Document Detail


Accuracy and reliability of fetal heart rate monitoring using maternal abdominal surface electrodes.
MedLine Citation:
PMID:  22924738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Compare the accuracy and reliability of fetal heart rate identification from maternal abdominal fetal electrocardiogram signals (ECG) and Doppler ultrasound with a fetal scalp electrode.
DESIGN: Prospective open method equivalence study.
SETTING: Three urban teaching hospitals in the Northeast United States.
SAMPLE: 75 women with normal pregnancies in labor at >37 weeks of gestation.
METHODS: Three fetal heart rate detection methods were used simultaneously in 75 parturients. The fetal scalp electrode was the standard against which abdominal fetal ECG and ultrasound were judged.
MAIN OUTCOME MEASURES: The positive percent agreement with the fetal scalp electrode indicated reliability. Bland-Altman analysis determined accuracy. The confusion rate indicated how frequently the devices tracked the maternal heart rate.
RESULTS: Positive percent agreement was 81.7 and 73% for the abdominal fetal ECG and ultrasound, respectively (p = 0.002). The abdominal fetal ECG had a lower root mean square error than ultrasound (5.2 vs. 10.6 bpm, p < 0.001). The confusion rate for ultrasound was 20-fold higher than for abdominal ECG (8.9 vs. 0.4%, respectively, p < 0.001).
CONCLUSION: Compared with the fetal scalp electrode, fetal heart rate detection using abdominal fetal ECG was more reliable and accurate than ultrasound, and abdominal fetal ECG was less likely than ultrasound to display the maternal heart rate in place of the fetal heart rate.
Authors:
Wayne R Cohen; Sophia Ommani; Sarmina Hassan; Fadi G Mirza; Molham Solomon; Raymond Brown; Barry S Schifrin; John M Himsworth; Barrie R Hayes-Gill
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2012-10-19
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  91     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-01-08     Revised Date:  2013-09-09    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1306-13     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Queens Hospital Center, New York, NY, USA. waynercohen@me.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Electrocardiography
Female
Fetal Monitoring / instrumentation,  methods*
Heart Rate, Fetal*
Humans
Pregnancy
Prospective Studies
Reproducibility of Results
Ultrasonography, Doppler
Ultrasonography, Prenatal
Young Adult
Comments/Corrections
Comment In:
Acta Obstet Gynecol Scand. 2013 Aug;92(8):992-3   [PMID:  23682692 ]
Acta Obstet Gynecol Scand. 2013 Aug;92(8):992   [PMID:  23607526 ]

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