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. 2012 Mar;72(3):211-214.
doi: 10.1055/s-0031-1298329.

Non-invasive Foetal ECG - a Comparable Alternative to the Doppler CTG?

J Reinhard  1 , F Louwen  1
Affiliations

Non-invasive Foetal ECG - a Comparable Alternative to the Doppler CTG?

J Reinhard et al. Geburtshilfe Frauenheilkd. 2012 Mar.

Abstract
in English, German

This review discusses the alternative of using the non-invasive foetal ECG compared with the conventionally used Doppler CTG. Non-invasive abdominal electrocardiograms (ECG) have been approved for clinical routine since 2008; subsequently they were also approved for antepartum and subpartum procedures. The first study results have been published. Non-invasive foetal ECG is especially indicated during early pregnancy, while the Doppler CTG is recommended for the vernix period. Beyond the vernix period no difference has been recorded in the success rate of either approach. The foetal ECG signal quality is independent of the BMI, whereas the success rate of the Doppler CTG is diminished with an increased BMI. During the first stage of labour, non-invasive foetal ECG demonstrates better signal quality; however during the second stage of labour no difference has been identified between the methods.

In diesem Review soll die Alternative einer fetalen EKG-Überwachung mit der bisher üblichen CTG-Überwachung verglichen werden. Seit 2008 gibt es ein für die klinische Routine zugelassenes, nicht invasives abdominales Elektrokardiogramm-(EKG-)Gerät, das inzwischen antepartal und unter der Geburt zugelassen ist. Erste Studienergebnisse sind publiziert. Das nicht invasive EKG ist besonders in den frühen Schwangerschaftswochen indiziert, während in der Vernix-Periode das CTG überlegen ist. Nach der Vernix-Periode zeigt sich kein Unterschied in der Erfolgsrate. Die Signalqualität des fetalen EKGs ist vom BMI unabhängig, während das CTG bei einem erhöhten BMI eine schlechtere Signalqualität zeigt. In der Eröffnungsperiode zeigt das EKG eine bessere Signalqualität als das CTG, in der Austreibungsperiode weisen beide Verfahren keine Unterschiede hinsichtlich der Signalqualität auf.

Keywords: Doppler CTG; fetal ECG; obstetrics.

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Conflict of interest statement

Conflict of Interest/Interessenkonflikt Financial support – Monica Healthcare Ltd, United Kingdom, sponsored studies of a total amount of approx. Euro 65 000. Finanzielle Unterstützung – Monica Healthcare Ltd, United Kingdom, unterstützte Studien in Gesamthöhe von ca. 65 000 Euro.

Figures

Fig. 1Abb. 1
Fig. 1Abb. 1
Signal quality of the non-invasive foetal ECG (AN 24 F) and of the CTG (Doppler F) during the first stage of labour.  Signalqualität des nicht invasiven fetalen EKGs (AN 24 F) und des CTGs (Doppler F) in der Eröffnungsphase.
Fig. 2 aAbb. 2 a
Fig. 2 aAbb. 2 a
to c a The last 10 minutes of the second stage of labour and b and c the first stage of labour with a possible confusion of the foetal and maternal pulse rate with CTG monitoring. Red: CTG, black: maternal heart rate, blue: non-invasive foetal ECG. bis c a Die letzten 10 Minuten der Austreibungsphase und b und c der Eröffnungsphase mit einer möglichen Verwechslung des fetalen mit dem mütterlichen Puls im CTG. Rot: CTG, schwarz: mütterliche Herzfrequenz, blau: nicht invasives fetales EKG.
Fig. 3 aAbb. 3 a
Fig. 3 aAbb. 3 a
and b Comparison of the last 32 minutes of the second stage of labour (spontaneous labour): a Comparison of CTG (red), foetal ECG (blue) and maternal ECG (black); b Tocogram (red) and electrohistogram (blue). und b Vergleich der letzten 32 Minuten der Austreibungsphase (Spontanpartus): a Vergleich CTG (rot), fetales EKG (blau) und mütterliches EKG (schwarz); b Tokogramm (rot) und Elektrohistogramm (blau).
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