Evaluation of Fetal Heart Rate Patterns during the Second Stage of Labor through Fetal Oximetry

Salamalekis, E.; Vitoratos, N.; Loghis, C.; Panayotopoulos, N.; Kassanos, Dimitrios; Creatsas, G.

doi:10.1159/000010162

Cited by 9 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More attention could be paid on the acoustics of fetal and maternal sound in the CTG loudspeakers. Maternal pulse oximetry can help to differentiate the risk of confusion; however pulse rate recordings are affected by maternal movement and other factors [2,9]. Our results show that the MHR can be reliably obtained through -abdominal ECG tracing; hence continuous FHR/MHR comparison can be made.…”

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Intrapartum Heart Rate Ambiguity: A Comparison of Cardiotocogram and Abdominal Fetal Electrocardiogram with Maternal Electrocardiogram

Reinhard¹,

Hayes‐Gill²,

Schiermeier³

et al. 2013

Gynecol Obstet Invest

View full text Add to dashboard Cite

Objective/Aims: To investigate the presence of signal ambiguity of intrapartum fetal heart rate (FHR) monitoring during delivery by comparing simultaneous cardiotocogram (CTG), abdominal fetal electrocardiogram (ECG) with continuous maternal ECG. Methods: A total of 144 simultaneous CTG (Corometrics^© 250 series), abdominal fetal ECG (Monica -AN24™) and maternal ECG (Monica AN24™) recordings were evaluated. Main Outcome Measures: When the FHR is within 5 bpm of the maternal heart rate (MHR) acquired from the ECG, it is classified as ‘MHR/FHR ambiguity'. Statistical analyses were performed with Fisher's exact test and the Wilcoxon signed-rank test. Results: Comparison of abdominal fetal ECG against CTG demonstrates significantly less ‘MHR/FHR ambiguity' in both the first stage (mean 0.70 vs. 1.22%, p < 0.001) and second stage of labour (mean 3.30 vs. 6.20%, p < 0.001). Conclusion: Intrapartum FHR monitoring in daily practice via the CTG modality provides significantly more ‘MHR/FHR ambiguity' than abdominal fetal ECG, which also provides additional information on the MHR.

show abstract

Section: Discussionmentioning

confidence: 81%

“…High inter- and intraobserver variability of obstetricians is assumed to be the main cause [9,10,11,12], hence guidelines for interpreting FHR traces have been established and computer-generated evaluation systems have been introduced [13,14,15,16,17]. …”

Section: Introductionmentioning

confidence: 99%

Intrapartum Heart Rate Ambiguity: A Comparison of Cardiotocogram and Abdominal Fetal Electrocardiogram with Maternal Electrocardiogram

Reinhard¹,

Hayes‐Gill²,

Schiermeier³

et al. 2013

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Besides, literature regarding intra partum CTG is much less rich than that about ante partum CTG, mainly due to registration difficulties. Therefore, it is important to try to obtain more reliable and objective methods for CTG interpretation and for neonatal outcome prediction [16,17,[33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Foetal heart rate variability frequency characteristics with respect to uterine contractions

Cesarelli¹,

Romano²,

Ruffo³

et al. 2010

JBiSE

View full text Add to dashboard Cite

Monitoring foetal health is important to appropriately plan pregnancy management and delivery. Cardiotocography (CTG) is one of the most employed diagnostic techniques. Because CTG interpretation still lacks of complete reliability, new methods of interpretation and parameters are necessary to further support physicians' decisions. To this aim, indexes related to variability of foetal heart rate (FHRV) are particularly studied. Frequency components of FHRV and their modifications can be analysed by applying a time-frequency approach, which allows for a distinct understanding of the spectral components related to foetal reactions to internal and external stimuli and their change over time. Being uterine contractions (UC) strong stimuli for the foetus and his autonomic nervous system (ANS), it is worth exploring the FHRV response to UC. This study analysed modifications of FHRV frequency characteristics with respect to 108 UC (relative to 35 healthy foetuses). Results showed a statistically significant (t-test, p < 0.01) power increase of the FHRV in both LF and HF bands in correspondence of the contractions. Moreover, we observed a shift to higher values of the maximum frequency contained in the signal corresponding to the power increase. Such modifications of the FHRV power spectrum can be a sign of ANS reaction and therefore represent additional, objective information about foetal reactivity and health during labour.

show abstract

“…Therefore, it is important to try to obtain more reliable and objective methods for CTG interpretation and for neonatal outcome prediction. For this purpose, several methodologies have been employed (foetal oximetry, computerised systems, umbilical cord blood gas analysis, nonlinear analysis techniques and others [28,34,37,42,54]). …”

Section: Discussionmentioning

confidence: 99%

Foetal heart rate power spectrum response to uterine contraction

et al. 2006

View full text Add to dashboard Cite

Cardiotocography is the most diffused prenatal diagnostic technique in clinical routine. The simultaneous recording of foetal heart rate (FHR) and uterine contractions (UC) provides useful information about foetal well-being during pregnancy and labour. However, foetal electronic monitoring interpretation still lacks reproducibility and objectivity. New methods of interpretation and new parameters can further support physicians' decisions. Besides common time-domain analysis, study of the variability of FHR can potentially reveal autonomic nervous system activity of the foetus. In particular, it is clinically relevant to investigate foetal reactions to UC to diagnose foetal distress early. Uterine contraction being a strong stimulus for the foetus and its autonomic nervous system, it is worth exploring the FHR variability response. This study aims to analyse modifications of the power spectrum of FHR variability corresponding to UC. Cardiotocographic signal tracts corresponding to 127 UC relative to 30 healthy foetuses were analysed. Results mainly show a general, statistically significant (t test, p<0.01) power increase of the FHR variability in the LF 0.03-0.2 Hz and HF 0.2-1 in correspondence of the contraction with respect to a reference tract set before contraction onset. Time evolution of the power within these bands was computed by means of time-varying spectral estimation to concisely show the FHR response along a uterine contraction. A synchronised grand average of these responses was also computed to verify repeatability, using the contraction apex as time reference. Such modifications of the foetal HRV that follow a contraction can be a sign of ANS reaction and, therefore, additional, objective information about foetal reactivity during labour.

show abstract

Evaluation of Fetal Heart Rate Patterns during the Second Stage of Labor through Fetal Oximetry

Cited by 9 publications

References 11 publications

Intrapartum Heart Rate Ambiguity: A Comparison of Cardiotocogram and Abdominal Fetal Electrocardiogram with Maternal Electrocardiogram

Intrapartum Heart Rate Ambiguity: A Comparison of Cardiotocogram and Abdominal Fetal Electrocardiogram with Maternal Electrocardiogram

Foetal heart rate variability frequency characteristics with respect to uterine contractions

Foetal heart rate power spectrum response to uterine contraction

Contact Info

Product

Resources

About