| Non-invasive fetal electrocardiography in singleton and multiple pregnancies. | |
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MedLine Citation:
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PMID: 12842058 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To document the duration of fetal cardiac time intervals in uncomplicated singleton pregnancies using a novel non-invasive fetal electrocardiography (fECG) system and to demonstrate this technique's ability to acquire recordings in twin and triplet pregnancies. DESIGN: Prospective cross sectional observational study. SETTING: Antenatal wards and clinics, day assessment unit and centre for fetal care at a tertiary referral hospital, London, UK. POPULATION OR SAMPLE: Three hundred and four singleton and multiple pregnancies, 15-41 weeks of gestation. METHODS: Using electrodes sited on the maternal abdomen, a fetal electrocardiography (fECG) system was developed and tested on 304 pregnant women from 15 to 41 weeks of gestation, of whom 241 were uncomplicated singletons, 58 had twin and 5 had triplet pregnancies. The composite abdominal signals were stored on a laptop computer and the fECG derived off-line using a digital signal processing technique. For singletons, linear regression was used to analyse PR, QRS, QT and QTc intervals, and construct time-specific reference ranges. MAIN OUTCOME MEASURE: Duration of fECG time intervals as a function of gestational age. Success of signal separation in singleton, twin and triplet pregnancies. RESULTS: For singletons, a total of 250 recordings was obtained from 241 individuals with a signal separation success rate of 85% (213/250). Success rates were significantly poorer between 27 and 36 weeks of gestation (2 x k chi(2), P < 0.0001), with 84% (31/37) of separation failures occurring during this period. P, Q, R and S waves were seen in all cases where fetal signals were separated and were used to generate fECG time interval reference ranges. In 22% (43/199) of analysed cases, no T waves were identified, 63% (27/43) of whom were < or =24 weeks of gestation. In twins and triplets, separate fetal signals were obtained in 78% (91/116) and 93% (14/15), respectively; P, Q, R and S waves were evident in all averaged fECGs, while T waves were identified in 59% (54/91) and 57% (8/14). CONCLUSIONS: This study provides reference ranges with gestation for fECG intervals derived non-invasively from normal singleton pregnancies and demonstrates the feasibility of obtaining complete fECG recordings non-invasively across a wide gestational range in pregnancies of all pluralities. The fECG time intervals described will enable the identification of pathological fECG recordings from high risk pregnancies where fECG abnormalities are suspected. |
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Authors:
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Myles J O Taylor; Mark J Smith; Matthew Thomas; Andrew R Green; Floria Cheng; Salome Oseku-Afful; Ling Y Wee; Nicholas M Fisk; Helena M Gardiner |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 110 ISSN: 1470-0328 ISO Abbreviation: BJOG Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-07-04 Completed Date: 2003-08-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 668-78 Citation Subset: AIM; IM |
Affiliation:
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Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, and Institute of Reproductive and Developmental Biology, Imperial College, London, UK. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiotocography Cross-Sectional Studies Electrocardiography / methods* Female Gestational Age Heart Rate, Fetal / physiology* Humans Pregnancy Pregnancy, Multiple / physiology* Prospective Studies Reference Values Sensitivity and Specificity Triplets Twins |
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