Effects of prenatal music stimulation on fetal cardiac state, newborn anthropometric measurements and vital signs of pregnant women: A randomized controlled trial.

BACKGROUND: Music has been used for medicinal purposes throughout history due to its variety of physiological, psychological and social effects. OBJECTIVE: To identify the effects of prenatal music stimulation on the vital signs of pregnant women at full term, on the modification of fetal cardiac status during a fetal monitoring cardiotocograph, and on anthropometric measurements of newborns taken after birth. MATERIAL AND METHOD: A randomized controlled trial was implemented. The four hundred and nine pregnant women coming for routine prenatal care were randomized in the third trimester to receive either music (n = 204) or no music (n = 205) during a fetal monitoring cardiotocograph. All of the pregnant women were evaluated by measuring fetal cardiac status (basal fetal heart rate and fetal reactivity), vital signs before and after a fetal monitoring cardiotocograph (maternal heart rate and systolic and diastolic blood pressure), and anthropometric measurements of the newborns were taken after birth (weight, height, head circumference and chest circumference). RESULTS: The strip charts showed a significantly increased basal fetal heart rate and higher fetal reactivity, with accelerations of fetal heart rate in pregnant women with music stimulation. After the fetal monitoring cardiotocograph, a statistically significant decrease in systolic blood pressure, diastolic blood pressure and heart rate in women receiving music stimulation was observed. CONCLUSION: Music can be used as a tool which improves the vital signs of pregnant women during the third trimester, and can influence the fetus by increasing fetal heart rate and fetal reactivity.

Comparación del método de Johnson-Toshach y la ultrasonografía para estimar el ponderado fetal en gestantes a término asistidas en el Hospital Regional de Cajamarca

Objetivo: Comparar el método de Johnson-Toshach y la ultrasonografía en la estimación del ponderado fetal en gestantes a término. Diseño: Estudio descriptivo, comparativo, prospectivo, longitudinal. Institución: Hospital Regional de Cajamarca, Cajamarca, Perú. Participantes: Gestantes a término. Métodos: A 236 gestantes entre 37 y 41 semanas se midió la altura uterina y según la fórmula de Johnson-Toshach se calculó el ponderado fetal; posteriormente, se realizó una ecografía obstétrica para estimar el ponderado fetal según la fórmula de Hadlock 2. Se esperó un máximo de 48 horas para el parto; luego, se pesó al recién nacido. Se realizó el análisis estadístico en el programa SPSS 19, utilizando las pruebas t student y de McNemar, con un valor p<0,05. Principales medidas de resultados: Peso fetal. Resultados: El promedio del peso fetal estimado por el método de Johnson-Toshach fue más exacto que el calculado por ultrasonografía, con un error relativo de 6,5% versus 8,6% (p=0,001). En fetos macrosómicos, la sensibilidad de la ultrasonografía fue significativamente superior a la del método de Johnson-Toshach (75% versus 62,5%, p=0,013). En fetos con peso normal, el método de Johnson-Toshach fue significativamente más sensible que la ultrasonografía (98% versus 89,3%, p=0,016). En fetos con peso bajo, la ultrasonografía tuvo mejor sensibilidad que el método de Johnson-Toshach (57,8% versus 51,2%), pero la diferencia no fue significativa (p=0,238). Conclusiones: El ponderado fetal estimado por el método de Johnson-Toshach fue más exacto que la ultrasonografía en gestantes entre 37 y 41 semanas de gestación, para fetos con pesos entre 2 501 y 3 999 g.

Objective: To compare Johnson-Toshachs method and ultrasonography in estimating fetal weight in term pregnant women. Design: Descriptive, comparative, prospective, longitudinal study. Institution: Hospital Regional de Cajamarca, Cajamarca, Peru. Participants: Term pregnant women. Methods: Uterine height was measured and fetal weight was estimated by Johnson-Toshachs formula in 236 pregnant women 37-41 weeks. Subsequently, an obstetric ultrasound was performed in the same women to determine the fetal weight according Hadlock´s 2 formula. Delivery was expected within 48 hours; then the weight of the newborn was obtained. Statistical analysis was done using SPSS 19 statistical package, student t and McNemar tests with p<0.05 significance. Main outcome measures: Fetal weight. Results: Fetal weight estimated by Johnson-Toshachs method was more accurate than that calculated by ultrasonography with relative error 6.5% versus 8.6% (p=0.001). Ultrasound sensitivity was significantly better than Johnson-Toshachs method for estimating fetal macrosomia (75% versus 62.5%, p=0.013). Johnson-Toshachs method was significantly more sensitive than ultrasound to detect fetuses with normal weight (98% versus 89.3%, p=0.016). Furthermore ultrasonography showed better sensitivity than Johnson-Toshachs method to detect low birth weight fetuses (57.8% versus 51.2%), but this difference was not significant (p=0.238). Conclusions: Fetal weight estimated by Johnson-Toshachs method was more accurate than ultrasonography in pregnant women between 37 and 41 weeks gestation who carried fetuses between 2 501- 3 999 g.