Document Detail


ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study.
MedLine Citation:
PMID:  12572595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the diagnostic power of cardiotocography (CTG) plus the ST interval of the electrocardiogram (ECG) clinical guidelines with combined fetal heart rate and ST waveform analysis of the fetal ECG recorded during labor, to identify an adverse labor outcome (neonatal neurological symptoms and/or metabolic acidosis). STUDY DESIGN: An observational, multicenter study was undertaken in 12 Nordic labor wards. A total of 573 women in labor were monitored using a prototype of the STAN S 21 recorder with fetal ECG data and computerized ST analysis. RESULTS: Fifteen cases of intrapartum fetal hypoxia identified from neurological neonatal symptoms and/or cord artery pH < 7.05 with base deficit in extracellular fluid > 12.0 mmol/l were recorded. All these cases were identified by CTG + ST clinical guidelines. Five developed neonatal symptoms and had ECG abnormalities during the first stage of labor and, of the remaining ten, eight showed ST changes during active pushing in the second stage. Another eight cases had acidemia only and normal neonatal outcome. Seven of these displayed CTG + ST abnormalities. The high sensitivity of CTG + ST to predict fetal acidosis was associated with a marked increase in positive predictive values compared with conventional CTG. CONCLUSION: The STAN clinical guidelines identify fetuses at risk of intrapartum asphyxia.
Authors:
I Amer-Wåhlin; P Bördahl; T Eikeland; C Hellsten; H Norén; T Sörnes; K G Rosén
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
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:  12     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2003-02-07     Completed Date:  2003-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  260-6     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Lund University Hospital, Lund, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Acidosis / congenital,  etiology*
Cardiotocography / instrumentation
Diagnosis, Computer-Assisted / instrumentation
Electrocardiography / instrumentation*
Female
Fetal Blood / chemistry
Fetal Hypoxia / complications,  diagnosis*
Fetal Monitoring / instrumentation*
Heart Rate, Fetal / physiology
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Labor, Obstetric*
Nervous System Diseases / congenital,  etiology*
Observation
Practice Guidelines as Topic*
Predictive Value of Tests
Pregnancy
Pregnancy Outcome

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


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