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Journal Club

Welcome to the IPBBN journal club. Every week we will post a new article along with an invattion to discuss any relevant issues and implications. Emphasis will be placed in posting groundbreaking/ thought provoking research, novel methodological approaches that could be aplied to the study perinatal brain and behavior and relevant findings that may have been overlooked.


This week's article:

Taylor MJ, Smith MJ, Thomas M, Green AR, Cheng F, Oseku-Afful S, Wee LY, Fisk NM, Gardiner HM. Non-invasive fetal electrocardiography in singleton and multiple pregnancies. BJOG. 2003 Jul;110(7):668-78. Pubmed Link

Abstract:

OBJECTIVES: To document the duration of fetal cardiac time intervals in uncomplicated singleton pregnancies using a novel non-invasive fetal electrocardiography (fECG) system and to demonstrate this technique's ability to acquire recordings in twin and triplet pregnancies. DESIGN: Prospective cross sectional observational study. SETTING: Antenatal wards and clinics, day assessment unit and centre for fetal care at a tertiary referral hospital, London, UK. POPULATION OR SAMPLE: Three hundred and four singleton and multiple pregnancies, 15-41 weeks of gestation. METHODS: Using electrodes sited on the maternal abdomen, a fetal electrocardiography (fECG) system was developed and tested on 304 pregnant women from 15 to 41 weeks of gestation, of whom 241 were uncomplicated singletons, 58 had twin and 5 had triplet pregnancies. The composite abdominal signals were stored on a laptop computer and the fECG derived off-line using a digital signal processing technique. For singletons, linear regression was used to analyse PR, QRS, QT and QTc intervals, and construct time-specific reference ranges. MAIN OUTCOME MEASURE: Duration of fECG time intervals as a function of gestational age. Success of signal separation in singleton, twin and triplet pregnancies. RESULTS: For singletons, a total of 250 recordings was obtained from 241 individuals with a signal separation success rate of 85% (213/250). Success rates were significantly poorer between 27 and 36 weeks of gestation (2 x k chi(2), P < 0.0001), with 84% (31/37) of separation failures occurring during this period. P, Q, R and S waves were seen in all cases where fetal signals were separated and were used to generate fECG time interval reference ranges. In 22% (43/199) of analysed cases, no T waves were identified, 63% (27/43) of whom were < or =24 weeks of gestation. In twins and triplets, separate fetal signals were obtained in 78% (91/116) and 93% (14/15), respectively; P, Q, R and S waves were evident in all averaged fECGs, while T waves were identified in 59% (54/91) and 57% (8/14). CONCLUSIONS: This study provides reference ranges with gestation for fECG intervals derived non-invasively from normal singleton pregnancies and demonstrates the feasibility of obtaining complete fECG recordings non-invasively across a wide gestational range in pregnancies of all pluralities. The fECG time intervals described will enable the identification of pathological fECG recordings from high risk pregnancies where fECG abnormalities are suspected.

 

 

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Journal Club

Archive

October 2006

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