Intrapartum non-invasive electrophysiological monitoring: A prospective observational study
| Autor: | Yves Jacquemyn, Guid Oei, Lore Noben, Michelle E.M.H. Westerhuis, Petra C A M Bakker, Bert P J Meershoek, Carlijn Lempersz, Gonnie van Osta, Martine L H Wassen, Rik Vullings, Marcos J. Cuerva |
|---|---|
| Přispěvatelé: | Center for Care & Cure Technology Eindhoven, Signal Processing Systems, Biomedical Diagnostics Lab, Eindhoven MedTech Innovation Center, EAISI High Tech Systems, EAISI Health |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Cardiotocography Cross-sectional study heart rate monitoring labor Fetal Body Mass Index 03 medical and health sciences 0302 clinical medicine Heart Rate Pregnancy Heart rate medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Electrodes 2. Zero hunger 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics Cephalic presentation fetal monitoring Reproducibility of Results Obstetrics and Gynecology Gestational age General Medicine Heart Rate Fetal medicine.disease non-invasive fetal electrocardiography 3. Good health fetus Cross-Sectional Studies Cardiotocography/instrumentation Female Human medicine business Wireless Technology Body mass index |
| Zdroj: | Acta obstetricia et gynecologica Scandinavica Acta Obstetricia et Gynecologica Scandinavica, 99(10), 1387-1395. Wiley-Blackwell |
| ISSN: | 0001-6349 |
| Popis: | Introduction: Doppler ultrasound cardiotocography is a non-invasive alternative that, despite its poor specificity, is often first choice for intrapartum monitoring. Doppler ultrasound suffers from signal loss due to fetal movements and is negatively correlated with maternal body mass index (BMI). Reported accuracy of fetal heart rate monitoring by Doppler ultrasound varies between 10.6 and 14.3 bpm and reliability between 62.4% and 73%. The fetal scalp electrode (FSE) is considered the reference standard for fetal monitoring but can only be applied after membranes have ruptured with sufficient cervical dilatation and is sometimes contra-indicated. A non-invasive alternative that overcomes the shortcomings of Doppler ultrasound, providing reliable information on fetal heart rate, could be the answer. Non-invasive fetal electrocardiography (NI-fECG) uses a wireless electrode patch on the maternal abdomen to obtain both fetal and maternal heart rate signals as well as an electrohysterogram. We aimed to validate a wireless NI-fECG device for intrapartum monitoring in term singleton pregnancies, by comparison with the FSE. Material and methods: We performed a multicenter cross-sectional observational study at labor wards of 6 hospitals located in the Netherlands, Belgium, and Spain. Laboring women with a healthy singleton fetus in cephalic presentation and gestational age between 36 and 42 weeks were included. Participants received an abdominal electrode patch and FSE after written informed consent. Accuracy, reliability, and success rate of fetal heart rate readings were determined, using FSE as reference standard. Analysis was performed for the total population and measurement period as well as separated by labor stage and BMI class (≤30 and >30 kg/m 2). Results: We included a total of 125 women. Simultaneous registrations with NI-fECG and FSE were available in 103 women. Overall accuracy is −1.46 bpm and overall reliability 86.84%. Overall success rate of the NI-fECG is around 90% for the total population as well as for both BMI subgroups. Success rate dropped to 63% during second stage of labor, similar results are found when looking at the separate BMI groups. Conclusions: Performance measures of the NI-fECG device are good in the overall group and the separate BMI groups. Compared with Doppler ultrasound performance measures from the literature, NI-fECG is a more accurate alternative. Especially, when women have a higher BMI, NI-fECG performs well, resembling FSE performance measures. |
| Databáze: | OpenAIRE |
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