Intrapartum Heart Rate Ambiguity: A Comparison of Cardiotocogram and Abdominal Fetal Electrocardiogram with Maternal Electrocardiogram

Department of Obstetrics and Gynaecology, Faculty of Medicine, Johann Wolfgang Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
Gynecologic and Obstetric Investigation (Impact Factor: 1.25). 01/2013; 75(2). DOI: 10.1159/000345059
Source: PubMed

ABSTRACT Objective/Aims: To investigate the presence of signal ambiguity of intrapartum fetal heart rate (FHR) monitoring during delivery by comparing simultaneous cardiotocogram (CTG), abdominal fetal electrocardiogram (ECG) with continuous maternal ECG. Methods: A total of 144 simultaneous CTG (Corometrics(©) 250 series), abdominal fetal ECG (Monica AN24™) and maternal ECG (Monica AN24™) recordings were evaluated. Main Outcome Measures: When the FHR is within 5 bpm of the maternal heart rate (MHR) acquired from the ECG, it is classified as 'MHR/FHR ambiguity'. Statistical analyses were performed with Fisher's exact test and the Wilcoxon signed-rank test. Results: Comparison of abdominal fetal ECG against CTG demonstrates significantly less 'MHR/FHR ambiguity' in both the first stage (mean 0.70 vs. 1.22%, p < 0.001) and second stage of labour (mean 3.30 vs. 6.20%, p < 0.001). Conclusion: Intrapartum FHR monitoring in daily practice via the CTG modality provides significantly more 'MHR/FHR ambiguity' than abdominal fetal ECG, which also provides additional information on the MHR.

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