Key result
Non-invasive fetal electrocardiography demonstrated a 95.7% reliability and an accuracy of 3.2 bpm for intrapartum fetal heart rate monitoring compared to invasive fetal scalp electrodes.
Why the study?
Current cardiotocography relies on invasive scalp electrodes, which carry risks and limitations, or Doppler ultrasound, which is inaccurate and suffers from signal loss.
Does non-invasive fetal electrocardiography accurately detect fetal heart rate compared to invasive scalp electrodes during intrapartum monitoring?
Observational (n=136)
No
Does non-invasive fetal electrocardiography accurately detect fetal heart rate compared to invasive scalp electrodes during intrapartum monitoring?
Transabdominal fetal electrocardiography is being evaluated as a potentially more reliable, non-invasive alternative to Doppler ultrasound and invasive scalp electrodes for intrapartum fetal heart rate monitoring.
Answers are grounded in this paper and cite their sources.
Offers reliable non-invasive fetal monitoring option; leaves open routine adoption pending larger validation studies.
Fetal monitoring is important to diagnose complications that can occur during pregnancy. If detected timely, these complications might be resolved before they lead to irreversible damage. Current fetal monitoring mainly relies on cardiotocography, the simultaneous registration of fetal heart rate and uterine activity. Unfortunately, the technology to obtain the cardiotocogram has limitations. In current clinical practice the fetal heart rate is obtained via either an invasive scalp electrode, that poses risks and can only be applied during labor and after rupture of the fetal membranes, or via non-invasive Doppler ultrasound technology that is inaccurate and suffers from loss of signal, in particular in women with high body mass, during motion, or in preterm pregnancies. In this study, transabdominal electrophysiological measurements are exploited to provide fetal heart rate non-invasively and in a more reliable manner than Doppler ultrasound. The performance of the fetal heart rate detection is determined by comparing the fetal heart rate to that obtained with an invasive scalp electrode during intrapartum monitoring. The performance is gauged by comparing it to performances mentioned in literature on Doppler ultrasound and on two commercially-available devices that are also based on transabdominal fetal electrocardiography.
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Vullings et al. (2020) conducted an observational in Intrapartum fetal monitoring (n=136). Non-invasive fetal electrocardiography vs. Fetal scalp electrode (FSE) was evaluated on Reliability (positive percent agreement within 10% of FSE) (95% CI 95.3-96.0). Non-invasive fetal electrocardiography demonstrated a 95.7% reliability and an accuracy of 3.2 bpm for intrapartum fetal heart rate monitoring compared to invasive fetal scalp electrodes.
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