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Quality and effectiveness of electronic fetal monitoring


Authors: K. Biringer;  J. Danko
Authors place of work: Gynekologicko-pôrodnícka klinika JLF UK a UNM, Martin, prednosta prof. MUDr. J. Danko, CSc.
Published in the journal: Ceska Gynekol 2011; 76(6): 481-484
Category: Original Article

Summary

Objective:
To evaluate effectiveness of electronic fetal monitoring methods during labor.

Design:
A case series study.

Setting:
Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic.

Methods:
We followed 112 fetuses with simultaneous continuous monitoring (cardiotocography (CTG), intrapartal fetal pulse oxymetry (IFPO), and analysis of ST segment in fetal electrocardiogram (STAN)) during labor. We determined the effective time for every diagnostic tool. Statistics: histograms, Kolmogorov-Smirnov test, Spearman’s coefficient; significance (alfa): p<0.05.

Results:
The effective time decreased significantly in a row: CTG > STAN > IFPO (94.8%±15.1% vs. 90.4%±18.3% vs. 87.4%±21.2%). STAN was the most effective tool in the second stage of labor (91.3%±9.4%).

Conclusion:
The most effective fetal monitoring tool is CTG. However STAN is the best diagnostic method in the second stage of labor, because of its bio-signal quality.

Key words:
fetal hypoxia, cardiotocography, pulse oxymetry, STAN, electronic fetal monitoring.


Zdroje

1. Amer-Wahlin, I., Hellsten, C., Norén, H., et al. Cardiotocography only versus cardiotocography plus analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. Lancet, 2001, 358, 9281, p. 534-538.

2. Amer-Wahlin, I., Ingemarsson, I., Marsal, K., et al. Fetal heart rate patterns and ECG ST segment changes preceeding metabolic acidaemia at birth. BJOG, 2005, 112, 2, p. 160-165.

3. Dervaitis, KL., Poole, M., Schmidt, G., et al. ST segment analysis of the fetal electrocardiogram plus electronic fetal heart rate monitoring in labor and its relationship to umbilical cord arterial blood gases. Am J Obstet Gynecol, 2004, 191, 3, p. 879-884.

4. Garite, TJ., Nageotte, MP., Porreco, R., et al. Fetal pulse oximetry (letters to the editor). Obstet Gynecol, 2002, 99, 3, p. 514-515.

5. http://www.answers.com/topic/fetal-monitoring

6. Kűhnert, M., Schmidt, S. Intrapartum management of nonreassuring fetal heart rate patterns: A randomized controlled trial of fetal pulse oximetry. Am J Obst Gynecol, 2004, 191, 6, p. 1989-1995.

7. Kwee, A., van der Hoorn-van den Beld, CW., Veerman, J., et al. STAN S21 fetal heart monitor for fetal surveillance during labor: an observational study in 637 patients. J Matern Fetal Neonatal Med, 2004, 15, 6, p. 400-407.

8. Nellcor-Puritan-Bennett. Fetal Oxygen Sensor FS-14 Series. Fetal Oxygen Sensor Placement Quick Guide. Pleasanton, CA, USA, 1995.

9. Schmidt, S., Koslowski, S., Sierra, F., et al. Clinical usefulness of pulse oximetry in the fetus with non-reassuring heart rate pattern. J Perinatol Med, 2000, 28, 4, p. 298-305.

10. Westerhuis, ME., Kwee, A., van Ginkel, AA., et al. Limitations of ST analysis in clinical practice: three cases of intrapartum metabolic acidosis. BJOG, 2007, 114, 10, p. 1194-1201.

Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Článok vyšiel v časopise

Czech Gynaecology

Číslo 6

2011 Číslo 6
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