The Noninvasive Fetal Electrocardiogram During Labor: A Review of the Literature

Carlijn Lempersz (Corresponding author), Lore Noben, Bart de Vries, Judith O E H van Laar, Michelle E M H Westerhuis, S Guid Oei

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Importance: The introduction of the cardiotocogram (CTG) during labor has not been found to improve neonatal outcome. The search for a more reliable, less invasive, and patient-friendly technique is ongoing. The noninvasive fetal electrocardiogram (NI-fECG) has been proposed as one such alternative.

Objectives: The aim of this study was to review the literature on the performance of NI-fECG for fetal monitoring during labor. Following the PRISMA guidelines, a systematic search in MEDLINE, EMBASE, and Cochrane Library was performed. Studies involving original research investigating the performance of NI-fECG during labor were included. Animal studies and articles in languages other than English, Dutch, or German were excluded. The QUADAS-2 checklist was used for quality assessment. A descriptive analysis of the results is provided.

Results: Eight articles were included. Pooled analysis of the results of the separate studies was not possible due to heterogeneity. All studies demonstrate that it is possible to apply NI-fECG during labor. Compared with Doppler ultrasound, NI-fECG performs equal or better in most studies.

Conclusions and Relevance: NI-fECG for fetal monitoring is a promising noninvasive and patient-friendly technique that provides accurate information. Future studies should focus on signal quality throughout labor, with the aim to further optimize technical development of NI-fECG.

Original languageEnglish
Pages (from-to)369-380
Number of pages12
JournalObstetrical and Gynecological Survey
Volume75
Issue number6
DOIs
Publication statusPublished - 1 Jun 2020

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