Use of fetal electrocardiogram for intrapartum monitoring.
نویسندگان
چکیده
INTRODUCTION Intrapartum fetal monitoring is essential for the identification of fetal hypoxia to reduce perinatal morbidity and mortality. Cardiotocography is associated with low specificity for fetal acidosis and poor perinatal outcome leading to unnecessary operative deliveries. ST waveform analysis of the fetal electrocardiogram has been shown to be a promising adjunctive intrapartum assessment tool. We aim to present the pathophysiology, the role of intrapartum monitoring and the practical usage of this relatively new technology in our review. METHODS An electronic search of Medline and OVID was carried out, followed by a manual search of the references identified by the electronic search. RESULTS The incorporation of ST waveform analysis to cardiotocography has been shown to reduce the rates of neonatal metabolic acidosis, moderate and severe neonatal encephalopathy, thus improving perinatal outcome. The reduction in operative delivery rates due to fetal distress is also significant. The pathophysiology and practical usage of this technology were discussed. CONCLUSIONS With more accurate identification of fetal hypoxia and reduction of unnecessary intervention rates, incorporation of ST waveform analysis of fetal electrocardiography into cardiotocography can improve the standard of intrapartum fetal monitoring.
منابع مشابه
Intrapartum heart rate ambiguity: a comparison of cardiotocogram and abdominal fetal electrocardiogram with maternal electrocardiogram.
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...
متن کاملIntrapartum fetal surveillance.
Intrapartum hypoxia was thought to contribute to the incidence of cerebral palsy, seizures and mental retardation. Electronic fetal monitoring was expected to prevent or reduce this incidence. Electronic fetal monitoring has a high false positive rate and fetal blood sampling, which is an invasive procedure, only allows an intermittent assessment. Efforts are being made to improve fetal heart r...
متن کاملIntrapartum monitoring of high-risk deliveries with ST analysis of the fetal electrocardiogram: an observational study of 6010 deliveries.
OBJECTIVE To evaluate the clinical use of ST analysis (STAN) for intrapartum monitoring of high-risk pregnancies. DESIGN Prospective observational study. SETTING University hospital, Norway, 2004-2008. POPULATION Singleton pregnancies with a gestational age above 35(+6) weeks. METHODS Analysis of maternal and neonatal outcomes for all deliveries according to the method of intrapartum mo...
متن کاملFetal electrocardiogram: ST waveform analysis in intrapartum surveillance
ST waveform analysis of fetal electrocardiogram (ECG) for intrapartum surveillance (STAN) is a newly introduced method for fetal surveillance. The purpose of this commentary is to assist in the proper use of fetal ECG in combination with cardiotocography (CTG) during labour. Guidelines and recommendations concerning CTG and ST waveform interpretation and classification are stated that were agre...
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BACKGROUND Previous studies indicate that analysis of the ST waveform of the fetal electrocardiogram provides information on the fetal response to hypoxia. We did a multicentre randomised controlled trial to test the hypothesis that intrapartum monitoring with cardiotocography combined with automatic ST-waveform analysis results in an improved perinatal outcome compared with cardiotocography al...
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ورودعنوان ژورنال:
- Annals of the Academy of Medicine, Singapore
دوره 36 6 شماره
صفحات -
تاریخ انتشار 2007