Z Geburtshilfe Neonatol 2011; 215 - PO05_07
DOI: 10.1055/s-0031-1293356

Intrapartum Fetal and Maternal Heart Rate Ambiguity – Doppler Ultrasound CTG and the Abdominal Fetal Electrocardiogram with Maternal Electrocardiogram

J Reinhard 1, BR Hayes-Gill 2, S Schiermeier 3, W Hatzmann 3, TM Heinrich 1, F Louwen 1
  • 1Klinik für Frauenheilkunde und Geburtshilfe, Johann Wolfgang Goethe-Universitätsklinikum, Frankfurt, Deutschland
  • 2Department of Electrical and Electronic Engineering, Faculty of Engineering, Nottingham, England
  • 3Marien-Hospital Witten, Lehrkrankenhaus der Ruhr-Universität Bochum, Witten

Objective: To investigate the presence of signal ambiguity of intrapartum fetal heart rate (FHR) monitoring during delivery using simultaneous Doppler Ultrasound CTG and abdominal fetal and maternal electrocardiogram.

Design: Prospective observational study.SETTING: Obstetric unit of a tertiary-care teaching hospital.SAMPLE: One hundred and forty-four FHR recordings during labour and delivery. Methods: Simultaneous Doppler Ultrasound CTG, abdominal fetal and maternal electrocardiogram recordings were evaluated.MAIN OUTCOME MEASURES: When the FHR is within 5 bpm of the maternal heart rate (MHR) acquired from the abdominal ECG it is classified as “Possible MHR/FHR ambiguity” and checked with the other surveillance modality. Statistical analyses were performed with the Fisher’s exact and the Wilcoxon signed rank tests.

Results: Comparison of abdominal fetal ECG against Doppler ultrasound CTG demonstrates significantly less “Possible MHR/FHR ambiguity” in both the first stage (mean 0.70% versus 1.22%, p < 0.001) and 2nd stage of labour (mean 3.30% versus 6.20%, p < 0.001).

Conclusion: Intrapartum FHR monitoring in daily practice via the Doppler ultrasound CTG modality provides significantly more “MHR/FHR ambiguity” than abdominal fetal ECG, which also provides additional information on the MHR.

fetal heart monitoring - fetal heart rate (FHR) - maternal and fetal electrocardiogram (ECG) - maternal heart rate (MHR) - signal ambiguity and confusion