Non-invasive fetal electrocardiography in singleton and multiple pregnancies

Taylor, Myles J.O., Smith, Mark J., Thomas, Matthew, Green, Andrew R., Cheng, Floria, Oseku-Afful, Salome, Wee, Ling Y., Fisk, Nicholas M. and Gardiner, Helena M. (2003) Non-invasive fetal electrocardiography in singleton and multiple pregnancies. British Journal of Obstetrics and Gynaecology, 110 7: 668-678. doi:10.1046/j.1471-0528.2003.02005.x


Author Taylor, Myles J.O.
Smith, Mark J.
Thomas, Matthew
Green, Andrew R.
Cheng, Floria
Oseku-Afful, Salome
Wee, Ling Y.
Fisk, Nicholas M.
Gardiner, Helena M.
Title Non-invasive fetal electrocardiography in singleton and multiple pregnancies
Journal name British Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 1470-0328
0140-7686
1471-0528
Publication date 2003-07-01
Year available 2003
Sub-type Article (original research)
DOI 10.1046/j.1471-0528.2003.02005.x
Open Access Status
Volume 110
Issue 7
Start page 668
End page 678
Total pages 11
Editor Philip Steer
Place of publication London, U.K.
Publisher Blackwell
Language eng
Subject 111402 Obstetrics and Gynaecology
1114 Paediatrics and Reproductive Medicine
Abstract Objectives To document the duration of fetal cardiac time intervals in uncomplicated singleton pregnancies using a novel non-invasive fetal electrocardiography (fECG) system and to demonstrate this technique's ability to acquire recordings in twin and triplet pregnancies.
Formatted abstract
Objectives: To document the duration of fetal cardiac time intervals in uncomplicated singleton pregnancies using a novel non-invasive fetal electrocardiography (fECG) system and to demonstrate this technique's ability to acquire recordings in twin and triplet pregnancies.
Design: Prospective cross sectional observational study.
Setting: Antenatal wards and clinics, day assessment unit and centre for fetal care at a tertiary referral hospital, London, UK.
Population or Sample: Three hundred and four singleton and multiple pregnancies, 15–41 weeks of gestation.
Methods: Using electrodes sited on the maternal abdomen, a fetal electrocardiography (fECG) system was developed and tested on 304 pregnant women from 15 to 41 weeks of gestation, of whom 241 were uncomplicated singletons, 58 had twin and 5 had triplet pregnancies. The composite abdominal signals were stored on a laptop computer and the fECG derived off-line using a digital signal processing technique. For singletons, linear regression was used to analyse PR, QRS, QT and QTc intervals, and construct time-specific reference ranges.
Main outcome measure: Duration of fECG time intervals as a function of gestational age. Success of signal seperation in singleton, twin and triplet pregnancies.
Results: For singletons, a total of 250 recordings was obtained from 241 individuals with a signal separation success rate of 85% (213/250). Success rates were significantly poorer between 27 and 36 weeks of gestation ( 2 × k Χ2, P < 0.0001 ), with 84% (31/37) of separation failures occurring during this period. P, Q, R and S waves were seen in all cases where fetal signals were separated and were used to generate fECG time interval reference ranges. In 22% (43/199) of analysed cases, no T waves were identified, 63% (27/43) of whom were ≤24 weeks of gestation. In twins and triplets, separate fetal signals were obtained in 78% (91/116) and 93% (14/15), respectively; P, Q, R and S waves were evident in all averaged fECGs, while T waves were identified in 59% (54/91) and 57% (8/14).
Conclusions: This study provides reference ranges with gestation for fECG intervals derived non-invasively from normal singleton pregnancies and demonstrates the feasibility of obtaining complete fECG recordings non-invasively across a wide gestational range in pregnancies of all pluralities. The fECG time intervals described will enable the identification of pathological fECG recordings from high risk pregnancies where fECG abnormalities are suspected.
©RCOG 2003 BJOG: an International Journal of Obstetrics and Gynaecology.

Keyword Fetal cardiac time intervals
Non-invasive fetal electrocardiography (fECG)
Singleton and multiple pregnancies
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Fri, 20 Mar 2009, 00:50:22 EST by Mary-Anne Marrington on behalf of Faculty Of Health Sciences