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  • Title: Clinical assessment of fetal electrocardiogram monitoring in labour.
    Author: Murphy KW, Russell V, Johnson P, Valente J.
    Journal: Br J Obstet Gynaecol; 1992 Jan; 99(1):32-7. PubMed ID: 1547169.
    Abstract:
    OBJECTIVE: To assess the potential clinical value of fetal electrocardiographic (ECG) monitoring in labour. DESIGN: Descriptive study of the use of ECG waveform analysis during labour and its correlation with other indices of fetal and neonatal well-being. SETTING: Teaching hospital in Oxford. SUBJECTS: 86 high risk pregnancies. MAIN OUTCOME MEASURES: Suitability of ST Segment Analyser (Cinventa, Sweden) for clinical use; relation between the T/QRS ratio during labour (an index of ST segment and T wave elevation) and intrapartum cardiotocography, umbilical artery pH at birth and Apgar scores; T/QRS ratio trends in labour. RESULTS: The system was robust and user-friendly. No statistically significant relation was found between T/QRS ratios in labour and FHR abnormalities in the cardiotocograph. There was a weak relation between T/QRS ratios and umbilical artery acidosis: at a cervical dilatation of 4 cm, the Spearman rank correlation of the mean T/QRS ratio with umbilical artery actual base deficit was r = -0.31, 0.05 greater than P greater than 0.01. The correlation of T/QRS with the umbilical artery pH was not statistically significant, although a trend was present (Spearman rank: r = -0.26, P greater than 0.05). Correlation of the T/QRS ratio with Apgar scores at 1 and at 5 min was not statistically significant. Only 3 of 16 infants with an Apgar score of less than 7 at 1 min had a mean T/QRS ratio above 0.25 at any time during labour. CONCLUSION: Further research is necessary before a decision can be made whether this new method of fetal monitoring should be introduced into clinical practice.
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