Fetal ECG waveform analysis

ROSEN, K

doi:10.1016/s1521-6934(04)00034-3

Cited by 17 publications

(28 citation statements)

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“…Several prospective studies have tested the possibility of using the fetal ECG during labor 11,12 and the CTG plus ST interval of the ECG (CTG + ST) clinical guidelines have been tested in a large randomized trial of 2400 high-risk, term deliveries. In this trial Westgate and collaborators 13 provided evidence of safely reducing 46% of operative interventions and of indicating a decrease in the number of babies born with cord metabolic acidosis.…”

Section: Introductionmentioning

confidence: 99%

ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study

Amer‐Wåhlin

Børdahl²,

Eikeland

et al. 2002

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Introductionmentioning

confidence: 99%

ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study

Amer‐Wåhlin

Børdahl²,

Eikeland

et al. 2002

The Journal of Maternal-Fetal & Neonatal Medicine

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“…However, if an abnormal CTG is present prior to application of STAN ® fetal blood sampling must be performed to ensure the fetus is not hypoxic, as the STAN ® analyser records only changes in the ST segment of the ECG and will not detect an already hypoxic fetus. STAN ® is based upon the idea that the ST waveform reflects the function of the fetal heart muscle in response to the stress of labour (14). An elevation of the ST segment and T wave, quantified by the ratio between the T wave height and the QRS height (T/QRS), identifies the response of fetal heart muscle to hypoxia by a catecholamine surge.…”

Section: Fetal Monitoring In Labourmentioning

confidence: 99%

Obstetrics And Gynaecology

Selby

2006

J R Army Med Corps

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This article outlines some recent advances in both obstetrics and gynaecology. In obstetrics, the new screening tests for Down's syndrome and the introduction of computer analysis of the fetal ECG are discussed. Cervical screening and the role of human papilloma virus detection is examined and advances in the non-surgical management of menorrhaghia and improvements in the management of urinary stress incontinence are also reviewed.

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“…Analysis of the ST waveform in the fetal electrocardiogram (ECG) has been introduced as a complement to cardiotocography (CTG), aiming to reduce unnecessary interventions and the incidence of asphyxia by increasing the specificity in identifying hypoxia 1,2 . The STAN S21 fetal heart monitor (Neoventa Medical, Gothenburg, Sweden) uses computerised ECG analysis to detect ST‐interval changes that may reflect myocardial hypoxia: continuous or episodic rises in T/QRS amplitude ratio or ST segment depressions (‘biphasic ST’) 1 . The current system has been evaluated in three randomised trials, comparing monitoring with CTG and ST analysis with CTG monitoring alone 2–4 .…”

Section: Introductionmentioning

confidence: 99%

Changes in the ST‐interval segment of the fetal electrocardiogram in relation to acid–base status at birth

Melin

Bonnevier

Cardell

et al. 2008

BJOG

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Objective To assess the occurrence of ST-interval segment changes of the fetal electrocardiogram (ECG) and cardiotocographic (CTG) abnormalities preceding acidaemia at birth.Design Case-control study.Setting University hospital labour ward.Sample Newborns with severe cord artery metabolic acidaemia (pH < 7.00 and lactate ‡ 10 mmol/l; n = 24), moderate metabolic acidaemia (pH 7.00-7.09 and lactate ‡ 10; n = 48), acidaemia (pH 7.00-7.09; n = 52), pre-acidaemia (pH 7.10-7.19; n = 265), and controls (pH ‡ 7.20; n = 117).Methods Monitoring traces were assessed blinded to outcome.Main outcome measures CTG and ST changes.Results Any ST event occurred significantly more often among cases with severe (79%) and moderate (75%) metabolic acidaemia than among controls (50%). The difference was restricted to baseline T/QRS rises and to the second stage of labour, during which any event only occurred significantly more often among cases with severe metabolic acidaemia (62%) than among controls (38%). ST events coincided with abnormal CTG patterns in 67, 44, 40, and 28% of cases with severe and moderate metabolic acidaemia, acidaemia, and pre-acidaemia, respectively, and in 12% of controls. ST events with intermediary CTG were similarly frequent in the case groups (0-6%) as in the controls (4%). The ST guidelines stated intervention in 96, 62, 73, and 49% of case groups and 23% of controls.Conclusions Only two of three cases with severe and less than half of cases with moderate metabolic acidaemia were preceded by ST events coinciding with CTG abnormalities. It is therefore important to intervene for long-lasting, rapidly deteriorating or marked (preterminal) CTG abnormalities, also in the absence of ST events.

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Fetal ECG waveform analysis

Cited by 17 publications

References 0 publications

ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study

ST analysis of the fetal electrocardiogram during labor: Nordic observational multicenter study

Obstetrics And Gynaecology

Changes in the ST‐interval segment of the fetal electrocardiogram in relation to acid–base status at birth

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