter|y Blood |
|000005d0| 56 65 6c 6f 63 69 6d 65 | 74 72 79 3a 20 20 41 20 |Velocime|try: A |
|000005e0| 50 72 6f 73 70 65 63 74 | 69 76 65 20 4c 6f 6e 67 |Prospect|ive Long|
|000005f0| 69 74 75 64 69 6e 61 6c | 20 53 74 75 64 79 20 69 |itudinal| Study i|
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|00000610| 49 6e 74 72 61 75 74 65 | 72 69 6e 65 20 47 72 6f |Intraute|rine Gro|
|00000620| 77 74 68 2d 52 65 74 61 | 72 64 65 64 20 46 65 74 |wth-Reta|rded Fet|
|00000630| 75 73 7d 0d 0a 24 41 75 | 74 68 6f 72 7b 76 61 6e |us}..$Au|thor{van|
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|00000660| 6e 2c 20 48 4a 41 0d 0a | 54 68 65 75 6e 69 73 73 |n, HJA..|Theuniss|
|00000670| 65 6e 2c 20 4d 0d 0a 48 | 6f 6f 67 6c 61 6e 64 2c |en, M..H|oogland,|
|00000680| 20 48 4a 0d 0a 64 65 20 | 48 61 61 6e 2c 20 4a 7d | HJ..de |Haan, J}|
|00000690| 0d 0a 24 41 66 66 69 6c | 69 61 74 69 6f 6e 7b 41 |..$Affil|iation{A|
|000006a0| 63 61 64 65 6d 69 63 20 | 48 6f 73 70 20 4d 61 61 |cademic |Hosp Maa|
|000006b0| 73 74 72 69 63 68 74 3b | 20 55 6e 69 76 20 6f 66 |stricht;| Univ of|
|000006c0| 20 4c 69 6d 62 75 72 67 | 2c 20 4d 61 61 73 74 72 | Limburg|, Maastr|
|000006d0| 69 63 68 74 2c 20 54 68 | 65 20 4e 65 74 68 65 72 |icht, Th|e Nether|
|000006e0| 6c 61 6e 64 73 7d 0d 0a | 24 4a 6f 75 72 6e 61 6c |lands}..|$Journal|
|000006f0| 7b 45 61 72 6c 79 20 48 | 75 6d 20 44 65 76 7d 0d |{Early H|um Dev}.|
|00000700| 0a 24 56 6f 6c 75 6d 65 | 7b 31 38 7d 0d 0a 24 50 |.$Volume|{18}..$P|
|00000710| 61 67 65 7b 35 39 2d 37 | 31 7d 0d 0a 24 44 61 74 |age{59-7|1}..$Dat|
|00000720| 65 7b 4e 6f 76 65 6d 62 | 65 72 20 31 39 38 38 7d |e{Novemb|er 1988}|
|00000730| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 39 30 20 59 65 |..$YBVol|{1990 Ye|
|00000740| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 4f 62 73 74 65 |ar Book |of Obste|
|00000750| 74 72 69 63 73 20 61 6e | 64 20 47 79 6e 65 63 6f |trics an|d Gyneco|
|00000760| 6c 6f 67 79 7d 0d 0a 24 | 43 68 61 70 74 65 72 7b |logy}..$|Chapter{|
|00000770| 35 2d 36 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |5-6}..$Y|BEditor{|
|00000780| 44 72 73 2e 20 4d 69 73 | 68 65 6c 6c 2c 20 4b 69 |Drs. Mis|hell, Ki|
|00000790| 72 73 63 68 62 61 75 6d | 2c 20 61 6e 64 20 4d 6f |rschbaum|, and Mo|
|000007a0| 72 72 6f 77 7d 0d 0a 24 | 54 61 62 6c 65 7b 7d 0d |rrow}..$|Table{}.|
|000007b0| 0a 24 43 6f 6d 6d 65 6e | 74 61 74 6f 72 7b 54 2e |.$Commen|tator{T.|
|000007c0| 48 2e 20 4b 69 72 73 63 | 68 62 61 75 6d 2c 20 4d |H. Kirsc|hbaum, M|
|000007d0| 2e 44 2e 7d 0d 0a 0d 0a | 43 6f 70 79 72 69 67 68 |.D.}....|Copyrigh|
|000007e0| 74 20 28 63 29 20 59 65 | 61 72 62 6f 6f 6b 20 4d |t (c) Ye|arbook M|
|000007f0| 65 64 69 63 61 6c 20 50 | 75 62 6c 69 73 68 65 72 |edical P|ublisher|
|00000800| 73 2c 20 49 6e 63 2e 2c | 20 31 39 39 30 0d 0a 0d |s, Inc.,| 1990...|
|00000810| 0a 31 39 39 30 20 59 65 | 61 72 20 42 6f 6f 6b 20 |.1990 Ye|ar Book |
|00000820| 6f 66 20 4f 62 73 74 65 | 74 72 69 63 73 20 61 6e |of Obste|trics an|
|00000830| 64 20 47 79 6e 65 63 6f | 6c 6f 67 79 20 28 52 29 |d Gyneco|logy (R)|
|00000840| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 35 2d 2d 41 |....Chap|ter 5--A|
|00000850| 6e 74 65 70 61 72 74 75 | 6d 20 46 65 74 61 6c 20 |ntepartu|m Fetal |
|00000860| 53 75 72 76 65 69 6c 6c | 61 6e 63 65 0d 0a 0d 0a |Surveill|ance....|
|00000870| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00000890| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|000008c0| 55 6d 62 69 6c 69 63 61 | 6c 20 41 72 74 65 72 79 |Umbilica|l Artery|
|000008d0| 20 42 6c 6f 6f 64 20 56 | 65 6c 6f 63 69 6d 65 74 | Blood V|elocimet|
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|00000900| 53 74 75 64 79 20 69 6e | 0d 0a 53 65 61 72 63 68 |Study in|..Search|
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|00000950| 73 65 6e 20 4b 4a 2c 20 | 53 63 68 6f 75 74 65 6e |sen KJ, |Schouten|
|00000960| 20 48 4a 41 2c 20 54 68 | 65 75 6e 69 73 73 65 6e | HJA, Th|eunissen|
|00000970| 20 4d 2c 20 48 6f 6f 67 | 6c 61 6e 64 20 48 4a 2c | M, Hoog|land HJ,|
|00000980| 20 64 65 20 48 61 61 6e | 20 4a 0d 0a 28 41 63 61 | de Haan| J..(Aca|
|00000990| 64 65 6d 69 63 20 48 6f | 73 70 20 4d 61 61 73 74 |demic Ho|sp Maast|
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|000009c0| 68 74 2c 20 54 68 65 20 | 4e 65 74 68 65 72 6c 61 |ht, The |Netherla|
|000009d0| 6e 64 73 29 0d 0a 45 61 | 72 6c 79 20 48 75 6d 20 |nds)..Ea|rly Hum |
|000009e0| 44 65 76 20 31 38 3a 35 | 39 2d 37 31 2c 20 4e 6f |Dev 18:5|9-71, No|
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|00000a40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00000a50| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|00000a60| 49 6e 74 72 61 75 74 65 | 72 69 6e 65 20 67 72 6f |Intraute|rine gro|
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|00000a80| 28 49 55 47 52 29 20 63 | 61 6e 20 62 65 20 61 73 |(IUGR) c|an be as|
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|00000b40| 0d 0a 41 20 73 6d 61 6c | 6c 20 66 65 74 75 73 20 |..A smal|l fetus |
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|00000c70| 61 72 64 61 74 69 6f 6e | 0d 0a 61 6e 64 20 61 70 |ardation|..and ap|
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|00000cb0| 20 20 49 6e 20 74 68 69 | 73 20 70 72 6f 73 70 65 | In thi|s prospe|
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|000028f0| 61 6e 20 53 65 63 74 69 | 6f 6e 0d 0a 52 61 74 65 |an Secti|on..Rate|
|00002900| 20 61 6e 64 20 57 69 74 | 68 20 4e 65 6f 6e 61 74 | and Wit|h Neonat|
|00002910| 61 6c 20 4d 6f 72 62 69 | 64 69 74 79 20 61 6e 64 |al Morbi|dity and|
|00002920| 20 4d 6f 72 74 61 6c 69 | 74 79 0d 0a 0d 0a 4d 63 | Mortali|ty....Mc|
|00002930| 43 75 73 6b 65 72 20 4a | 2c 20 48 61 72 72 69 73 |Cusker J|, Harris|
|00002940| 20 44 52 2c 20 48 6f 73 | 6d 65 72 20 44 57 20 4a | DR, Hos|mer DW J|
|00002950| 72 0d 0a 28 55 6e 69 76 | 20 6f 66 20 4d 61 73 73 |r..(Univ| of Mass|
|00002960| 61 63 68 75 73 65 74 74 | 73 2c 20 41 6d 68 65 72 |achusett|s, Amher|
|00002970| 73 74 29 0d 0a 41 6d 20 | 4a 20 50 75 62 6c 69 63 |st)..Am |J Public|
|00002980| 20 48 65 61 6c 74 68 20 | 37 38 3a 31 31 37 30 2d | Health |78:1170-|
|00002990| 31 31 37 34 2c 20 53 65 | 70 74 65 6d 62 65 72 20 |1174, Se|ptember |
|000029a0| 31 39 38 38 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1988..--|--------|
|000029b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000029c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000029d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000029e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000029f0| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00002a00| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 69 6e 66 |.... | The inf|
|00002a10| 6c 75 65 6e 63 65 20 6f | 66 20 65 6c 65 63 74 72 |luence o|f electr|
|00002a20| 6f 6e 69 63 20 66 65 74 | 61 6c 20 6d 6f 6e 69 74 |onic fet|al monit|
|00002a30| 6f 72 69 6e 67 20 28 45 | 46 4d 29 20 64 75 72 69 |oring (E|FM) duri|
|00002a40| 6e 67 20 6c 61 62 6f 72 | 20 6f 6e 0d 0a 70 72 65 |ng labor| on..pre|
|00002a50| 67 6e 61 6e 63 79 20 6f | 75 74 63 6f 6d 65 73 20 |gnancy o|utcomes |
|00002a60| 77 61 73 20 61 6e 61 6c | 79 7a 65 64 20 75 73 69 |was anal|yzed usi|
|00002a70| 6e 67 20 64 61 74 61 20 | 66 72 6f 6d 20 74 68 65 |ng data |from the|
|00002a80| 20 31 39 38 30 20 4e 61 | 74 69 6f 6e 61 6c 20 4e | 1980 Na|tional N|
|00002a90| 61 74 61 6c 69 74 79 0d | 0a 53 75 72 76 65 79 2e |atality.|.Survey.|
|00002aa0| 20 20 4f 66 20 39 2c 39 | 34 31 20 73 75 62 6a 65 | Of 9,9|41 subje|
|00002ab0| 63 74 73 20 69 6e 20 74 | 68 65 20 64 61 74 61 20 |cts in t|he data |
|00002ac0| 62 61 73 65 2c 20 61 64 | 65 71 75 61 74 65 20 64 |base, ad|equate d|
|00002ad0| 61 74 61 20 77 65 72 65 | 20 61 76 61 69 6c 61 62 |ata were| availab|
|00002ae0| 6c 65 20 66 6f 72 0d 0a | 35 2c 38 36 33 3b 20 45 |le for..|5,863; E|
|00002af0| 46 4d 20 77 61 73 20 75 | 73 65 64 20 69 6e 20 32 |FM was u|sed in 2|
|00002b00| 2c 38 37 31 20 63 61 73 | 65 73 2e 20 20 54 68 65 |,871 cas|es. The|
|00002b10| 20 6d 6f 73 74 20 63 6f | 6d 6d 6f 6e 20 6d 65 74 | most co|mmon met|
|00002b20| 68 6f 64 20 77 61 73 20 | 44 6f 70 70 6c 65 72 0d |hod was |Doppler.|
|00002b30| 0a 75 6c 74 72 61 73 6f | 6e 6f 67 72 61 70 68 79 |.ultraso|nography|
|00002b40| 2e 0d 0a 20 20 20 20 20 | 4c 6f 67 69 73 74 69 63 |... |Logistic|
|00002b50| 20 72 65 67 72 65 73 73 | 69 6f 6e 20 61 6e 61 6c | regress|ion anal|
|00002b60| 79 73 69 73 20 73 68 6f | 77 65 64 20 61 20 73 69 |ysis sho|wed a si|
|00002b70| 67 6e 69 66 69 63 61 6e | 74 20 61 73 73 6f 63 69 |gnifican|t associ|
|00002b80| 61 74 69 6f 6e 20 62 65 | 74 77 65 65 6e 20 45 46 |ation be|tween EF|
|00002b90| 4d 0d 0a 61 6e 64 20 69 | 6e 63 72 65 61 73 65 64 |M..and i|ncreased|
|00002ba0| 20 63 65 73 61 72 65 61 | 6e 20 73 65 63 74 69 6f | cesarea|n sectio|
|00002bb0| 6e 20 64 65 6c 69 76 65 | 72 79 20 72 61 74 65 73 |n delive|ry rates|
|00002bc0| 2e 20 20 45 6c 65 63 74 | 72 6f 6e 69 63 20 66 65 |. Elect|ronic fe|
|00002bd0| 74 61 6c 20 6d 6f 6e 69 | 74 6f 72 69 6e 67 0d 0a |tal moni|toring..|
|00002be0| 77 61 73 20 61 73 73 6f | 63 69 61 74 65 64 20 77 |was asso|ciated w|
|00002bf0| 69 74 68 20 61 20 6c 6f | 77 20 35 2d 6d 69 6e 75 |ith a lo|w 5-minu|
|00002c00| 74 65 20 41 70 67 61 72 | 20 73 63 6f 72 65 20 6f |te Apgar| score o|
|00002c10| 6e 6c 79 20 77 68 65 6e | 20 73 65 63 74 69 6f 6e |nly when| section|
|00002c20| 20 64 65 6c 69 76 65 72 | 79 20 74 6f 6f 6b 0d 0a | deliver|y took..|
|00002c30| 70 6c 61 63 65 2e 20 20 | 49 74 20 77 61 73 20 6e |place. |It was n|
|00002c40| 6f 74 20 69 6e 64 65 70 | 65 6e 64 65 6e 74 6c 79 |ot indep|endently|
|00002c50| 20 61 73 73 6f 63 69 61 | 74 65 64 20 77 69 74 68 | associa|ted with|
|00002c60| 20 72 65 73 70 69 72 61 | 74 6f 72 79 20 64 69 73 | respira|tory dis|
|00002c70| 74 72 65 73 73 2e 20 20 | 54 68 65 72 65 0d 0a 77 |tress. |There..w|
|00002c80| 61 73 20 6e 6f 20 61 70 | 70 61 72 65 6e 74 20 72 |as no ap|parent r|
|00002c90| 65 6c 61 74 69 6f 6e 73 | 68 69 70 20 62 65 74 77 |elations|hip betw|
|00002ca0| 65 65 6e 20 45 46 4d 20 | 61 6e 64 20 6e 65 6f 6e |een EFM |and neon|
|00002cb0| 61 74 61 6c 20 6d 6f 72 | 74 61 6c 69 74 79 2c 20 |atal mor|tality, |
|00002cc0| 62 75 74 20 6f 6e 6c 79 | 20 35 35 0d 0a 6e 65 6f |but only| 55..neo|
|00002cd0| 6e 61 74 61 6c 20 64 65 | 61 74 68 73 20 77 65 72 |natal de|aths wer|
|00002ce0| 65 20 61 6e 61 6c 79 7a | 65 64 2e 0d 0a 20 20 20 |e analyz|ed... |
|00002cf0| 20 20 45 6c 65 63 74 72 | 6f 6e 69 63 20 66 65 74 | Electr|onic fet|
|00002d00| 61 6c 20 6d 6f 6e 69 74 | 6f 72 69 6e 67 20 6d 61 |al monit|oring ma|
|00002d10| 79 20 69 64 65 6e 74 69 | 66 79 20 68 79 70 6f 78 |y identi|fy hypox|
|00002d20| 69 63 20 69 6e 66 61 6e | 74 73 2c 20 77 68 6f 20 |ic infan|ts, who |
|00002d30| 6f 66 74 65 6e 20 61 72 | 65 0d 0a 64 65 6c 69 76 |often ar|e..deliv|
|00002d40| 65 72 65 64 20 62 79 20 | 63 65 73 61 72 65 61 6e |ered by |cesarean|
|00002d50| 20 73 65 63 74 69 6f 6e | 2e 20 20 41 6c 74 68 6f | section|. Altho|
|00002d60| 75 67 68 20 73 65 63 74 | 69 6f 6e 20 64 65 6c 69 |ugh sect|ion deli|
|00002d70| 76 65 72 79 20 69 73 20 | 6d 75 63 68 20 73 61 66 |very is |much saf|
|00002d80| 65 72 20 74 68 61 6e 0d | 0a 69 6e 20 65 61 72 6c |er than.|.in earl|
|00002d90| 69 65 72 20 79 65 61 72 | 73 2c 20 61 20 72 69 73 |ier year|s, a ris|
|00002da0| 6b 20 6f 66 20 69 61 74 | 72 6f 67 65 6e 69 63 20 |k of iat|rogenic |
|00002db0| 70 72 65 6d 61 74 75 72 | 69 74 79 20 61 6e 64 20 |prematur|ity and |
|00002dc0| 72 65 73 70 69 72 61 74 | 6f 72 79 20 64 69 73 74 |respirat|ory dist|
|00002dd0| 72 65 73 73 0d 0a 73 79 | 6e 64 72 6f 6d 65 20 72 |ress..sy|ndrome r|
|00002de0| 65 6d 61 69 6e 73 2c 20 | 61 73 20 77 65 6c 6c 20 |emains, |as well |
|00002df0| 61 73 20 6d 61 74 65 72 | 6e 61 6c 20 6d 6f 72 74 |as mater|nal mort|
|00002e00| 61 6c 69 74 79 20 61 6e | 64 20 6d 6f 72 62 69 64 |ality an|d morbid|
|00002e10| 69 74 79 20 72 69 73 6b | 73 2e 20 20 4d 6f 73 74 |ity risk|s. Most|
|00002e20| 0d 0a 65 76 69 64 65 6e | 63 65 20 66 72 6f 6d 20 |..eviden|ce from |
|00002e30| 73 74 75 64 69 65 73 20 | 6f 66 20 6c 6f 77 65 72 |studies |of lower|
|00002e40| 2d 72 69 73 6b 20 70 72 | 65 67 6e 61 6e 63 69 65 |-risk pr|egnancie|
|00002e50| 73 20 67 69 76 65 20 6c | 69 74 74 6c 65 20 65 76 |s give l|ittle ev|
|00002e60| 69 64 65 6e 63 65 20 6f | 66 0d 0a 62 65 6e 65 66 |idence o|f..benef|
|00002e70| 69 74 20 66 72 6f 6d 20 | 45 46 4d 2e 0d 0a 0d 0a |it from |EFM.....|
|00002e80| 50 6f 73 74 2d 43 6f 6d | 6d 65 6e 74 0d 0a 0d 0a |Post-Com|ment....|
|00002e90| 20 20 20 20 20 54 68 65 | 20 31 39 38 30 20 4e 61 | The| 1980 Na|
|00002ea0| 74 69 6f 6e 61 6c 20 4e | 61 74 61 6c 69 74 79 20 |tional N|atality |
|00002eb0| 53 75 72 76 65 79 20 6f | 66 20 74 68 65 20 4e 61 |Survey o|f the Na|
|00002ec0| 74 69 6f 6e 61 6c 20 43 | 65 6e 74 65 72 20 66 6f |tional C|enter fo|
|00002ed0| 72 20 48 65 61 6c 74 68 | 0d 0a 53 74 61 74 69 73 |r Health|..Statis|
|00002ee0| 74 69 63 73 20 67 69 76 | 65 73 20 75 73 20 61 20 |tics giv|es us a |
|00002ef0| 6c 6f 6f 6b 20 61 74 20 | 45 46 4d 20 61 70 70 6c |look at |EFM appl|
|00002f00| 69 65 64 20 74 6f 20 6d | 6f 64 65 72 6e 20 6f 62 |ied to m|odern ob|
|00002f10| 73 74 65 74 72 69 63 73 | 2c 20 75 73 69 6e 67 0d |stetrics|, using.|
|00002f20| 0a 65 78 70 65 72 69 65 | 6e 63 65 20 64 65 72 69 |.experie|nce deri|
|00002f30| 76 65 64 20 66 72 6f 6d | 20 62 6f 74 68 20 61 63 |ved from| both ac|
|00002f40| 61 64 65 6d 69 63 2d 20 | 61 6e 64 20 6e 6f 6e 61 |ademic- |and nona|
|00002f50| 63 61 64 65 6d 69 63 2d | 62 61 73 65 64 20 68 65 |cademic-|based he|
|00002f60| 61 6c 74 68 20 63 61 72 | 65 0d 0a 66 61 63 69 6c |alth car|e..facil|
|00002f70| 69 74 69 65 73 2e 20 20 | 41 73 20 62 65 66 6f 72 |ities. |As befor|
|00002f80| 65 2c 20 74 68 65 20 75 | 73 65 20 6f 66 20 45 46 |e, the u|se of EF|
|00002f90| 4d 20 70 72 6f 76 65 64 | 20 74 6f 20 62 65 20 61 |M proved| to be a|
|00002fa0| 73 73 6f 63 69 61 74 65 | 64 20 77 69 74 68 20 61 |ssociate|d with a|
|00002fb0| 6e 0d 0a 69 6e 63 72 65 | 61 73 65 64 20 72 69 73 |n..incre|ased ris|
|00002fc0| 6b 20 6f 66 20 70 72 69 | 6d 61 72 79 20 63 65 73 |k of pri|mary ces|
|00002fd0| 61 72 65 61 6e 20 73 65 | 63 74 69 6f 6e 2c 20 61 |arean se|ction, a|
|00002fe0| 20 35 2d 6d 69 6e 75 74 | 65 20 41 70 67 61 72 20 | 5-minut|e Apgar |
|00002ff0| 73 63 6f 72 65 20 6f 66 | 20 6c 65 73 73 0d 0a 74 |score of| less..t|
|00003000| 68 61 6e 20 35 2c 20 72 | 65 73 70 69 72 61 74 6f |han 5, r|espirato|
|00003010| 72 79 20 64 69 73 74 72 | 65 73 73 20 73 79 6e 64 |ry distr|ess synd|
|00003020| 72 6f 6d 65 2c 20 61 6e | 64 20 6e 65 6f 6e 61 74 |rome, an|d neonat|
|00003030| 61 6c 20 6d 6f 72 74 61 | 6c 69 74 79 2e 20 20 54 |al morta|lity. T|
|00003040| 68 65 20 69 6d 70 6f 72 | 74 61 6e 74 0d 0a 71 75 |he impor|tant..qu|
|00003050| 65 73 74 69 6f 6e 2c 20 | 62 65 63 61 75 73 65 20 |estion, |because |
|00003060| 74 68 65 20 69 6e 63 69 | 64 65 6e 63 65 20 6f 66 |the inci|dence of|
|00003070| 20 45 46 4d 20 69 6e 20 | 74 68 69 73 20 73 75 72 | EFM in |this sur|
|00003080| 76 65 79 20 77 61 73 20 | 61 62 6f 75 74 20 35 30 |vey was |about 50|
|00003090| 25 2c 20 69 73 0d 0a 77 | 68 65 74 68 65 72 20 6d |%, is..w|hether m|
|000030a0| 6f 6e 69 74 6f 72 69 6e | 67 20 6f 72 20 74 68 65 |onitorin|g or the|
|000030b0| 20 69 6e 64 69 63 61 74 | 69 6f 6e 73 20 66 6f 72 | indicat|ions for|
|000030c0| 20 73 65 6c 65 63 74 69 | 76 65 20 6d 6f 6e 69 74 | selecti|ve monit|
|000030d0| 6f 72 69 6e 67 20 77 65 | 72 65 0d 0a 72 65 73 70 |oring we|re..resp|
|000030e0| 6f 6e 73 69 62 6c 65 20 | 66 6f 72 20 74 68 6f 73 |onsible |for thos|
|000030f0| 65 20 72 65 73 75 6c 74 | 73 2e 20 20 4d 75 6c 74 |e result|s. Mult|
|00003100| 69 70 6c 65 20 6c 6f 67 | 69 73 74 69 63 20 72 65 |iple log|istic re|
|00003110| 67 72 65 73 73 69 6f 6e | 20 61 6e 61 6c 79 73 69 |gression| analysi|
|00003120| 73 20 77 61 73 20 75 73 | 65 64 0d 0a 74 6f 20 64 |s was us|ed..to d|
|00003130| 65 61 6c 20 77 69 74 68 | 20 74 68 69 73 20 71 75 |eal with| this qu|
|00003140| 65 73 74 69 6f 6e 2e 20 | 20 4e 6f 74 65 20 74 68 |estion. | Note th|
|00003150| 61 74 20 34 31 25 20 6f | 66 20 74 68 65 20 61 76 |at 41% o|f the av|
|00003160| 61 69 6c 61 62 6c 65 20 | 39 2c 39 34 31 20 63 61 |ailable |9,941 ca|
|00003170| 73 65 73 20 77 65 72 65 | 0d 0a 65 78 63 6c 75 64 |ses were|..exclud|
|00003180| 65 64 20 62 65 63 61 75 | 73 65 20 6f 66 20 6d 69 |ed becau|se of mi|
|00003190| 73 73 69 6e 67 20 65 6c | 65 63 74 72 6f 6e 69 63 |ssing el|ectronic|
|000031a0| 20 6d 6f 6e 69 74 6f 72 | 69 6e 67 20 64 61 74 61 | monitor|ing data|
|000031b0| 2c 20 70 6c 61 6e 6e 65 | 64 20 72 65 70 65 61 74 |, planne|d repeat|
|000031c0| 0d 0a 63 65 73 61 72 65 | 61 6e 20 73 65 63 74 69 |..cesare|an secti|
|000031d0| 6f 6e 2c 20 6d 75 6c 74 | 69 70 6c 65 20 62 69 72 |on, mult|iple bir|
|000031e0| 74 68 73 2c 20 6f 72 20 | 62 69 72 74 68 73 20 6f |ths, or |births o|
|000031f0| 75 74 73 69 64 65 20 74 | 68 65 20 68 6f 73 70 69 |utside t|he hospi|
|00003200| 74 61 6c 2e 0d 0a 20 20 | 20 20 20 49 6e 20 63 61 |tal... | In ca|
|00003210| 73 65 73 20 77 69 74 68 | 20 61 20 68 69 67 68 20 |ses with| a high |
|00003220| 6c 69 6b 65 6c 69 68 6f | 6f 64 20 6f 66 20 63 65 |likeliho|od of ce|
|00003230| 73 61 72 65 61 6e 20 73 | 65 63 74 69 6f 6e 20 28 |sarean s|ection (|
|00003240| 74 6f 74 61 6c 20 70 6c | 61 63 65 6e 74 61 0d 0a |total pl|acenta..|
|00003250| 70 72 65 76 69 61 2c 20 | 74 72 61 6e 73 76 65 72 |previa, |transver|
|00003260| 73 65 20 6c 69 65 2c 20 | 61 62 6e 6f 72 6d 61 6c |se lie, |abnormal|
|00003270| 20 70 65 6c 76 69 73 29 | 20 45 46 4d 20 77 61 73 | pelvis)| EFM was|
|00003280| 2c 20 6f 66 20 63 6f 75 | 72 73 65 2c 20 69 72 72 |, of cou|rse, irr|
|00003290| 65 6c 65 76 61 6e 74 20 | 74 6f 20 74 68 65 0d 0a |elevant |to the..|
|000032a0| 63 65 73 61 72 65 61 6e | 20 73 65 63 74 69 6f 6e |cesarean| section|
|000032b0| 20 69 6e 63 69 64 65 6e | 63 65 2e 20 20 45 78 63 | inciden|ce. Exc|
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|000032d0| 6e 67 20 72 65 6c 61 74 | 69 6f 6e 73 68 69 70 73 |ng relat|ionships|
|000032e0| 2c 20 69 74 20 77 61 73 | 20 6e 6f 74 0d 0a 70 6f |, it was| not..po|
|000032f0| 73 73 69 62 6c 65 20 74 | 6f 20 64 65 6d 6f 6e 73 |ssible t|o demons|
|00003300| 74 72 61 74 65 20 61 20 | 62 65 6e 65 66 69 63 69 |trate a |benefici|
|00003310| 61 6c 20 65 66 66 65 63 | 74 20 6f 66 20 45 46 4d |al effec|t of EFM|
|00003320| 2e 20 20 4f 6e 20 74 68 | 65 20 6f 74 68 65 72 20 |. On th|e other |
|00003330| 68 61 6e 64 2c 0d 0a 62 | 65 63 61 75 73 65 20 6d |hand,..b|ecause m|
|00003340| 6f 6e 69 74 6f 72 65 64 | 20 69 6e 66 61 6e 74 73 |onitored| infants|
|00003350| 20 64 65 6c 69 76 65 72 | 65 64 20 62 79 20 63 65 | deliver|ed by ce|
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|00003370| 61 76 65 20 61 20 68 69 | 67 68 65 72 0d 0a 69 6e |ave a hi|gher..in|
|00003380| 63 69 64 65 6e 63 65 20 | 6f 66 20 6c 6f 77 20 28 |cidence |of low (|
|00003390| 3c 35 29 20 41 70 67 61 | 72 20 73 63 6f 72 65 73 |<5) Apga|r scores|
|000033a0| 20 74 68 61 6e 20 6e 6f | 6e 6d 6f 6e 69 74 6f 72 | than no|nmonitor|
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|000033d0| 74 73 20 73 75 67 67 65 | 73 74 20 74 68 65 20 76 |ts sugge|st the v|
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|000033f0| 70 73 20 69 6e 20 64 65 | 74 65 63 74 69 6e 67 20 |ps in de|tecting |
|00003400| 66 65 74 61 6c 20 64 69 | 73 74 72 65 73 73 20 69 |fetal di|stress i|
|00003410| 6e 20 75 74 65 72 6f 2e | 0d 0a 52 65 6d 65 6d 62 |n utero.|..Rememb|
|00003420| 65 72 20 74 68 61 74 20 | 74 68 65 20 73 6b 69 6c |er that |the skil|
|00003430| 6c 20 69 6e 20 65 76 61 | 6c 75 61 74 69 6e 67 20 |l in eva|luating |
|00003440| 45 46 4d 20 69 73 20 75 | 6e 63 6f 6e 74 72 6f 6c |EFM is u|ncontrol|
|00003450| 6c 65 64 20 68 65 72 65 | 2e 20 20 41 6e 0d 0a 61 |led here|. An..a|
|00003460| 6c 74 65 72 6e 61 74 69 | 76 65 20 65 78 70 6c 61 |lternati|ve expla|
|00003470| 6e 61 74 69 6f 6e 20 74 | 68 61 74 20 63 61 6e 6e |nation t|hat cann|
|00003480| 6f 74 20 62 65 20 72 65 | 66 75 74 65 64 20 69 73 |ot be re|futed is|
|00003490| 20 74 68 61 74 20 6f 62 | 73 74 65 74 72 69 63 69 | that ob|stetrici|
|000034a0| 61 6e 73 20 6d 6f 72 65 | 20 6f 72 0d 0a 6c 65 73 |ans more| or..les|
|000034b0| 73 20 63 6f 72 72 65 63 | 74 6c 79 20 73 69 6e 67 |s correc|tly sing|
|000034c0| 6c 65 20 6f 75 74 20 63 | 61 73 65 73 20 61 74 20 |le out c|ases at |
|000034d0| 69 6e 63 72 65 61 73 65 | 64 20 72 69 73 6b 20 66 |increase|d risk f|
|000034e0| 6f 72 20 65 6c 65 63 74 | 72 6f 6e 69 63 20 6d 6f |or elect|ronic mo|
|000034f0| 6e 69 74 6f 72 69 6e 67 | 0d 0a 61 6e 64 20 64 6f |nitoring|..and do|
|00003500| 20 6e 6f 74 20 6d 6f 6e | 69 74 6f 72 20 6f 74 68 | not mon|itor oth|
|00003510| 65 72 73 2e 20 20 49 6e | 20 67 65 6e 65 72 61 6c |ers. In| general|
|00003520| 2c 20 6e 6f 20 73 75 70 | 70 6f 72 74 20 66 6f 72 |, no sup|port for|
|00003530| 20 6d 6f 6e 69 74 6f 72 | 69 6e 67 20 6c 6f 77 2d | monitor|ing low-|
|00003540| 72 69 73 6b 0d 0a 70 72 | 65 67 6e 61 6e 63 69 65 |risk..pr|egnancie|
|00003550| 73 20 69 73 20 73 65 65 | 6e 20 68 65 72 65 2e 0d |s is see|n here..|
|00003560| 0a 20 20 20 20 20 54 68 | 65 73 65 20 61 72 65 20 |. Th|ese are |
|00003570| 74 68 65 20 70 72 6f 62 | 6c 65 6d 73 20 69 6e 20 |the prob|lems in |
|00003580| 65 76 61 6c 75 61 74 69 | 6e 67 20 69 6e 20 72 65 |evaluati|ng in re|
|00003590| 74 72 6f 73 70 65 63 74 | 20 61 20 76 65 72 79 20 |trospect| a very |
|000035a0| 70 6f 70 75 6c 61 72 2c | 20 77 69 64 65 6c 79 0d |popular,| widely.|
|000035b0| 0a 65 6d 70 6c 6f 79 65 | 64 20 74 65 63 68 6e 69 |.employe|d techni|
|000035c0| 71 75 65 20 6e 6f 74 20 | 73 75 62 6a 65 63 74 65 |que not |subjecte|
|000035d0| 64 20 74 6f 20 63 6f 6e | 74 72 6f 6c 6c 65 64 20 |d to con|trolled |
|000035e0| 74 72 69 61 6c 20 62 65 | 66 6f 72 65 20 69 74 20 |trial be|fore it |
|000035f0| 77 61 73 20 69 6e 74 72 | 6f 64 75 63 65 64 2c 0d |was intr|oduced,.|
|00003600| 0a 61 64 6f 70 74 65 64 | 2c 20 61 6e 64 20 70 72 |.adopted|, and pr|
|00003610| 61 63 74 69 63 65 64 2e | 20 20 54 68 61 74 20 73 |acticed.| That s|
|00003620| 68 6f 75 6c 64 20 62 65 | 20 72 65 6d 65 6d 62 65 |hould be| remembe|
|00003630| 72 65 64 20 69 6e 20 63 | 61 73 65 73 20 6f 66 20 |red in c|ases of |
|00003640| 66 75 74 75 72 65 0d 0a | 74 65 63 68 6e 69 63 61 |future..|technica|
|00003650| 6c 20 69 6e 6e 6f 76 61 | 74 69 6f 6e 73 20 69 6e |l innova|tions in|
|00003660| 20 6f 62 73 74 65 74 72 | 69 63 73 2e 20 20 43 6f | obstetr|ics. Co|
|00003670| 6e 74 72 6f 6c 6c 65 64 | 20 70 72 65 6c 69 6d 69 |ntrolled| prelimi|
|00003680| 6e 61 72 79 20 74 72 69 | 61 6c 73 20 61 72 65 0d |nary tri|als are.|
|00003690| 0a 6e 65 65 64 65 64 2c | 20 6e 6f 74 20 6f 6e 6c |.needed,| not onl|
|000036a0| 79 20 66 6f 72 20 63 6f | 73 74 20 65 66 66 65 63 |y for co|st effec|
|000036b0| 74 69 76 65 6e 65 73 73 | 20 62 75 74 20 61 6c 73 |tiveness| but als|
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|00003a20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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|00003ad0| 20 4a 4d 47 2c 20 48 61 | 73 61 61 72 74 20 54 48 | JMG, Ha|saart TH|
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|00003b00| 73 20 41 50 47 2c 20 64 | 65 20 48 61 61 6e 20 4a |s APG, d|e Haan J|
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|00003b20| 20 4d 61 61 73 74 72 69 | 63 68 74 3b 20 55 6e 69 | Maastri|cht; Uni|
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|00003bc0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00003bd0| 0d 0a 41 62 73 74 72 61 | 63 74 0d 0a 0d 0a 20 20 |..Abstra|ct.... |
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|00004af0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
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