New Possibilities for Fetal Monitoring Using Unobtrusive Abdominal Electrocardiography

Abstract

Currently, the basis for fetal monitoring is the analysis of the fetal heart rate (FHR) acquired via ultrasound Doppler. Because of the complex nature of the ultrasonic wave, the substantial measurements averaging applied makes difficult assessment of instantaneous FHR variability. These limitations are the reason for searching for more effective methods for fetal risk assessment. For many years, a growing interest in monitoring of bioelectrical fetal heart activity has been observed. Monitoring based on a fetal electrocardiogram (FECG) enables determining the fetal heart rate with a beat-to-beat accuracy. At the same time an analysis of the fetal electrocardiogram provides a new diagnostic information in the form of QRS complex morphology changes, that allow to distinguish suspicious from truly abnormal records. Two methods for recording of fetal electrocardiogram can be distinguished: a direct method applicable only during labour (dFECG) where the electrode is placed on the fetal head, and an indirect one (abFECG) where measuring electrodes are placed on maternal abdomen. Our goal was to evaluate the possibility of introduction to a common clinical practice the new developed abFECG system. The results confirmed that the proposed method offers accuracy sufficient for reliable assessment of the FHR variability.