Abstract
Objective: To determine the quality of fetal heart rate (FHR) recordings during the first and
second stage of labor by quantifying the amount of fetal signal loss in relation to
the method of monitoring: external ultrasound or directly via a scalp electrode. Study Design: Analysis of 239 intrapartum recordings stored between 1 January 2001 and 1 July
2001 from consecutive deliveries at the Vrije Universiteit Medical Center in Amsterdam.
Singletons delivered via the vaginal route were included in the study. FHR recordings
had duration of at least 1 h prior to birth of the infant. Subdivision in three groups took place on the basis
of the recording technique which had been used; i.e. ultrasound, scalp electrode or
a combination of both methods. FHR data was obtained using HP-M1350 cardiotocographs.
The status (pen on, pen off, maternal signal) and the mode of the signals were acquired.
The duration of pen lifts and maternal signals was divided by the total duration of
the recording. Statistical analyses were performed with the Mann–Whitney U-test and the Wilcoxon signed ranks test. Results: Recordings obtained via ultrasound demonstrated significantly more fetal signal
loss than those obtained via the direct mode, particularly in the second stage. The
FIGO criteria for fetal signal loss with external ultrasound were not fulfilled during
this stage for about half the cases. Conclusion: Intrapartum FHR monitoring via a scalp electrode provides far better quality FHR
signals than external ultrasound and deserves a more prominent position in fetal surveillance
than it currently has.
Keywords
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Article info
Publication history
Accepted:
January 6,
2004
Received in revised form:
October 28,
2003
Received:
August 18,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
