Fetales Elektrokardiogramm (EKG) als Alternative der Doppler-Kardiotokografie (CTG) zur antepartualen Überwachung des Feten – erste Ergebnisse

Abstract

Computer analysing software is required for the assessment of CTGs because of the low sensitivity and high intra- and interobserver variability. The German Society of Gynaecology and Obstetrics advises the use of computer analysing CTG software. This study is aimed at evaluating the use of a new foetal ECG analysis system as an alternative to the traditional Doppler ultrasound CTGs in the setting of a university labour suite. 10 pregnant women beyond the 32 (nd) week of gestation, who were admitted to hospital and gave informed consent to this study, were connected to the foetal EKG monitor system Monica AN24. Patient satisfaction, maternal and foetal EKG detection rates and time required to connect the patient were evaluated. 8 out of 10 women would prefer the Monica AN24 monitor system over the traditional Doppler ultrasound CTG. In total, the mean foetal ECG detection rate was 62.3 % (SD +/- 30.4) during the recorded time interval; at rest the detection rate was 75.3 % (SD +/- 33.2); during the night time (23.00 to 7.00) the detection rate was 78.3 % (SD +/- 25.4); and during night time and at rest the detection rate was 82.2 % (SD +/- 24.3). The mean recorded time interval was 6 h and 54 min (SD +/- 2 h and 43 min). In total, the maternal ECG detection rate was as high as 99.7 % (SD +/- 0.4). The mean time required for applying the Monica AN24 monitor system was 3.2 min (SD +/- 0.6). The foetal ECG monitor system may be a good alternative to Doppler ultrasound CTGs. With the perspective to analyse in a beat to beat manner foetal EKG heart rates, this new monitor system should be superior to Doppler ultrasound CTGs, however further larger studies are needed to confirm this hypothesis.