title: Predictive value of the baseline T-QRS ratio of the fetal electrocardiogram in intrapartum fetal monitoring: a prospective cohort study.
abstract: OBJECTIVE
  To evaluate the added value of the baseline T/QRS ratio to other known risk factors in predicting adverse outcome and interventions for suspected fetal distress.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Three academic and six non-academic teaching hospitals in the Netherlands.
  
  
  METHODS
  Laboring women with a high-risk cephalic singleton pregnancy beyond 36 weeks of gestation.
  
  
  METHODS
  We obtained STAN(®) recordings (ST-analysis, Neoventa, Sweden) from two previous studies. Three patient groups were defined: cases with adverse outcome, cases with emergency delivery because of suspected fetal distress without adverse outcome, and a reference group of uncomplicated cases. Baseline T/QRS ratios among the adverse outcome and intervention for suspected fetal distress cases were compared to those of the uncomplicated cases. The ability of baseline T/QRS to predict adverse outcome and suspected fetal distress was determined using a multivariable logistic model.
  
  
  METHODS
  The added value of the baseline T/QRS to other known risk factors in the prediction of adverse outcome and interventions for suspected fetal distress.
  
  
  RESULTS
  From 3462 recordings, 2459 were available for analysis. Median baseline T/QRS for uncomplicated cases, adverse outcome and interventions for suspected fetal distress were 0.12 (range 0.00-0.52), 0.12 (0.00-0.42) and 0.13 (0.00-0.39), respectively. There was no statistical difference between these groups. Multivariable analysis showed no added value of baseline T/QRS in the prediction of either adverse outcome or interventions for suspected fetal distress.
  
  
  CONCLUSIONS
  Baseline T/QRS has no added value in the prediction of adverse neonatal outcome or interventions for suspected fetal distress.
authors: Department of Obstetrics, University Medical Center Utrecht, the Netherlands. j.h.becker@umcutrecht.nl
authors: Jeroen H
authors: JH
authors: Becker
authors: Lidewij J M
authors: LJ
authors: Kuipers
authors: Ewoud
authors: E
authors: Schuit
authors: Gerard H A
authors: GH
authors: Visser
authors: Eline S A
authors: ES
authors: Van Den Akker
authors: Erik
authors: E
authors: Van Beek
authors: Antoinette C
authors: AC
authors: Bolte
authors: Robert J P
authors: RJ
authors: Rijnders
authors: Ben Willem J
authors: BW
authors: Mol
authors: Martina M
authors: MM
authors: Porath
authors: Addy P
authors: AP
authors: Drogtrop
authors: Nico W E
authors: NW
authors: Schuitemaker
authors: Christine
authors: C
authors: Willekes
authors: Michelle E M H
authors: ME
authors: Westerhuis
authors: Karel G M
authors: KG
authors: Moons
authors: Anneke
authors: A
authors: Kwee
mesh_terms: D000328:Adult; D004562:Electrocardiography; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012372:ROC Curve