Maternal and Fetal Health Research Center, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St. Mary's Hospital, Manchester, UK.
Manchester University NHS Foundation Trust, St. Mary's Hospital, Manchester Academic Health Science Center, Manchester, UK.
Acta Obstet Gynecol Scand. 2018 Dec;97(12):1515-1523. doi: 10.1111/aogs.13446. Epub 2018 Sep 27.
Continuous fetal monitoring is used to objectively record the fetal heart rate and fetal activity over an extended period of time; however, its feasibility and acceptability to women is currently unknown. The study addressed the hypothesis that continuous fetal monitoring is feasible and acceptable to pregnant women.
Pregnant participants (n = 22) were monitored using a continuous fetal electrocardiography device, the Monica AN24. Signal quality, duration of recording and cardiotocography findings were correlated with maternal and fetal factors. Participants' change in anxiety before and after monitoring was assessed using validated questionnaires. Participants' experiences were explored through a questionnaire (n = 20) and semi-structured interview (n = 13).
Recordings were successfully obtained in 19 of the 22 participants (86.3%). The mean recording quality of fetal heart rate was 69.0% (range 17.4%-99.4%) and maternal heart rate was 99.0% (90.9%-100.0%). Recording quality was positively correlated with gestational age (P = 0.05) and negatively correlated with uterine activity and maternal movement (P < 0.001). Overall, participants were satisfied with their experience of continuous fetal monitoring; 30% considered it preferable to intermittent monitoring. Continuous fetal monitoring did not significantly increase maternal anxiety, with a trend towards a reduction in Pregnancy Specific Anxiety score (P = 0.07). Qualitative analysis grouped women's responses into three themes: (a) reassurance and anxiety, (b) the physical device and (c) future developments in continuous fetal monitoring.
Continuous fetal monitoring is a feasible and acceptable form of monitoring to pregnant women although further practical improvements could be incorporated. Further research is required to assess the ability of continuous fetal monitoring to detect fetal compromise.
连续胎儿监测用于客观记录长时间内的胎儿心率和胎儿活动；然而，目前尚不清楚其对孕妇的可行性和可接受性。本研究旨在验证连续胎儿监测对孕妇而言是可行且可接受的这一假设。
使用连续胎儿心电图设备（Monica AN24）对 22 名孕妇进行监测。对信号质量、记录持续时间和胎心监护结果与母婴因素进行相关性分析。使用经过验证的问卷评估监测前后孕妇焦虑的变化。通过问卷（n=20）和半结构化访谈（n=13）探索参与者的体验。
22 名参与者中的 19 名（86.3%）成功获得了记录。胎儿心率的平均记录质量为 69.0%（范围 17.4%-99.4%），母体心率为 99.0%（90.9%-100.0%）。记录质量与胎龄呈正相关（P=0.05），与子宫活动和母体运动呈负相关（P<0.001）。总体而言，参与者对连续胎儿监测的体验感到满意；30%的人认为它优于间歇性监测。连续胎儿监测并未显著增加孕妇的焦虑，妊娠特异性焦虑评分呈下降趋势（P=0.07）。定性分析将女性的反应分为三个主题：（a）安心和焦虑，（b）物理设备，（c）连续胎儿监测的未来发展。
连续胎儿监测对孕妇来说是一种可行且可接受的监测方式，尽管可以进一步进行实际改进。需要进一步的研究来评估连续胎儿监测检测胎儿窘迫的能力。
