Document Detail


Clinical outcomes of high-risk labours monitored using fetal electrocardiography.
MedLine Citation:
PMID:  20126811     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the study was to review clinical and laboratory outcomes of a cohort of fetuses monitored during high-risk labours, simultaneously by fetal electrocardiography (FECG) and routine cardiotocography (CTG). MATERIALS AND METHODS: Eighty-three parturients from the Department of Obstetrics and Gynecology of Medical University were included in the clinical study. Inclusive criteria to the study group were: (i) singleton pregnancy at term (between 37 and 42 weeks' gestation), (ii) longitudinal fetal lying, (iii) more than 2500 g of estimated fetal weight, (iv) meconium-stained liquor, and (v) induction of labour due to fetal indications. Fetal outcome parameters analysed included Apgar scores at 1st, 5th and 10th minute after birth, cord artery acid-base assessment and lactate concentrations analysis. FECG was performed during labour, until the neonate was born, with the use of single spiral scalp electrode connected to the STAN S21 heart monitor. Immediately after delivery, arterial cord blood gas and venous cord blood lactate's concentrations were analysed. RESULTS: The sensitivity (100%), specificity (97%), negative predictive value (NPV) (100%) and positive predictive value (33%) were higher for FECG than for CTG. Moreover, several significant correlations between episodic/baseline T/QRS ratio rises and cord artery acid-base as well as lactate concentrations were demonstrated. CONCLUSIONS: Correlations between episodic/baseline T/QRS ratio rises and fetal outcome parameters indicate that observed changes in FECG reflect neonatal metabolic lactate acidosis. The high sensitivity, specificity and especially very high NPV are proof that FECG serves as a reliable method for electronic fetal monitoring during high-risk labours.
Authors:
Rafal Rzepka; Andrzej Torb?; Sebastian Kwiatkowski; Wojciech Blogowski; Ryszard Czajka
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Annals of the Academy of Medicine, Singapore     Volume:  39     ISSN:  0304-4602     ISO Abbreviation:  Ann. Acad. Med. Singap.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503289     Medline TA:  Ann Acad Med Singapore     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  27-32     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland. rafalrz@sci.pam.szczecin.pl
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MeSH Terms
Descriptor/Qualifier:
Acidosis, Lactic / blood,  diagnosis*
Adult
Apgar Score
Blood Gas Analysis
Cardiotocography*
Electrocardiogram Pattern*
Electrocardiography*
Female
Fetal Blood / chemistry
Humans
Infant, Newborn
Pregnancy
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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