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Principles and limits of clinical methods in the diagnosis of fetal hypoxia


Authors: M. Hrtánková;  J. Siváková;  P. Šumichrastová;  P. Lukáč;  J. Višňovský
Authors‘ workplace: Gynekologicko-pôrodnícka klinika Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Slovenská republika, prednosta prof. MUDr. J. Danko, CSc.
Published in: Ceska Gynekol 2014; 79(4): 326-331

Overview

Objective:
An overview of electronic fetal monitoring methods (EFM), and an analysis of their physical and technical limits.

Design:
A review article.

Setting:
Department of Gynecology and Obstetrics Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic.

Methods:
An analysis of the literature using database search engines PubMed, and SCOPE in the years 2000 – 2013 in field of diagnostic methods of fetal status in utero.

Results:
The essential aim of modern perinatology is the birth of a live and healthy newborn. This aim is strongly related to the abilities of the diagnostic methods to evaluate the intrauterine fetal status and with the professional skills of obstetricians to analyze these methods accurately. Nowadays, EFM is exposed to criticism, in spite of its widespread use. It is associated with some degree of failure in terms of an over-evaluation and under-evaluation. An over-evaluation of results can lead to unnecessary, often surgical, intervention. An under-evaluation of results can lead to an adverse fetal outcome with a neurologic handicap or intrauterine death. The long-term efforts currently underway to improve the reliability of EFM still remain to show any great progress.

Keywords:
cardiotocography, intermittent auscultation, pulse oximetry, ST analysis, fetal electrocardiography


Sources

1. Alfirevic, Z., Devane, D., Gyte, GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev, 2006, 19(3), CD006066.

2. American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee Opinion. Number 258, September 2001. Fetal pulse oximetry. Obstet Gynecol, 2001, 98(3), p. 523–524.

3. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol, 2009, 114(1), p. 192–202.

4. Amer-Wahlin, I., Hellsten, C., Norén, H., et al. Cardio-tocography only versus cardiotocography plus analysis of fetal electrogardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. Lancet, 2001, 358(9281), p. 534–538.

5. Avalon Fetal Monitor FM 20, FM 30 – Service guide. Philips 2005. Dostupné na http://www.frankshospitalworkshop.com/equipment/documents/ecg/service_manuals/Philips_Avalon_FM20_FM30-_Service_manual.pdf 26.9.2013

6. Avalon Fetal Monitor FM 20, FM 30 – Service guide Addendum 2009. Dostupné na http://www.healthcare.philips.com/pwc_hc/main/shared/Assets/Documents/patient_monitoring/avalon/AV_ADD_ENG_453564191101.pdf 26.9.2013

7. Baskett, TF., Calder, AA., Arulkumaran, S. Munro Kerr‘s Operative Obstetrics. Philadelphia: Saunders, 2007, 356 p.

8. Becker, JH., Bax, L., Amer-Wåhlin, I., et al. ST analysis of the fetal electrocardiogram in intrapartum fetal monitoring: a meta-analysis. Obstet Gynecol, 2012, 119(1), p. 145-154.

9. Biringer, K., Danko, J. Kvalita a efektivita elektronického monitorovania plodu. Čes Gynek, 2011, 76(6), s. 481–484.

10. Biringer, K., Danko, J., Žúbor, P., et al. Biofyzikálne metódy diagnostiky intrapartálnej fetálnej hypoxie. Čes Gynek, 2011, 76(3), s. 222–229.

11. Cohen, WR., Ommani, S., Hassan, S., et al. Accuracy and reliability of fetal heart rate monitoring using maternal abdominal surface electrodes. Acta Obstet Gynecol Scand, 2012, 91 (11), p. 1306–1313.

12. Debdas, A. Practical cardiotocography. New Delhi: Jaypee Brothers Medical Publishers (P), 2013, 350 p.

13. Devane, D., Lalor, JG., Daly, S., et al. Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing. Cochrane Database Syst Rev, 2012, 15(2), CD005122.

14. East, CE., Chan, FY., Colditz, PB., Begg, LM. Fetal pulse oximetry for fetal assessment in labour. Cochrane Database Syst Rev, 2007, 18(2), CD004075.

15. Freeman, RK., Garite, TJ., Nageotte, MP. Fetal heart rate monitoring. Philadephia: Lippincott Williams & Wilkins, 2012, 271 p.

16. Ginosar, Y., Reynolds, F., Halpern, SH., Weiner, CP. Anesthesia and the fetus. Chichester: Blackwell Publishing, 2013, 399 p.

17. Gupta, HV., Narinder, R. Neonatal outcomes with continuous intrapartum electronic fetal monitoring vs. intermittent auscultation. Intern J Basic Applied Med Sci, 2013. Dostupné na http://www.cibtech.org/J%20MEDICAL%20SCIENCES/PUBLICATIONS/2013/Vol_3_No_2/JMS...13-007...Harshvardhan%20Gupta...Neonatal....pdf

18. Liston, R., Sawchuck, D., Young, D. Fetal health surveillance: antepartum and intrapartum consensus guideline. J Obstet Gynaecol Can, 2007, 29(9), p. 25–54.

19. Lyndon, A., Ali, LU. Fetal heart monitoring principles and practices. 4th Ed. Dubuque: Kendall-Hunt Publishing, 2009, 335 p.

20. Neilson, JP. Fetal electrocardiogram (ECG) for fetal monitoring during labour. Cochrane Database Syst Rev, 2013, 31(5), CD000116.

21. Nelson, KB. Can we prevent cerebral palsy? N Engl J Med, 2003, 349(18), p. 1765–1769.

22. Nonnenmacher, A., Hopp, H., Dudenhausen, J. Predictive value of pulse oximetry for the development of fetal acidosis.J Perinat Med, 2010, 38(1), p. 83–86.

23. Norén, H., Amer-Wåhlin, I., Hagberg, H., et al. Fetal electrocardiography in labor and neonatal outcome: data from the Swedish randomized controlled trial on intrapartum fetal monitoring. Am J Obstet Gynecol, 2003, 188(1), p. 183–192.

24. Norén, H., Carlsson, A. Reduced prevalence of metabolic acidosis at birth: an analysis of established STAN usage in the total population of deliveries in a Swedish district hospital. Am J Obstet Gynecol, 2010, 202(6), 546.e1-7.

25. Ojala, K., Vääräsmäki, M., Mäkikallio, K., et al. A comparison of intrapartum automated fetal electrocardiography and conventional cardiotocography – a randomised controlled study. BJOG, 2006, 113(4), p. 419–423.

26. Potti, S., Berghella, V. ST waveform analysis versus cardiotocography alone for intrapartum fetal monitoring: a meta-analysis of randomized trials. Am J Perinatol, 2012, 29(8), p. 657–664.

27. Santo, S., Ayres-de-Campos, D. Human factors affecting the interpretation of fetal heart rate tracings: an update. Curr Opin Obstet Gynecol, 2012, 24(2), p. 84–88.

28. Schiermeier, S., Westhof, G., Leven, A., et al. Intra- and interobserver variability of intrapartum cardiotocography: a multicenter study comparing the FIGO classification with computer analysis software. Gynecol Obstet Invest, 2011, 72(3), p. 169–173.

29. Stampalija, T., Signaroldi, M., Mastroianni, C., et al. Fetal and maternal heart rate confusion during intra-partum monitoring: comparison of trans-abdominal fetal electrocardiogram and Doppler telemetry. J Matern Fetal Neonatal Med, 2012, 25(8), p. 1517–1520.

30. STAN® S31 Specifiche Tecniche, © Neoventa Medical AB, 2004. Dostupné na http://www.palmerio.it/Neoventa/Specifiche%20TecnicheMSP2.pdf 26.9.2013

31. Vayssière, C., David, E., Meyer, N., et al. A French randomized controlled trial of ST-segment analysis in a population with abnormal cardiotocograms during labor. Am J Obstet Gynecol, 2007, 197(3), 299.e1-6.

32. Westerhuis, ME., Visser, GH., Moons, KG., et al. Cardio-tocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial. Obstet Gynecol, 2010, 115(6), p. 1173–1180.

33. Williams, KP., Galerneau, F. Intrapartum fetal heart rate patterns in the prediction of neonatal acidemia. Am J Obstet Gynecol, 2003, 188(3), p. 820–823.

34. Wróbel, J., Jezewski, J., Matonia, A., et al. Telemedical system for home fetal monitoring with online analysis of bioelectrical abdominal signals. MIT, 2008, 12, p. 91–95.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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