Use of fetal electrocardiogram for intrapartum monitoring.
BACKGROUND
Intrapartum fetal monitoring is essential for the identification of fetal hypoxia to reduce perinatal morbidity and mortality. Cardiotocography is associated with low specificity for fetal acidosis and poor perinatal outcome leading to unnecessary operative deliveries. ST waveform analysis of the fetal electrocardiogram has been shown to be a promising adjunctive intrapartum assessment tool. We aim to present the pathophysiology, the role of intrapartum monitoring and the practical usage of this relatively new technology in our review.


METHODS
An electronic search of Medline and OVID was carried out, followed by a manual search of the references identified by the electronic search.


RESULTS
The incorporation of ST waveform analysis to cardiotocography has been shown to reduce the rates of neonatal metabolic acidosis, moderate and severe neonatal encephalopathy, thus improving perinatal outcome. The reduction in operative delivery rates due to fetal distress is also significant. The pathophysiology and practical usage of this technology were discussed.


CONCLUSIONS
With more accurate identification of fetal hypoxia and reduction of unnecessary intervention rates, incorporation of ST waveform analysis of fetal electrocardiography into cardiotocography can improve the standard of intrapartum fetal monitoring.
Su
Lin-Lin
LL
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. obgsll@nus.edu.sg
Chong
Yap-Seng
YS
Biswas
Arijit
A
D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D005311:Fetal Hypoxia / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D012846:Singapore