title: Monitoring Fetal Heart Rate during Labor: A Comparison of Three Methods.
abstract: The purpose of the study was to compare the accuracy of a noninvasive fetal heart rate monitor with that of ultrasound, using a fetal scalp electrode as the gold standard, in laboring women of varying body habitus, throughout labor and delivery. Laboring women requiring fetal scalp electrode were monitored simultaneously with the investigational device (noninvasive fetal ECG), ultrasound, and fetal scalp electrode. An algorithm extracted the fetal heart rate from the noninvasive fetal ECG signal. Each noninvasive device recording was compared with fetal scalp electrode with regard to reliability by positive percent agreement and accuracy by root mean squared error. Seventy-one women were included in this analysis. Positive percent agreement was 83.4 ± 15.4% for noninvasive fetal ECG and 62.4 ± 26.7% for ultrasound. The root mean squared error compared with fetal scalp electrode-derived fetal heart rate was 4.8 ± 2.0 bpm for noninvasive fetal ECG and 14.3 ± 8.2 bpm for ultrasound. The superiority of noninvasive fetal ECG was maintained for stages 1 and 2 of labor and increases in body mass index. Compared with fetal scalp electrode-derived fetal heart rate, noninvasive fetal ECG is more accurate and reliable than ultrasound for intrapartum monitoring for stages 1 and 2 of labor and is less affected by increasing maternal body mass index. This confirms the results of other workers in this field.
authors.affiliation: Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA; Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Tammy Y
authors.identifier: 0000-0002-2998-5638
authors.initials: TY
authors.lastname: Euliano
authors.affiliation: OBMedical, Jonesville, FL, USA.
authors.forename: Shalom
authors.initials: S
authors.lastname: Darmanjian
authors.affiliation: OBMedical, Jonesville, FL, USA.
authors.forename: Minh Tam
authors.initials: MT
authors.lastname: Nguyen
authors.affiliation: Winnie Palmer Hospital for Women & Babies, Orlando, FL, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Busowski
authors.affiliation: OBMedical, Jonesville, FL, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Euliano
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL, USA.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Gregg
mesh_terms: D000328:Adult; D015148:Cardiotocography / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D011247:Pregnancy; D015203:Reproducibility of Results; D012535:Scalp; D018608:Ultrasonography, Doppler; D014590:Uterine Contraction / Q000502:physiology