TY - JOUR
T1 - Predictive value of the baseline T-QRS ratio of the fetal electrocardiogram in intrapartum fetal monitoring
T2 - A prospective cohort study
AU - Becker, Jeroen H.
AU - Kuipers, Lidewij J M
AU - Schuit, Ewoud
AU - Visser, Gerard H A
AU - Van Den Akker, Eline S A
AU - Van Beek, Erik
AU - Bolte, Antoinette C.
AU - Rijnders, Robert J P
AU - Mol, Ben Willem J
AU - Porath, Martina M.
AU - Drogtrop, Addy P.
AU - Schuitemaker, Nico W E
AU - Willekes, Christine
AU - Westerhuis, Michelle E M H
AU - Moons, Karel G M
AU - Kwee, Anneke
PY - 2012/2/1
Y1 - 2012/2/1
N2 - Objective. To evaluate the added value of the baseline T/QRS ratio to other known risk factors in predicting adverse outcome and interventions for suspected fetal distress. Design. Prospective cohort study. Setting. Three academic and six non-academic teaching hospitals in the Netherlands. Population. Laboring women with a high-risk cephalic singleton pregnancy beyond 36 weeks of gestation. Methods. We obtained STAN® recordings (ST-analysis, Neoventa, Sweden) from two previous studies. Three patient groups were defined: cases with adverse outcome, cases with emergency delivery because of suspected fetal distress without adverse outcome, and a reference group of uncomplicated cases. Baseline T/QRS ratios among the adverse outcome and intervention for suspected fetal distress cases were compared to those of the uncomplicated cases. The ability of baseline T/QRS to predict adverse outcome and suspected fetal distress was determined using a multivariable logistic model. Main outcome measures. The added value of the baseline T/QRS to other known risk factors in the prediction of adverse outcome and interventions for suspected fetal distress. Results. From 3462 recordings, 2459 were available for analysis. Median baseline T/QRS for uncomplicated cases, adverse outcome and interventions for suspected fetal distress were 0.12 (range 0.00-0.52), 0.12 (0.00-0.42) and 0.13 (0.00-0.39), respectively. There was no statistical difference between these groups. Multivariable analysis showed no added value of baseline T/QRS in the prediction of either adverse outcome or interventions for suspected fetal distress. Conclusion. Baseline T/QRS has no added value in the prediction of adverse neonatal outcome or interventions for suspected fetal distress.
AB - Objective. To evaluate the added value of the baseline T/QRS ratio to other known risk factors in predicting adverse outcome and interventions for suspected fetal distress. Design. Prospective cohort study. Setting. Three academic and six non-academic teaching hospitals in the Netherlands. Population. Laboring women with a high-risk cephalic singleton pregnancy beyond 36 weeks of gestation. Methods. We obtained STAN® recordings (ST-analysis, Neoventa, Sweden) from two previous studies. Three patient groups were defined: cases with adverse outcome, cases with emergency delivery because of suspected fetal distress without adverse outcome, and a reference group of uncomplicated cases. Baseline T/QRS ratios among the adverse outcome and intervention for suspected fetal distress cases were compared to those of the uncomplicated cases. The ability of baseline T/QRS to predict adverse outcome and suspected fetal distress was determined using a multivariable logistic model. Main outcome measures. The added value of the baseline T/QRS to other known risk factors in the prediction of adverse outcome and interventions for suspected fetal distress. Results. From 3462 recordings, 2459 were available for analysis. Median baseline T/QRS for uncomplicated cases, adverse outcome and interventions for suspected fetal distress were 0.12 (range 0.00-0.52), 0.12 (0.00-0.42) and 0.13 (0.00-0.39), respectively. There was no statistical difference between these groups. Multivariable analysis showed no added value of baseline T/QRS in the prediction of either adverse outcome or interventions for suspected fetal distress. Conclusion. Baseline T/QRS has no added value in the prediction of adverse neonatal outcome or interventions for suspected fetal distress.
KW - fetal electrocardiogram
KW - intrapartum monitoring
KW - metabolic acidosis
KW - ST-analysis
KW - STAN®
KW - T-QRS ratio
UR - http://www.scopus.com/inward/record.url?scp=84856090675&partnerID=8YFLogxK
U2 - 10.1111/j.1600-0412.2011.01320.x
DO - 10.1111/j.1600-0412.2011.01320.x
M3 - Article
C2 - 22066545
AN - SCOPUS:84856090675
SN - 0001-6349
VL - 91
SP - 189
EP - 197
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
IS - 2
ER -