The Significance of the Foetal Electrocardiogram During Labour with Detailed Report of One Case

The preceding study reported continuous monitoring of the foetal heart rate (FHR) during labour in 86 cases. In 60 cases assessment of the FHR was based upon the foetal electrocardiogram (FECG) recorded by means of a lead from the presenting foetal part after rupture of the membranes. In 31 instances the FECG was of such good quality that the entire ECG complex was recorded distinctly. Of these deliveries 16 were entirely normal, while in 7 the infant was born with the cord around its neck and 8 were complicated by placental dysfunction. The average values for the normal FECG are presented. It is noted that the T wave is negative only in exceptional cases. In one case in which the cord was around the neck there was a period of extrasystoles and in another case transient notching of the initial complex. In placental dysfunction the T waves are usually negative without the infants being at all depressed. One case of severe placental dysfunction is described in detail. The foetus died during labour, and the FHR showed pronounced changes. In the electrocardiogram the T waves grew deep and peaked, and terminally there was a prolonged conduction time and notching of the initial complex. It is concluded that the FECG is a poor indicator of foetal welfare during labour.