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Microprocessor based waveform analysis of the fetal electrocardiogram during labor.

H Lilja¹, K Karlsson, K Lindecrantz

¹Department of Obstetrics and Gynaecology, University of Goteborg, Sweden.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics

|October 1, 1989

Summary

Fetal ECG (FECG) T wave amplitude changes during delivery correlate with fetal acidosis. A microprocessor system accurately reproduced these FECG changes, adding valuable information to routine fetal monitoring.

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Area of Science:

Obstetrics and Gynecology
Fetal Monitoring
Cardiology

Background:

Elevated fetal ECG (FECG) T wave amplitude is linked to catecholamines and glycogenolysis.
FECG alterations are observed during human childbirth.
Investigating real-time FECG analysis for clinical correlation is crucial.

Purpose of the Study:

To reproduce FECG changes in a real-time microprocessor system.
To correlate FECG waveform alterations with biochemical and clinical data.
To assess the added value of FECG analysis to cardiotocography (CTG).

Main Methods:

Real-time FECG signal acquisition and averaging from 40 deliveries.
Microcomputer system used for signal processing.
Correlation of FECG parameters (T/QRS ratio, ST segment) with umbilical artery pH and CTG data.

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Main Results:

The system accurately reproduced ST waveform changes, with a minor 10% reduction in QRS magnitude.
Lower umbilical artery pH (<7.25) correlated with significantly higher T/QRS ratios (0.33 ± 0.10) compared to normal pH (0.26 ± 0.19).
Significant differences in T/QRS ratios were observed in the final hour before birth between normal and low pH groups (P<0.01).

Conclusions:

Real-time FECG analysis via microprocessor is feasible and provides insights into fetal well-being.
Increased T/QRS ratio is a potential indicator of fetal acidosis during delivery.
FECG analysis can supplement CTG, offering additional data on fetal condition.