TY - JOUR
T1 - Fetal acidaemia, the cardiotocograph and the T/QRS ratio of the fetal ECG in labour
AU - MACLACHLAN, NEIL A.
AU - SPENCER, JOHN A.D.
AU - HARDING, KATE
AU - ARULKUMARAN, SABARATNAM
PY - 1992
Y1 - 1992
N2 - Objective To relate the T/QRS ratio of the fetal electrocardiogram (ECG) to the cardiotocogram (CTG) and fetal pH during labour. Design Prospective data collection from selected monitored labours. Setting A postgraduate teaching hospital delivery suite. Subjects 113 women in labour at term. Main outcome measures Correlation of fetal T/QRS ratio values with pH values at the time of fetal blood sampling and at birth (umbilical artery blood). Comparison of the predictive values of raised T/QRS ratio and a pathological CTG for fetal acidaemia. Results Complete data sufficient for analysis was available for 51 fetal scalp blood samples and 93 umbilical artery pH samples. The median (range) of T/QRS ratio values before birth of 88 babies not requiring admission to the neonatal unit was 0.13 (0.00–0.32) with a 97.5th centile value of 0.28. T/QRS ratios did not correlate with fetal scalp pH values. Fetal scalp acidaemia (pH<7.20) was detected with rates of 50 and 13% respectively by a pathological CTG and by a T/QRS ratio above 0.28, the positive predictive values being 40% and 50%, respectively. There was a significant correlation between increasing T/QRS ratio and falling pH. Detection rates (sensitivities) for umbilical artery acidaemia (pH<7.12) were 76% and 29% whereas positive predictive values were 38% and 71% respectively for a pathological CTG and a T/QRS ratio above 0.28. Conclusion A raised T/QRS ratio (<0.28) had a considerably lower detection rate for fetal acidaemia during labour than a pathological CTG.
AB - Objective To relate the T/QRS ratio of the fetal electrocardiogram (ECG) to the cardiotocogram (CTG) and fetal pH during labour. Design Prospective data collection from selected monitored labours. Setting A postgraduate teaching hospital delivery suite. Subjects 113 women in labour at term. Main outcome measures Correlation of fetal T/QRS ratio values with pH values at the time of fetal blood sampling and at birth (umbilical artery blood). Comparison of the predictive values of raised T/QRS ratio and a pathological CTG for fetal acidaemia. Results Complete data sufficient for analysis was available for 51 fetal scalp blood samples and 93 umbilical artery pH samples. The median (range) of T/QRS ratio values before birth of 88 babies not requiring admission to the neonatal unit was 0.13 (0.00–0.32) with a 97.5th centile value of 0.28. T/QRS ratios did not correlate with fetal scalp pH values. Fetal scalp acidaemia (pH<7.20) was detected with rates of 50 and 13% respectively by a pathological CTG and by a T/QRS ratio above 0.28, the positive predictive values being 40% and 50%, respectively. There was a significant correlation between increasing T/QRS ratio and falling pH. Detection rates (sensitivities) for umbilical artery acidaemia (pH<7.12) were 76% and 29% whereas positive predictive values were 38% and 71% respectively for a pathological CTG and a T/QRS ratio above 0.28. Conclusion A raised T/QRS ratio (<0.28) had a considerably lower detection rate for fetal acidaemia during labour than a pathological CTG.
UR - http://www.scopus.com/inward/record.url?scp=0026586550&partnerID=8YFLogxK
U2 - 10.1111/j.1471-0528.1992.tb14387.x
DO - 10.1111/j.1471-0528.1992.tb14387.x
M3 - Article
C2 - 1547167
AN - SCOPUS:0026586550
SN - 1470-0328
VL - 99
SP - 26
EP - 31
JO - BJOG: An International Journal of Obstetrics & Gynaecology
JF - BJOG: An International Journal of Obstetrics & Gynaecology
IS - 1
ER -