Electronic Fetal Monitoring of the Preterm Fetus

Baird, Suzanne McMurtry; Ruth, Donna Jean

doi:10.1097/00005237-200206000-00004

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…As gestational age progresses, maturation of the parasympathetic nervous system leads to a decrease in baseline FHR, although it generally remains within the normal range of 110 to 160 bpm. In preterm fetuses, baseline FHR is close to the generally accepted upper limit of normality, and as noted, decreases as gestation proceeds [ 9 ]. Shuffrey et al [ 10 ] published the largest longitudinal study carried out to date to analyze changes in FHR, variability, and fetal body movements throughout gestation in healthy fetuses.…”

Section: Resultsmentioning

confidence: 86%

Characteristics of Heart Rate Tracings in Preterm Fetus

et al. 2021

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Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM). The aims of this narrative review were to summarize the most relevant concepts in the field of CTG interpretation in preterm fetuses, and to provide a practical approach that can be useful in clinical practice. Materials and Methods: A MEDLINE search was carried out, and the published articles thus identified were reviewed. Results: Compared to term fetuses, preterm fetuses have a slightly higher baseline FHR. Heart rate is faster in more immature fetuses, and variability is lower and increases in more mature fetuses. Transitory, low-amplitude decelerations are more frequent during the second trimester. Transitory increases in FHR are less frequent and become more frequent and increase in amplitude as gestational age increases. Conclusions: The main characteristics of FHR tracings changes as gestation proceeds, and it is of fundamental importance to be aware of these changes in order to correctly interpret CTG patterns in preterm fetuses.

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Section: Resultsmentioning

confidence: 86%

Characteristics of Heart Rate Tracings in Preterm Fetus

et al. 2021

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“…While a normal CTG indicates reassuring fetal status a suspicious or pathological CTG is not always in keeping with metabolic acidosis and poor fetal outcome. The poor-positive predictive value of CTG in addition to variation in CTG interpretation can often lead to unnecessary intervention and high-operative delivery rates [11]. …”

Section: Role Of Additional Tests Of Fetal Wellbeing In Monitoringmentioning

confidence: 99%

Use of Continuous Electronic Fetal Monitoring in a Preterm Fetus: Clinical Dilemmas and Recommendations for Practice

Afors

Chandraharan

2011

Journal of Pregnancy

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The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. Although, National Guidelines on electronic fetal monitoring exist for term fetuses, there is paucity of recommendations based on scientific evidence for monitoring preterm fetuses during labour. Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. 93% of these preterm births occur after 28 weeks, 6% between 22–27 weeks, and 1% before 22 weeks. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. This review describes the features of normal fetal heart rate patterns at different gestations and the physiological responses of a preterm fetus compared to a fetus at term. We have proposed an algorithm “ACUTE” to aid management.

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“…While previous research has focused on fetal electronic monitoring in the term fetus, much less is known about the interpretation of the preterm fetus (15). In order to improve surveillance of the preterm fetus at risk, it would be valuable to know whether FECG analysis earlier in gestation also can identify the compromised fetus, similar to that previously demonstrated in more mature fetuses.…”

mentioning

confidence: 99%

Electrocardiographic changes following umbilical cord occlusion in the midgestation fetal sheep

Welin¹,

Blad²,

Hagberg³

et al. 2005

Acta Obstetricia Et Gynecologica Scandinavica

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These studies show that the midgestation fetal sheep has the capacity to react to umbilical cord occlusion with a significant increase in the amplitude of the ST waveform together with an augmentation of blood pressure, which then subsides as the occlusion continues. The appearance of negative ST segment appears to signify significant cardiac dysfunction. The characteristic progression of ST-waveform changes in response to umbilical cord occlusion in midgestation fetal sheep, suggests that monitoring the ST waveform may contribute clinically important information also in the preterm individual.

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Electronic Fetal Monitoring of the Preterm Fetus

Cited by 5 publications

References 22 publications

Characteristics of Heart Rate Tracings in Preterm Fetus

Characteristics of Heart Rate Tracings in Preterm Fetus

Use of Continuous Electronic Fetal Monitoring in a Preterm Fetus: Clinical Dilemmas and Recommendations for Practice

Electrocardiographic changes following umbilical cord occlusion in the midgestation fetal sheep

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