{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:14:50Z","timestamp":1773252890516,"version":"3.50.1"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>\n            Objectives\u2003The aim of the study is to evaluate how current management of Category II fetal heart rate tracings compares with that suggested by a published algorithm and whether these differences lead to disparate neonatal outcomes.<\/jats:p><jats:p>\n            Study Design\u2003This is a retrospective observational study from the resident service at an academic-community tertiary care center from 2013 to 2018. We reviewed archived fetal heart rate tracings from patients with cesarean delivery performed for nonreassuring fetal heart rate tracing and interpreted tracings against the algorithm. We assigned tracings to one of three categories: Group A\u2014consistent; Group B\u2014inconsistent too early (algorithm permits the patient to labor longer); Group C\u2014inconsistent too late (algorithm suggests performing the cesarean delivery sooner). Maternal demographics, features of labor, and neonatal outcomes were compared.<\/jats:p><jats:p>\n            Results\u2003Of the 110 cases, 27 (24.5%) had a cesarean delivery performed in group A, 49 (44.5%) in group B, and 34 (30.9%) in group C. Baseline characteristics were similar. Of the 49 in group B, 46 (93.9%) violated the algorithm at the same branchpoint. In group C, cesarean deliveries would have been performed on average 244\u2009minutes earlier had the algorithm been used. Neonatal outcomes were not significantly different among the groups, including 5-minute Apgar &lt;7, pH &lt;7.1, and NICU admit.<\/jats:p><jats:p>\n            Conclusion\u2003Our retrospective application of the algorithm showed that 44.5% of patients who have cesarean delivery for nonreassuring fetal heart rate tracing may be able to labor longer and that violation at a common decision point on the algorithm (moderate variability or accelerations, but a lack of recurrent decelerations) is responsible for nearly all such cesarean deliveries. More studies are needed to evaluate if cesarean delivery rates for nonreassuring fetal heart rate tracing can be reduced without impacting neonatal outcomes using the algorithm.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1739412","type":"journal-article","created":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T23:31:51Z","timestamp":1638142311000},"page":"342-348","source":"Crossref","is-referenced-by-count":2,"title":["Application of a Proposed Algorithm to Cesarean Deliveries for Nonreassuring Fetal Heart Rate Tracing"],"prefix":"10.1055","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6390-5315","authenticated-orcid":false,"given":"Dana Senderoff","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7918-197X","authenticated-orcid":false,"given":"Adam","family":"Crosland","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Bosse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Makhoul","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Long Beach Memorial Miller Children's and Women's Hospital, Long Beach, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily L.","family":"Seet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Long Beach Memorial Miller Children's and Women's Hospital, Long Beach, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0b013e31821e5f65","article-title":"Indications contributing to the increasing cesarean delivery rate","volume":"118","author":"E L Barber","year":"2011","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1097\/AOG.0b013e3181841395","article-title":"The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines","volume":"112","author":"G A Macones","year":"2008","journal-title":"Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/AOG.0b013e3181aef106","article-title":"Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. 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Electronic fetal heart rate monitoring: research guidelines for interpretation","volume":"177","year":"1997","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"e20152872","DOI":"10.1542\/peds.2015-2872","article-title":"Birth prevalence of cerebral palsy: a population-based study","volume":"137","author":"K Van Naarden Braun","year":"2016","journal-title":"Pediatrics"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"523.e1","DOI":"10.1016\/j.ajog.2018.01.026","article-title":"A prospective cohort study of fetal heart rate monitoring: deceleration area is predictive of fetal acidemia","volume":"218","author":"A G Cahill","year":"2018","journal-title":"Am J Obstet Gynecol"},{"issue":"14","key":"ref12","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1055\/s-0038-1660459","article-title":"A standardized approach for category II fetal heart rate with significant decelerations: maternal and neonatal outcomes","volume":"35","author":"L E Shields","year":"2018","journal-title":"Am J Perinatol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1739412.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:50:37Z","timestamp":1645836637000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1739412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,28]]},"references-count":12,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,2,25]]},"published-print":{"date-parts":[[2022,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1739412","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,28]]}}}