title: Signal loss during fetal heart rate monitoring using maternal abdominal surface electrodes between 28 and 42 weeks of pregnancy.
abstract: BACKGROUND
  Fetal electrocardiography is one of the methods for monitoring the well-being of the fetus. Signal loss limits the proper interpretation of electrocardiogram traces.
  
  
  OBJECTIVE
  The aim of this study was to assess the average signal loss in non-invasive abdominal fetal electrocardiogram (fECG) monitoring using the KOMPOREL fetal monitoring system (ITAM, Zabrze, Poland) in women between 28 and 42 week of pregnancy. The results were compared to FIGO (International Federation of Gynaecology and Obstetric) and DGGG (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe e.V.) recommendations concerning fetal heart monitoring. The correlation between fetal ECG signal quality, week of pregnancy and patient BMI was evaluated.
  
  
  METHODS
  773 pregnant women, hospitalized and diagnosed in the Department of Gynecology and Obstetrics, Wroclaw Medical University, underwent 30 min of abdominal fECG recordings using the KOMPOREL fetal monitoring system.
  
  
  RESULTS
  The average signal loss in abdominal fECG monitoring in the study group was 32%. FIGO recommendations describe an acceptable fetal signal loss of 20%. In our study, 46% (357/773) of the recordings were up to FIGO standards, with fetal heart rate success rates above 80%. According to DGGG guidelines, with acceptable fetal signal loss of 15%, only 39% (303/773) of the recordings could be assessed as accurate. No correlation between fECG signal quality, week of pregnancy and patient BMI was proved.
  
  
  CONCLUSIONS
  The average signal loss in abdominal fECG monitoring in our study group was 32%. Low fECG signal quality may constitute a potentially limiting factor of the described fetal heart monitoring system. No relationship between fECG signal quality, week of pregnancy and patient BMI was proved.
authors.affiliation: 2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Fuchs
authors.affiliation: 2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Pomorski
authors.affiliation: 2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Grobelak
authors.affiliation: 2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Tomiałowicz
authors.affiliation: 2nd Department and Clinic of Gynaecology, Obstetrics and Neonatology, Wroclaw Medical University, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Zimmer