Perinatology Obstetrics and Gynecology Department, Kharkiv Medical Academy of Postgraduate Education, Ukraine, Kharkiv, Kogchagintsev.
Ann Acad Med Singap. 2015 Nov;44(11):519-23.
Fetal distress is a result of acute or chronic disturbances in the system of "mother-placenta-fetus" in pre-eclampsia (PE). The aim of the investigation was to compare the accuracy of antenatal fetal distress diagnostics in cases of traditional cardiotocography (CTG) waveform evaluation and analysis of morphological non-invasive electrocardiogram (ECG) parameters in anterpartum patients with PE.
Fetal non-invasive ECG antenatal recordings of 122 pregnant patients at 34 to 40 weeks of gestation were examined. In Group I, there were 32 women with physiological gestation and normal fetal condition according to haemodynamic Doppler values. Group II involved 48 patients with mild and moderate PE whom were performed Doppler investigation. In Group III, 42 patients with severe PE were monitored with haemodynamic Doppler.
Fetal autonomic tone was lower with the relative increase of low frequency (LF) branch in the patients of pre-eclamptic group. The increased value of the amplitude of mode (AMo) and stress index (SI) was associated with adrenergic overactivity. It has induced pQ and QT shortening, increased T/QRS ratio and decelerations appearance. The rate of antenatal fetal distress retrospectively was 31.1 % in PE. The traditional analysis of CTG parameters has showed sensitivity (72.7%) and specificity (87.1%). In addition to the conventional CTG analysis, evaluation of ECG parameters has contributed to better diagnostics of fetal distress. Sensitivity and specificity of non-invasive fetal ECG were absolutely equal in this study (100%).
The results suggest that fetal non-invasive ECG monitoring is more objective than conventional CTG.
子痫前期（PE）中“母亲-胎盘-胎儿”系统发生急性或慢性紊乱会导致胎儿窘迫。本研究旨在比较传统胎心监护（CTG）波形评估和分析产前子痫前期患者形态学无创心电图（ECG）参数在产前胎儿窘迫诊断中的准确性。
检查了 122 名 34 至 40 孕周孕妇的胎儿无创心电图产前记录。在 I 组中，有 32 名妇女具有生理妊娠和正常胎儿状况，根据血流动力学多普勒值。II 组包括 48 名患有轻度和中度 PE 的患者，他们进行了多普勒检查。在 III 组中，42 名患有严重 PE 的患者接受了血流动力学多普勒监测。
子痫前期组患者的自主神经张力较低，低频（LF）分支相对增加。模式幅度（AMo）和应激指数（SI）的增加值与肾上腺素能过度活跃有关。它导致了 pQ 和 QT 缩短，增加了 T/QRS 比值和减速的出现。回顾性产前胎儿窘迫的发生率为 31.1%。传统 CTG 参数分析显示敏感性（72.7%）和特异性（87.1%）。除了传统的 CTG 分析外，ECG 参数的评估有助于更好地诊断胎儿窘迫。在本研究中，无创胎儿 ECG 的敏感性和特异性绝对相等（100%）。
结果表明，胎儿无创心电图监测比传统 CTG 更客观。
