Breuker K H, Khalili-Brunklaus D, Bolte A
Arch Gynakol. 1976 Oct 15;221(3):211-35. doi: 10.1007/BF00667716.
The application possibilities of abdominal fetal electrocardiography for pre- and subpartual continuous registration of the fetal heart frequency are examined. For this purpose the technical quality of 403 abdominal FEKG-registrations were checked in the individual stages of pregnancy and during birth. The average time spent looking for the best position with the greatest R-wave amplitude amounting to 2.6 min. The abdominal longitudinal position and the right hand oblique abdominal position proved to be advantageous with longitudinal presentation of the fetus. With fetal oblique to transverse presentation and in the 6th to 7th month of pregnancy the transverse abdominal position was likewise favourable. The technical quality of the supervision varied in the individual months of pregnancy. The best results were achieved in the 6th and 11th month of pregnancy. The worst technical quality was registered in the 8th month. In the 7th and 9th month two thirds of registrations were at least adequate. Sub partu the registrations during the first stage of labour were in two thirds of the cases very good and good, in a quarter satisfactory, in approx. a sixth adequate and fairly bad. In the second stage the registrations were considerably worse, 10.7% were satisfactory, 28.6% adequate and 59.8% deficient. Prepartually the technical quality was dependent on the fetal R-wave amplitude. In the second stage of labour no correlation between fetal R-wave amplitude and technical quality could be ascertained. The rupture of the amnion only influenced the quality of the registrations, if the satisfactory of labour increased. Adiposis and the position of the placenta did not affect the technical quality of the registrations. The lateral positions of the patient led to unusable registrations in 26.2%, in 46.9% the left and in 44.6% the right lateral position could be accepted without loss of quality. The comparison of the subpartual parallel registrations by means of phonocardiography/abdominal fetal electrocardiography, as well as direct/abdominal fetal electrocardiography showed no differences in the baseline. Differences in the floating-line in the case of simultaneous phonocardiography/abdominal fetal electrocardiography concerned the phonocardiographic registrations and in the case of simultaneous abdominal/direct fetal electrocardiography the abdominal registrations. They were caused by reduction in the technical quality. The fluctuation types of the abdominal and direct registrations were identical. In the case of simultaneous phonocardiography/abdominal fetal electrocardiography differences were found both in the oscillation amplitude and the oscillation frequency. The difference in the oscillation frequency was caused by a bad technical quality. The lower oscillation amplitude in abdominal fetal EKG-registrations was defined by the more exactly signal of the fetal R-wave...
研究了腹部胎儿心电图在产前和分娩时连续记录胎儿心率的应用可能性。为此,对403次腹部胎儿心电图记录在妊娠各阶段及分娩期间的技术质量进行了检查。寻找R波振幅最大的最佳位置平均耗时2.6分钟。对于纵产式胎儿,腹部纵向位置和右手斜腹位被证明是有利的。当胎儿呈斜位至横位时,在妊娠6至7个月时,腹部横位同样有利。妊娠各月监测的技术质量有所不同。在妊娠第6个月和第11个月取得了最佳结果。技术质量最差的是在第8个月。在第7个月和第9个月,三分之二的记录至少是合格的。分娩时,第一产程中的记录在三分之二的病例中非常好和良好,四分之一令人满意,约六分之一合格且相当差。在第二产程中,记录明显更差,10.7%令人满意,28.6%合格,59.8%不合格。产前技术质量取决于胎儿R波振幅。在第二产程中,未发现胎儿R波振幅与技术质量之间存在相关性。胎膜破裂仅在分娩满意度增加时才会影响记录质量。肥胖和胎盘位置不影响记录的技术质量。患者的侧卧位导致26.2%的记录不可用,在46.9%的情况下左侧卧位和44.6%的情况下右侧卧位可被接受且不损失质量。通过心音图/腹部胎儿心电图以及直接/腹部胎儿心电图对分娩时平行记录进行比较,发现基线无差异。在心音图/腹部胎儿心电图同步记录时,浮动线的差异涉及心音图记录,而在腹部/直接胎儿心电图同步记录时,差异涉及腹部记录。它们是由技术质量下降引起的。腹部和直接记录的波动类型相同。在心音图/腹部胎儿心电图同步记录时,在振荡幅度和振荡频率方面均发现差异。振荡频率的差异是由技术质量差引起的。腹部胎儿心电图记录中较低的振荡幅度是由胎儿R波信号更精确所决定的……