Menéndez T, Achenbach S, Moshage W, Flüg M, Beinder E, Kollert A, Bittel A, Bachmann K
Medizinische Klinik II mit Poliklinik, Friedrich-Alexander-Universität, Erlangen-Nürnberg.
Z Kardiol. 1998 Feb;87(2):111-8. doi: 10.1007/s003920050162.
Fetal magnetocardiography (fMCG) registers the magnetic field generated by the fetal heart. In contrast to the fetal electrocardiogram, fECG permits non-invasive registration of fetal heart activity and documentation of all parts of the PQRST-wave-forms from the second trimenon onwards. This facilitates the determination of cardiac time intervals and establishment of reference values for different stages of pregnancy. We examined 53 women in 104 recordings from the 10th week of gestation onwards (1 to 10 recordings per individual). The fMCG (37 magnetic channels, sampling rate 1024 Hz, bandwidth 1-200 Hz) was recorded non-invasively over the mother's abdomen in a magnetically shielded room. Registration of fetal heart beats was generally successful from the 20/21th week of gestation onwards. In a few cases, fetal heart beats could be registered as early as in the 16th week. Cardiac time intervals and amplitudes of fMCG increased concordantly with fetal growth. Mean P wave duration increased from 31 to 49 ms (p < 0.05), PQ interval from 95 to 107 ms (n.s.) and QRS duration from 36 to 52 ms (p < 0.01). The mean amplitudes of the P and R waves also increased. FMCG, furthermore permits a prenatal diagnosis of fetal cardiac arrhythmias. We recorded fetal arrhythmias in 20 cases (26-38th week), including episodes of ventricular and supraventricular arrhythmias or atrioventricular blockings. Due to its high resolution, fMCG offers new information on the development of fetal cardiac activity which cannot be achieved by conventional methods like cardiotocography or dopplerultrasound. Therefore, fMCG could become a new diagnostic instrument for monitoring fetal wellbeing during pregnancy.
胎儿磁心动图(fMCG)记录胎儿心脏产生的磁场。与胎儿心电图不同,fMCG允许对胎儿心脏活动进行无创记录,并从妊娠中期开始记录PQRST波形的所有部分。这有助于确定心脏时间间隔并建立不同妊娠阶段的参考值。我们对53名女性进行了检查,从妊娠第10周开始进行了104次记录(每人1至10次记录)。在磁屏蔽室内,通过母亲腹部对fMCG(37个磁通道,采样率1024Hz,带宽1 - 200Hz)进行无创记录。从妊娠第20/21周开始,胎儿心跳记录通常成功。在少数情况下,早在第16周就能记录到胎儿心跳。fMCG的心脏时间间隔和幅度随胎儿生长而相应增加。P波平均持续时间从31ms增加到49ms(p < 0.05),PQ间期从95ms增加到107ms(无统计学意义),QRS波持续时间从36ms增加到52ms(p < 0.01)。P波和R波的平均幅度也增加。此外,fMCG还可用于胎儿心律失常的产前诊断。我们记录了20例胎儿心律失常(妊娠26 - 38周),包括室性和室上性心律失常发作或房室传导阻滞。由于其高分辨率,fMCG提供了关于胎儿心脏活动发育的新信息,这是传统方法如胎心监护或多普勒超声无法获得的。因此,fMCG可能成为孕期监测胎儿健康的一种新的诊断工具。