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Published online: 2022-10-27
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The clinical significance of electronic fetal heart rate monitoring in twins

Anna Dera-Szymanowska1, Martyna Polska1, Wieslaw Markwitz1, Jerzy Moczko2, Nikodem Horst3, Krzysztof Szymanowski1
DOI: 10.5603/GP.a2022.0129
·
Pubmed: 36378125
Affiliations
  1. Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
  3. Department of General and Colorectal Surgery, Poznan University of Medical Sciences, Poznan, Poland

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2022-10-27

Abstract

Objectives: Fully effective intrapartum cardiotocographic (CTG) fetal heart monitoring is still missing. Visual analysis is far from credibility. Additional, computerized analysis techniques were proposed however they did not substantially decrease possible risks of fetal asphyxia. In twin pregnancies the problem is even more complicated. Our goal is to find the most valuable parameters in intrapartum CTG surveillance in twins, based on actual FIGO criteria.

Material and methods: Study included 58 women in labor who had been admitted to Delivery Department of tertiary care hospital with twin pregnancy in a period of one year. The features of the CTG (e.g., baseline, oscillation, decelerations, brady- or tachycardia) were grouped to create three variables that were closest to the FIGO CTG scale. All three groups were compared according to neonatal status (Apgar score at 5 min ≥ 7 or < 7; pH value in umbilical artery ≥ 7.20, < 7.20 or < 7.10 and BE (base excess) > or ≤ –12). Fetal status and its acid — base equilibrium was compared either with long term variability (LTV), short term variability (STV), or percentage of the signal loss.

Results: Out of 58 twin pregnancies, a total of 116 babies were born. One baby was born dead. From this group, 11 deliveries were natural births and 47 deliveries were C-sections. None of the analyzed features (pH, BE, Apgar, CTG features except tracing length, CTG FIGO categories) were statistically different between groups of singleton and twin pregnancies, except percentage of C-sections. No differences were found either for STV or LTV and fetal status.org CTG categories.

Conclusions: Prior to cardiotocographic tracing of twins during labor, ultrasound examination should be mandatory. Considerable loss of signal in CTG tracing in twins should provoke ultrasonographic confirmation of the fetal status.

Abstract

Objectives: Fully effective intrapartum cardiotocographic (CTG) fetal heart monitoring is still missing. Visual analysis is far from credibility. Additional, computerized analysis techniques were proposed however they did not substantially decrease possible risks of fetal asphyxia. In twin pregnancies the problem is even more complicated. Our goal is to find the most valuable parameters in intrapartum CTG surveillance in twins, based on actual FIGO criteria.

Material and methods: Study included 58 women in labor who had been admitted to Delivery Department of tertiary care hospital with twin pregnancy in a period of one year. The features of the CTG (e.g., baseline, oscillation, decelerations, brady- or tachycardia) were grouped to create three variables that were closest to the FIGO CTG scale. All three groups were compared according to neonatal status (Apgar score at 5 min ≥ 7 or < 7; pH value in umbilical artery ≥ 7.20, < 7.20 or < 7.10 and BE (base excess) > or ≤ –12). Fetal status and its acid — base equilibrium was compared either with long term variability (LTV), short term variability (STV), or percentage of the signal loss.

Results: Out of 58 twin pregnancies, a total of 116 babies were born. One baby was born dead. From this group, 11 deliveries were natural births and 47 deliveries were C-sections. None of the analyzed features (pH, BE, Apgar, CTG features except tracing length, CTG FIGO categories) were statistically different between groups of singleton and twin pregnancies, except percentage of C-sections. No differences were found either for STV or LTV and fetal status.org CTG categories.

Conclusions: Prior to cardiotocographic tracing of twins during labor, ultrasound examination should be mandatory. Considerable loss of signal in CTG tracing in twins should provoke ultrasonographic confirmation of the fetal status.

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Keywords

fetal heart; twin pregnancy; monitoring; cardiotocography

About this article
Title

The clinical significance of electronic fetal heart rate monitoring in twins

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2022-10-27

Page views

185

Article views/downloads

130

DOI

10.5603/GP.a2022.0129

Pubmed

36378125

Keywords

fetal heart
twin pregnancy
monitoring
cardiotocography

Authors

Anna Dera-Szymanowska
Martyna Polska
Wieslaw Markwitz
Jerzy Moczko
Nikodem Horst
Krzysztof Szymanowski

References (16)
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