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用于产时胎心监护的无创胎儿心电图

Non-invasive Fetal Electrocardiography for Intrapartum Cardiotocography.

作者信息

Vullings Rik, van Laar Judith O E H

机构信息

Biomedical Diagnostics Lab Eindhoven, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.

Nemo Healthcare, Veldhoven, Netherlands.

出版信息

Front Pediatr. 2020 Dec 9;8:599049. doi: 10.3389/fped.2020.599049. eCollection 2020.

Abstract

Fetal monitoring is important to diagnose complications that can occur during pregnancy. If detected timely, these complications might be resolved before they lead to irreversible damage. Current fetal monitoring mainly relies on cardiotocography, the simultaneous registration of fetal heart rate and uterine activity. Unfortunately, the technology to obtain the cardiotocogram has limitations. In current clinical practice the fetal heart rate is obtained via either an invasive scalp electrode, that poses risks and can only be applied during labor and after rupture of the fetal membranes, or via non-invasive Doppler ultrasound technology that is inaccurate and suffers from loss of signal, in particular in women with high body mass, during motion, or in preterm pregnancies. In this study, transabdominal electrophysiological measurements are exploited to provide fetal heart rate non-invasively and in a more reliable manner than Doppler ultrasound. The performance of the fetal heart rate detection is determined by comparing the fetal heart rate to that obtained with an invasive scalp electrode during intrapartum monitoring. The performance is gauged by comparing it to performances mentioned in literature on Doppler ultrasound and on two commercially-available devices that are also based on transabdominal fetal electrocardiography.

摘要

胎儿监测对于诊断孕期可能出现的并发症很重要。如果能及时发现,这些并发症在导致不可逆转的损害之前可能得到解决。目前的胎儿监测主要依靠胎心宫缩图,即同时记录胎儿心率和子宫活动。不幸的是,获取胎心宫缩图的技术存在局限性。在当前临床实践中,胎儿心率要么通过侵入性头皮电极获取,这种方法有风险且只能在分娩期间和胎膜破裂后应用;要么通过非侵入性多普勒超声技术获取,该技术不准确且存在信号丢失问题,尤其是在体重过高的女性、运动期间或早产孕妇中。在本研究中,利用经腹电生理测量以比多普勒超声更可靠的方式无创提供胎儿心率。通过在产时监测中将胎儿心率与通过侵入性头皮电极获得的心率进行比较来确定胎儿心率检测的性能。通过将其与文献中提到的关于多普勒超声以及另外两种同样基于经腹胎儿心电图的商用设备的性能进行比较来评估该性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3663/7755891/ae92408c6c38/fped-08-599049-g0001.jpg

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