Quality Predictors of Abdominal Fetal Electrocardiography Recording in Antenatal Ambulatory and Bedside Settings.
BACKGROUND
Fetal electrocardiography using an abdominal monitor (Monica AN24™) could increase the diagnostic use of fetal heart rate (fHR) variability measurements. However, signal quality may depend on factors such as maternal physical activity, posture, and bedside versus ambulatory setting.


METHODS
Sixty-three healthy women wore the monitor at home and 42 women during a hospital stay. All women underwent a posture experiment, and all home and 13 hospital participants wore the monitor during daytime and nighttime. The success rate (SR) of fHR detection was analyzed in relation to maternal physical activity, posture, daytime versus nighttime, and other maternal and fetal predictors.


RESULTS
Ambulatorily, the SR was 86.8% for nighttime and 40.2% for daytime. The low daytime SR was largely due to effects of maternal physical activity and posture. The in-hospital SR was lower during nighttime (71.1%) and similar during daytime (43.3%). SR was related to gestational age, but not affected by pre-pregnancy and current body mass index or fetal growth restriction.


CONCLUSIONS
The success of beat-to-beat fHR detection strongly depends on the home/hospital setting and predictors such as time of recording, activity levels, and maternal posture. Its clinical utility may be limited in periods of unsupervised recording with physical activity or posture shifts.
Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland.
Evelyn A
EA
Huhn
Maren I
MI
Müller
Andrea H
AH
Meyer
Gwendolin
G
Manegold-Brauer
Wolfgang
W
Holzgreve
Irene
I
Hoesli
Frank H
FH
Wilhelm
D000328:Adult; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy
Abdominal electrocardiography; Ambulatory monitoring; Fetal electrocardiography; Fetal heart rate; Heart rate variability; Monica AN24™