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The quality of intrapartum cardiotocography in preterm labour
Journal of Perinatal Medicine ( IF 1.7 ) Pub Date : 2021-09-17 , DOI: 10.1515/jpm-2021-0214
Zohal Faiz 1 , Eline M Van 't Hof 1 , Gerard J Colenbrander 2 , Ralf Lippes 1 , Petra C A M Bakker 1
Affiliation  

Objectives The aim of this study is to determine the quality of the foetal heart rate (FHR) recording, defined as signal loss, during preterm labour below 28 weeks gestational age (GA) and contribute to the discussion if cardiotocography (CTG) is of value for the extreme preterm foetus. Methods From January 2010 to December 2019 a retrospective study was conducted with data of 95 FHR recordings of singletons born between 24 and 28 weeks GA at the Amsterdam University Medical Centre, location VUmc. FHR tracings had a duration of at least 30 min and were obtained via external ultrasound mode. Data of all recordings were divided in two groups according to gestation (24–26 weeks and 26–28 weeks). Signal loss was analysed. Statistical significance was calculated by non-parametric tests and chi-square tests. The median signal loss and the proportion of cases exceeding the International Federation of Gynaecology and Obstetrics Guidelines (FIGO) threshold of 20% signal loss were calculated. Results One-third of the recordings exceeded the 20% FIGO-criterion for adequate signal quality during the first stage of labour. In the second stage, this was nearly 75%. Similarly, the median signal loss was 13% during the first and 30% during the second stage of labour (p<0.01). Conclusions The quality of FHR monitoring in the extreme preterm foetus is inadequate in a large proportion of the foetuses, especially during the second stage. FHR monitoring is therefore controversial and should be used with caution.

中文翻译:

早产产时心电图的质量

目的 本研究的目的是确定胎心率 (FHR) 记录的质量,定义为胎龄低于 28 周 (GA) 的早产期间的信号丢失,并有助于讨论胎心造影 (CTG) 是否有价值对于极端早产儿。方法从 2010 年 1 月至 2019 年 12 月,在阿姆斯特丹大学医学中心 VUmc 地点,对 95 例出生于 GA 24 至 28 周的单胎的 FHR 记录数据进行了一项回顾性研究。FHR 跟踪的持续时间至少为 30 分钟,并通过外部超声模式获得。所有记录的数据根据​​妊娠(24-26 周和 26-28 周)分为两组。分析了信号损失。通过非参数检验和卡方检验计算统计显着性。计算了中位信号丢失和超过国际妇产科联合会 (FIGO) 20% 信号丢失阈值的病例比例。结果 三分之一的录音在分娩的第一阶段超过了 20% 的FIGO 标准,以获得足够的信号质量。在第二阶段,这一比例接近 75%。同样,第一产程的中位信号损失为 13%,第二产程为 30%(p<0.01)。结论 极度早产儿的FHR监测质量在很大一部分胎儿中存在不足,尤其是在第二阶段。因此胎心率监测存在争议,应谨慎使用。结果 三分之一的录音在分娩的第一阶段超过了 20% 的FIGO 标准,以获得足够的信号质量。在第二阶段,这一比例接近 75%。同样,第一产程的中位信号损失为 13%,第二产程为 30%(p<0.01)。结论 极度早产儿的FHR监测质量在很大一部分胎儿中存在不足,尤其是在第二阶段。因此胎心率监测存在争议,应谨慎使用。结果 三分之一的录音在分娩的第一阶段超过了 20% 的FIGO 标准,以获得足够的信号质量。在第二阶段,这一比例接近 75%。同样,第一产程的中位信号损失为 13%,第二产程为 30%(p<0.01)。结论 极度早产儿的FHR监测质量在很大一部分胎儿中存在不足,尤其是在第二阶段。因此胎心率监测存在争议,应谨慎使用。结论 极度早产儿的FHR监测质量在很大一部分胎儿中存在不足,尤其是在第二阶段。因此胎心率监测存在争议,应谨慎使用。结论 极度早产儿的FHR监测质量在很大一部分胎儿中存在不足,尤其是在第二阶段。因此胎心率监测存在争议,应谨慎使用。
更新日期:2021-09-17
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