Document Detail


Continuous fetal heart rate monitoring in patients with preterm premature rupture of membranes undergoing expectant management.
MedLine Citation:
PMID:  19488937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Continuous fetal heart rate (FHR) monitoring is considered by some as necessary to the expectant management of patients with preterm premature rupture of membranes (PPROM). No data exist to support this premise, and liability may be incurred if such an order cannot be practically carried out. The purpose of our study is to evaluate the performance of prolonged FHR monitoring in terms of the completeness of recorded tracings. METHODS: A retrospective cohort study was performed between 2004 and 2006 in a tertiary care hospital on patients being expectantly managed with PPROM at 24-34 weeks of gestation. Forty-seven singleton gravidas with a physician order of continuous external FHR monitoring were included. Exclusion criteria were evidence of labour, chorioamnionitis or FHR abnormalities that prompted delivery. FHR tracings during the prolonged monitoring period were reviewed. RESULTS: The study cohort was monitored for a duration of 321-2272 min (mean 970 min). In total, 28.3% (95% confidence interval 23.8-33%) of the tracing did not show a legible recording. Gestational age is negatively correlated with the proportion of absent tracing, whereas body mass index is positively correlated. There is no significant difference in the absent signal proportion between the first half of the monitoring period and the second half or between day and night. CONCLUSIONS: In patients with PPROM being expectantly managed, a significant proportion (28.3%) of the FHR tracing was not recorded as ordered. This suggests that 'continuous' prolonged external fetal monitoring may not be practically feasible and alternative monitoring approaches should be considered.
Authors:
Yi Li; Bernard Gonik
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  22     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  589-92     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Civista Medical Center, Waldorf, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Circadian Rhythm / physiology
Cohort Studies
Female
Fetal Membranes, Premature Rupture / diagnosis*,  therapy*
Gestational Age
Heart Rate, Fetal / physiology*
Humans
Monitoring, Physiologic / methods*
Pregnancy
Retrospective Studies
Ultrasonography, Prenatal / methods
Young Adult

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