Fetal electrocardiogram plus heart rate recording for fetal monitoring during labour.
BACKGROUND
It is thought that adding fetal electrocardiography (ECG) to cardiotocography (CTG) alone may provide better information about fetal heart activity.


OBJECTIVE
The objective of this review was to assess the effects of simultaneous recording of fetal electrocardiographic waveforms plus conventional cardiotocography, with cardiotocography alone, during labour.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group trials register.


METHODS
Randomised trials of electrocardiogram waveform analysis with or without cardiotocography during labour.


METHODS
Trial quality was independently assessed by two reviewers. Data extraction was done by one reviewer and checked by the second reviewer. Study authors were contacted for additional information.


RESULTS
One study of 2434 pregnant women was included. This trial was of sound methodological quality. The number of operative deliveries for fetal distress was reduced by half in the electrocardiographic waveform and cardiotocography group (odds ratio 0.53, 95% confidence interval 0.39 to 0.73). There was no apparent effect on the rate of operative delivery for poor progress of labour (odds ratio 1.05, 95% confidence interval 0.87 to 1.27). The use of the electrocardiographic waveform analysis monitor had no obvious effect on the condition of the newborn.


CONCLUSIONS
Analysis of the fetal electrocardiographic waveform during labour may be associated with reduced obstetric intervention without jeopardising fetal outcome.
Neilson
J P
JP
Department of Obstetrics and Gynaecology, University of Liverpool, Liverpool, UK, L69 3BX. jneilson@liverpool.ac.uk
Mistry
R T
RT
D015148:Cardiotocography; D004452:Echocardiography; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy