ST Analysis of Fetal ECG in Premature Deliveries during 30th–36th Week of Pregnancy

Czech version

Authors: Petr Janků ¹; Lukáš Hruban ¹; B. Kuřecová ¹; A. Roztočil ²; P. Kachlík ³; J. Zahradníčková ⁴
Authors‘ workplace: Gynekologicko–porodnická klinika MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc. ¹; Gynekologicko-porodnické oddělení, Nemocnice Jihlava, primář prof. MUDr. A. Roztočil, CSc. ²; Katedra speciální pedagogiky, PedF MU, Brno, vedoucí katedry prof. PhDr. M. Vítková, CSc. ³; Neonatologické oddělení FN, Brno, primář MUDr. I. Borek ⁴
Published in: Ceska Gynekol 2006; 71(3): 163-168
Category: Original Article

Overview

Objective:
To determine the possibilities of ST analysis of fetal ECG (STAN) in premature deliveries between 30th to 36th week of pregnancy. To compare the results of a group of premature deliveries monitored by ST analysis with a control group of premature deliveries monitored by means of cardiotocography (CTG) and intrapartum fetal pulse oxymetry (IFPO).

Type of study:
A prospective study.

Setting:
Department of Gynecology-Obstetrics, Masaryk University and Faculty Hospital Brno.

Methods:
The authors evaluated 39 women with premature delivery between 30th and 36th week of pregnancy from a total cohort of 239 high-risk pregnant women, who had been monitored by means of ST analysis of fetal ECG. The control group included 229 pregnant women who gave birth between 30th and 36th week of pregnancy under the monitoring with CTG and IFPO. The allocation into individual groups was at random order. The authors evaluated the duration and way of termination of delivery, pH in arterial umbilical blood, Apgar score in the first, fifth and tenth minute, total duration of hospitalization, necessity and duration of stay at the Neonatologic Intensive Care Unit, Intermediatry Intensive Care Unit, the presence of sepsis, hyperbilirubinemia and neurological state of the newborn. The statistical analysis was performed by means of the Fisher’s exact test, Kruskal-Wallis test, χ² test and the parametric test Anova.

Results:
Almost none of the observed parameters in both categories of premature deliveries (STAN vs. CTG+IFPO) exhibited a statistically significant difference except a mild neurological affection of the newborn. In the group of premature deliveries monitored by ST analysis there are only 33.3% of newborns with signs of light neurological damage as compared with the control group, where 56.3% subjects were so affected (p<0.01).

Conclusion:
It has become obvious that the ST analysis of fetal ECG in premature deliveries between 30th and 36th week of pregnancy provides the same results as the so far used monitoring by CTG and IFPO. In the group of premature deliveries monitored by the ST analysis, there were significantly less frequent neurological disturbances.

Key words:
ST analysis, fetal ECG, premature delivery, monitoring, cardiography, IFPO