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Title: Clinical assessment of long-term fetal heart rate monitoring using transabdominal fetal elektrocardiotocography

Abstract:

Introduction. With the development of fetus biophysical diagnostic techniques over the past years, a significant decrease in perinatal morbidity and mortality was obtained, but despite the increase in the percentage of cesarean sections, incidence of cerebral palsy has continued to be observed and it is comparable with the previous period. This prompts to undertake further research to improve the ability to assess the actual intrauterine comfort.Aim of the study. The aim of this study was to optimise the identification of the actual intrauterine fetal distress during pregnancy by assessing the clinical utility of long-term monitoring of fetal heart rate using transabdominal fetal Holter electrocardiotocography as a component of a broad range of biophysical studies assessing intrauterine fetal condition.Materials and methods. The study was conducted among pregnant women hospitalised in the Department of Obstetrics and Perinatology of the University Hospital in Krakow in the period from March to August 2014. The study was prospective and covered singleton pregnancies. The condition of each pregnant woman was assessed in detail. The pregnant women were subjected to standard procedures of biophysical fetal monitoring, including cardiotocographic recording and holter electrocardiotocographic recording with indirect measurement using AN24 Monica -Fetal / Maternal Holter Recorder from Monica Healthcare. The study group included physiological and pathological pregnancies. In pathological pregnancies, conditions such as hypertension, intrauterine fetal hypotrophy and diabetes were identified. The group consisted of 159 women. Holter records were assessed using Dawes-Redman criteria. Following initial assessment, of the 159 records 152 were qualified for detailed statistical analysis. The results of analysing the cardiotocographic and electrocardiotocographic records were compared with pregnancy results. The week of delivery and manner of delivery were taken into consideration. The newborn was assessed based on the following clinical parameters: gender, body weight, body length, Apgar score. ; Results and conclusions:1. Body weight of the woman, her BMI, AFI and the bearing location do not affect signal loss of fetal heart rate - FHR%.2. It has been found that the type of bearing is associated with the frequency of loss of signal. Grade One on Grannum scale is associated with a higher signal loss than grades two and three. At the same time there was no difference in signal loss between grades two and three on Grannum scale.3. It has been shown that the higher estimated weight of the fetus, EFW, is associated with less loss of signal - FHR%.4. It has been found that the short-term volatility, STV, significantly decreases with the stage of pregnancy, which requires further study over a much wider material to confirm.5. Statistically significant lower fetus STV and MMR in pregnancies with hypertension compared to pregnancies without hypertension was proved, however no differences in CTG records between these groups were found.6. Statistically significant bigger number of small and large acceleration and episodes of high volatility in fetuses from pregnancies with diabetes compared to pregnancies without diabetes were proved, however no differences in CTG records between these groups were found.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

położnictwo

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Krzysztof Rytlewski

Date issued:

2015

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:4043

Call number:

ZB-123662

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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Last modified:

May 24, 2021

In our library since:

Mar 9, 2016

Number of object content hits:

8

Number of object content views in PDF format

8

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/4043

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ZB-123662 May 24, 2021
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