Fetal acidosis and hyperkalaemia are associated with a significant leftward shift in the fetal and neonatal cardiac axis.
Leftward fetal cardiac axis shift may reflect acidosis and hyperkalaemia; leaves open its value for intrapartum surveillance.
Summary An analysis of the configuration of the fetal electrocardiogram assessed by recording the ratio of the positive and negative deflections of the QRS complex has been performed in relation to the QRS complex of the neonatal electrocardiogram. Changes in R/S ratios in the fetal electrocardiogram late in labour were significantly related to changes in Lead II of the neonatal electrocardiogram. On the basis of the method described by Larks (1965) the mean cardiac axis of the fetus early in labour was +144.5° and late in labour +143.2°. The mean neonatal cardiac axis recorded within five hours after delivery was +134°. The fetal cardiac axis showed a significant shift to the left in relation to fetal acidosis and hyperkalaemia. Similar changes were seen in the neonatal electrocardiogram in relation to biochemical changes.
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E. M. Symonds (1972) studied this question.
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