Feasibility of antenatal ambulatory fetal electrocardiography: a systematic review

Liu, Becky; Ridder, Anna; Smith, Vinayak; Thilaganathan, B.; Bhide, A.

doi:10.1080/14767058.2023.2204390

Cited by 7 publications

(9 citation statements)

References 30 publications

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“…There are a multitude of factors that affect this phenomenon, and one of the larger studies observing the use of NIFECG in the antenatal period confirmed that signal loss is associated with gestation. 66,67 This study reports the relationship of gestation and signal loss as linear; however, other studies have shown that although there is a good level of signal acquisition toward the end of the second trimester, the principal time of signal loss is 26-34 weeks of gestation. This coincides with the presence of the vernix caseosa, which is hypothesized to decrease signal conductance.…”

Section: Signal Lossmentioning

confidence: 89%

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Antenatal Noninvasive Fetal Electrocardiography: A Literature Review

Pegorie,

Liu,

Thilaganathan

et al. 2024

Maternal Fetal Med

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Fetal heart rate (FHR) monitoring is one of the central parts of obstetric care. Ultrasound-based technologies such as cardiotocography (CTG) remain the most common method for FHR monitoring. The CTG’s limitations, including subjective interpretation, high interobserver variability, and the need for skilled professionals, led to the development of computerized CTG (cCTG). While cCTG demonstrated advantages, its superiority over visual interpretation remains inconclusive. This has prompted the exploration of alternatives like noninvasive fetal electrocardiography (NIFECG). This review explores the landscape of antenatal FHR monitoring and the need for remote FHR monitoring in a patient-centered care model. Additionally, FHR monitoring needs to evolve from the traditional approach to incorporate artificial intelligence and machine learning. The review underscores the importance of aligning fetal monitoring with modern healthcare, leveraging artificial intelligence algorithms for accurate assessments, and enhancing patient engagement. The physiology of FHR variability (FHRV) is explained emphasizing its significance in assessing fetal well-being. Other measures of FHRV and their relevance are described. It delves into the promising realm of NIFECG, detailing its history and recent technological advancements. The potential advantages of NIFECG are objective FHR assessment, beat-to-beat variability, patient comfort, remote prolonged use, and less signal loss with increased maternal body mass index. Despite its promise, challenges such as signal loss must be addressed. The clinical application of NIFECG, its correlation with cCTG measures, and ongoing technological advancements are discussed. In conclusion, this review explores the evolution of antenatal FHR monitoring, emphasizing the potential of NIFECG in providing reliable, home-based monitoring solutions. Future research directions are outlined, urging longitudinal studies and evidence generation to establish NIFECG’s role in enhancing fetal well-being assessments during pregnancy.

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Section: Signal Lossmentioning

confidence: 89%

“…64,65 A systematic review of women using NIFECG and CTG in labor or antenatally suggests that fetal monitoring with NIFECG could be more acceptable to women for long periods of monitoring such as during induction. 66…”

Section: Potential For Remote Monitoringmentioning

confidence: 99%

Antenatal Noninvasive Fetal Electrocardiography: A Literature Review

Pegorie,

Liu,

Thilaganathan

et al. 2024

Maternal Fetal Med

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“…A pressure transducer evaluates fetal movement, and a Doppler transducer monitors fetal heart rates. The Monica AN24 is a portable device for monitoring fetal heart rate and uterine activity; it has the highest signal success in the second trimester and lowest in the early third trimester [ 114 ]. This technology is also being used to measure fetal cardiac time intervals with variable success [ 115 ].…”

Section: Diagnostic Toolsmentioning

confidence: 99%

Diagnosis and Management of Fetal Arrhythmias in the Current Era

Killen,

Strasburger

2024

JCDD

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Diagnosis and management of fetal arrhythmias have changed over the past 40–50 years since propranolol was first used to treat fetal tachycardia in 1975 and when first attempts were made at in utero pacing for complete heart block in 1986. Ongoing clinical trials, including the FAST therapy trial for fetal tachycardia and the STOP-BLOQ trial for anti-Ro-mediated fetal heart block, are working to improve diagnosis and management of fetal arrhythmias for both mother and fetus. We are also learning more about how “silent arrhythmias”, like long QT syndrome and other inherited channelopathies, may be identified by recognizing “subtle” abnormalities in fetal heart rate, and while echocardiography yet remains the primary tool for diagnosing fetal arrhythmias, research efforts continue to advance the clinical envelope for fetal electrocardiography and fetal magnetocardiography. Pharmacologic management of fetal arrhythmias remains one of the most successful achievements of fetal intervention. Patience, vigilance, and multidisciplinary collaboration are key to successful diagnosis and treatment.

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“…Відомо, що STV і LTV є критеріями вивчення функціонального стану плода за шкалою Dawes-Redman. Значне зниження STV є характерним для дистресу плода [22]. Тому можна вважати це показником погіршення стану плода у пацієнток ІІ групи.…”

Section: результати дослідження та їх обговоренняunclassified

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Lakhno,

Martynenko,

Raimondi

et al. 2023

RHW

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Fetal growth retardation (FGR) is one of the most serious problems in current perinatology. This pathology leads not only to the deterioration of perinatal outcomes but also significantly increases morbidity during adult life. FGR is known to be featured by its delayed “neurological maturation”. This is manifested in a decrease in autonomic nervous regulation according to the fetal heart rate variability (HRV) scores and indices. The objective: to study HRV in fetuses with normal biometric indices compared to similar parameters of growth retarded fetuses. Materials and methods. The 47 pregnant women who had fetuses with normal biometric indices (I group) and 33 patients with fetal growth retardation (II group) were included in the study. The investigation of the fetal HRV was performed by processing the R–R intervals obtained via non-invasive electrocardiogram (ECG) and involved the following indices: STV (short term variations), LTV (long term variations), AC/DC (acceleration capacity/deceleration capacity), TP (total power), SI (stress index), SDNN (standard deviation of normal to normal intervals), EnRE (entropy of the time series), D2 (correlation dimension of the time series), Z (temporary irreversibility) і FL (measure of fuzzy logic, integrated measure of HRV). Results. The obtained data indicated that the indices of fetal HRV were reduced in the patients with FGR. These indices have utility in screening programs for the detection of fetal intrauterine nutrition and growth disturbances. The results of the study allow us to believe that the ability to accelerate heart rate patterns is partly preserved even during FGR. This may indicate a very ancient phylogenetic nature of the reaction of the heart system of the fetus to its motile activity. However, decelerations according to the DC were typical for FGR. A non-invasive fetal ECG could become a useful supplementary method in the current methods’ spectrum used in perinatal medicine. Conclusions. Therefore, the development of algorithms for the diagnosis of FGR requires the inclusion of the following HRV indices: STV, LTV, DC, TP, SI, SDNN, D2, Z, and FL. These biophysical markers of FGR can be used as a screening program in conditions of lack of access to high-quality ultrasound diagnostics or be a valuable addition to existing perinatal strategies.

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Feasibility of antenatal ambulatory fetal electrocardiography: a systematic review

Cited by 7 publications

References 30 publications

Antenatal Noninvasive Fetal Electrocardiography: A Literature Review

Antenatal Noninvasive Fetal Electrocardiography: A Literature Review

Diagnosis and Management of Fetal Arrhythmias in the Current Era

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

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