University of Granada researchers have demonstrated that fetal electrocardiogram (ECG) is the best method for detecting early acidosis and the risk of loss of fetal well being. The method shows the effects of lack of oxygen in the heart and brain of the fetus. The study finds that this system is better than pulse oximetry, which measures oxygen saturation in fetuses.
This study was conducted with 180 women in labour who were admitted to the dilation area of the University Hospital Virgen de las Nieves in Granada, Spain.
The study was carried out by Mercedes Valverde Pareja, a researcher at the Department of Gynecology and Obstetrics at the University of Granada, and conducted by professors Alberto Puertas Prieto, Alberto Salamanca Ballesteros and Francisco Montoya Ventoso. To carry out this study, its authors conducted a prospective randomized study with 180 women in labour admitted to the dilation area of the University Hospital Virgen de las Nieves, Granada, Spain.
Researchers found that women in labour monitored with fetal ECG and with recorded CTG compatible with risk of loss of fetal well being, recorded a lower cesarean rate (30% vs. 46.7%), obtained better fetal Apgar test results and better values in fetal umbilical cord gas analysis at birth than those recorded with pulse oximetry. They also observed greater real-time monitoring, adequate signal, fetal ECG providing more continuous information, thus helping the obstetrician to control the state of the fetus.
Advantages of the method
This study showed that fetal electrocardiogram is very useful to detect fetuses at risk of suffering acidosis. Once the risk is detected, the delivery is expedited before the fetus shows signs of acidosis and is affected. Moreover, this technique allows the detection of false recorded CTG positives.
To date, both methods of intrapartum fetal monitoring had been analysed separately (fetal pulse oximetry and fetal electrocardiogram), but there were no previous studies comparing them to each other to assess which one is more effective in detecting risk of loss of fetal welfare.
As Mercedes Valverde explains, "some people believe that both methods are equally effective and that they can be used in the same cases. With this work, we found that their effectiveness is not the same, as they operate at different levels of fetal physiology and therefore give some very precise data. Furthermore, if compared, fetal electrocardiogram (ECG-fetal) detects acidosis at an earlier stage, thus allowing to have healthy fetuses. "
The results obtained in this study were partially published in the journal Progresos en ginecología y obstetricia, edited by the Sociedad Española de Ginecología y Obstetricia (Spanish Society of Gynecology and Obstetrics).
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