Why the study?
Does fetal ECG ST waveform monitoring correlate with conventional signs of fetal distress and cord plasma lactate during labour?
Does fetal ECG ST waveform monitoring correlate with conventional signs of fetal distress and cord plasma lactate during labour?
Fetal ECG ST waveform changes (T/QRS ratio) correlate with CTG changes and cord plasma lactate values during labour, suggesting potential utility for fetal surveillance.
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Supports adjunctive fetal ST analysis evaluation; leaves open whether it improves neonatal outcomes over CTG alone.
Waveform changes in the fetal electrocardiogram (ECG) are under reassessment as a means of fetal surveillance. The purpose of the study was to identify ST waveform changes from the fetal scalp lead during labour and to compare any change with conventional signs of fetal distress. Two scalp electrodes provided a sufficiently stable signal from which ST waveform changes could be identified and measured as the T/QRS ratio. No infant was clinically hypoxic. Only 26% of the 46 patients studied had a continuously normal CTG whereas 67% had no ST waveform abnormalities. A relation was found between the two variables as the mean T/QRS ratio increased from 0.20 (SD 0.11) during epochs of normal CTG to 0.27 (SD 0.17) with CTG changes. A linear correlation (r = 0.58, P less than 0.01) was found between the T/QRS ratio before birth and the cord plasma lactate values.
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Lilja et al. (1985) studied this question.
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