title: Non-invasive intrapartum fetal ECG: preliminary report.
abstract: OBJECTIVE
  To obtain fetal heart rate, detailed fetal electrocardiography (fECG) signals and uterine contractions during labour using a single device.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Delivery suite at a tertiary referral hospital, London, UK.
  
  
  METHODS
  Fifteen patients at median gestation of 39 weeks (range 24-41) were recruited at median cervical dilatation of 4.0 cm (range 0-10) of whom 8/15 (53%) had intact amniotic membranes.
  
  
  METHODS
  Using 12 abdominally sited electrodes, we recorded the composite abdominal signal in pregnancies intrapartum. The recorded data were analysed off-line using a blind signal separation technique.
  
  
  METHODS
  Success of signal separation and fECG time intervals.
  
  
  RESULTS
  Successful fECG signal acquisition was achieved in 12/15 (80%) patients and an averaged fECG waveform acquired. In these patients, P and QRS waves were seen in all cases, and T waves in 11/12 (92%). True beat-to-beat heart rate (HR) was displayed and measures of its variability obtained. The mother's ECG and uterine electrical activity, shown to match tocographically recorded uterine contractions, were also separated and displayed. Failure to acquire fECG in three cases was attributed to excessive abdominal muscular activity and electrical interference.
  
  
  CONCLUSIONS
  This study demonstrates a non-invasive technique that displays detailed intrapartum fECG waveforms, HR variability, maternal ECG and uterine contractions simultaneously, all in a single device and which avoids the potential risks of invasive monitoring with a fetal scalp electrode.
authors.affiliation: Queen Charlotte's and Chelsea Hospital and Division of Paediatrics, Obstetrics and Gynaecology, Faculty of Medicine, Imperial College, London, UK.
authors.forename: Myles J O
authors.initials: MJ
authors.lastname: Taylor
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Thomas
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Smith
authors.forename: Salome
authors.initials: S
authors.lastname: Oseku-Afful
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Fisk
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Green
authors.forename: Sara
authors.initials: S
authors.lastname: Paterson-Brown
authors.forename: Helena M
authors.initials: HM
authors.lastname: Gardiner
mesh_terms: D015148:Cardiotocography / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D005240:Feasibility Studies; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D014590:Uterine Contraction / Q000502:physiology*