Donanım ve Artefaktlar
Özet
Kadın doğum hekimlerinin veya yardımcı sağlık personellerinin fetal monitorizasyonu doğru anlayabilmesi için öncelikle, fetal kalp atım hızını ve uterus aktivitesini anlatan monitorizasyon yöntemlerini ve artefaktları iyi anlaması gerekir. Elektronik fetal monitörler birçok zaman doğru yorum yapsa da bazen çıktılar yanıltıcı olabilir. Fetal kalp hızının yorumlanmasında yapılan hatalar genelde veri elde etme kalitesi ve prezentasyonla ilişkilidir. Bu bölümde elektronik fetal monitorizasyonunun uygulama hataları ve artefaktlar hakkında bilgi verilecektir.
For obstetricians and allied healthcare professionals to accurately interpret fetal monitoring, it is essential to have a solid understanding of the methods used to assess fetal heart rate and uterine activity, as well as the artifacts that may occur. While electronic fetal monitors often provide reliable interpretations, the outputs can sometimes be misleading. Errors in interpreting fetal heart rate are generally related to the quality of data acquisition and its presentation. This section will provide information on the application errors and artifacts associated with electronic fetal monitoring.
Referanslar
Goodline RC, Cheatham JP. Electronic fetal monitor paced by maternal implanted pacemaker. American journal of obstetrics and gynecology, 1985;153(5), 570-571. doı:10.1016/0002-9378(85)90479-x .
Westgren M, Ingemarsson I. Maternal pacemaker activity mimicking fetal heart during labor. Zeitschrift fur Geburtshilfe und Perinatologie, 1980;184(6), 443-444. PMID: 7222876.
Schneiderman CL, Waxman B, Goodman CJ Jr. Maternal-fetal electrocardiogram conduction with intrapartum death. American Journal of Obstetrics and Gynecology, 113(8), 1130-1133. doı: 10.1016/0002-9378(72)90747-8 .
Lackritz R, Schiff I, GibsonM. et al. Decelerations on fetal electrocardiography with fetal demise. Obstetrics & Gynecology, 51(3), 367-368. doı: 10.1097/00006250-197803000-00025 .
Fukushima T, Flores CA, Hon EH, et al. Limitations of autocorrelation in fetal heart rate monitoring. American journal of obstetrics and gynecology, 1985;153:685. doı: 10.1016/s0002-9378(85)80261-1 .
Amato J: Fetal heart rate monitoring. American journal of obstetrics and gynecology, 1983;147:967. doı: 10.1016/0002-9378(83)90255-7.
Cremer M. Über die direkte Ableitung der Aktionsströme des menschlichen Herzens vom Oesophagus und über das Elektrokardiogramm des Fötus. Münch Med Wschr. 1906;53:811–13. doi:10.1016/0002-8703(58)90213-8.
Larks SD, Dasgupta K. Fetal electrocardiography with special reference to early pregnancy. American Heart Journal, 56(5), 701-714. doı: 10.1016/0002-8703(58)90213-8 .
Hon EH, Hess OW. The clinical value of fetal electrocardigraphy. American journal of obstetrics and gynecology.1960;79(5):1012-1023. doı: 10.1016/0002-9378(60)90699-2 .
Nageotte MP, Freeman RK, Freeman AG, et al. Short term variability assessment from abdominal electrocardiogram during the antenatal period. American Journal of Obstetrics and Gynecology. 1983;145(5):566-569. doı: 10.1016/0002-9378(83)91197-3 .
Oldenburg JT, Macklin M. Changes in the conduction of the fetal electrocardiogram to the maternal abdominal surface during gestation. American journal of obstetrics and gynecology. 1977;129(4): 425-433. doı: 10.1016/0002-9378(77)90589-0.
Devoe LD, Gardner P, Dear C, et al. Monitoring intrauterine pressure during active labor:A prospective comparison of two methods. The Journal of Reproductive Medicine.1989; 34(10): 811-814.PMID: 2795563.
Murata Y, Martin CB. Systolic time intervals of the fetal cardiac cycle.Obstetrics & Gynecology: 1974; 44(2): 224-232. PMID: 4422839.
Wolfson R, Zador I, Pillay S, et al. Antenatal investigation of human fetal systolic time intervals. American Journal of Obstetrics and Gynecology. 1977;129(2):203-207. doı: 10.1016/0002-9378(77)90745-1 .
Murata Y, Martin C, Ikenoue T,et al. Antepartum evaluation of the pre-ejection period of the fetal cardiac cycle. Journal of Obstetrics and Gynecology. 1978;132(3):278-284. doı: 10.1016/0002-9378(78)90893-1 .
Murata Y, Martin C, Ikenoue T,et al. Cardiac systolic intervals in fetal monkeys: pre-ejection period. American Journal of Obstetrics and Gynecology. 1978:132(3): 285-293. doı: 10.1016/0002-9378(78)90894-3 .
Murata Y, Miyake K, Quilligan E.Pre-ejection of cardiac cycles in fetal lamb.- American Journal of Obstetrics and Gynecology. 133(5), 509-514. doı: 10.1016/0002-9378(79)90285-0 .
Greene KR, Dawes GS, Lilja H, et al. Changes in the ST waveform of the lamb electrocardiogram with hypoxia. American Journal of Obstetrics and Gynecology. 1982;144(8):950-958. doı: 10.1016/0002-9378(82)90190-9 .
Windmark C, Jansson T, Lindecrantz K, et al. ECG waveform, short term heart rate variability and plasma catecholamine concentrations in response to hypoxia in intrauterine growth retarded guinea pig fetuses. Journal of Developmental Physiology.1991; 15(3):161-168.PMID: 1940143.
Lijia H, Karlsson K, Lindecrantz K, et al. Microprocessor based waveform analysis of the fetal electrocardiogram during labor. International Journal of Gynecology & Obstetrics. 1989;30(2):109-116. doı: 10.1016/0020-7292(89)90304-4 .
Arulkumaran S, Lijia H, Lindecrantz K, et al. Fetal ECG waveform analysis should improve fetal surveillance in labor. Journal of Perinatal Medicine. 1990;18:13-22. doı: 10.1515/jpme.1990.18.1.13 .
Westgate J, Harris M, Curnow JSH, et al. Plymouth randomized trial of cardiotocogram only versus ST waveform plus cardiotocogram for intrapartum monitoring: 2400 cases. American journal of obstetrics and gynecology. 169(5), 1151-1160. doı: 10.1016/0002-9378(93)90273-l .
Amer-Wahlin I, Hellsten C, Noren H, et al. Cardiotocogram only versus cardiotocography plus ST analysis of the fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomized controlled trial.The Lancet. 358;(9281):534-538. doı: 10.1016/s0140-6736(01)05703-8.
Referanslar
Goodline RC, Cheatham JP. Electronic fetal monitor paced by maternal implanted pacemaker. American journal of obstetrics and gynecology, 1985;153(5), 570-571. doı:10.1016/0002-9378(85)90479-x .
Westgren M, Ingemarsson I. Maternal pacemaker activity mimicking fetal heart during labor. Zeitschrift fur Geburtshilfe und Perinatologie, 1980;184(6), 443-444. PMID: 7222876.
Schneiderman CL, Waxman B, Goodman CJ Jr. Maternal-fetal electrocardiogram conduction with intrapartum death. American Journal of Obstetrics and Gynecology, 113(8), 1130-1133. doı: 10.1016/0002-9378(72)90747-8 .
Lackritz R, Schiff I, GibsonM. et al. Decelerations on fetal electrocardiography with fetal demise. Obstetrics & Gynecology, 51(3), 367-368. doı: 10.1097/00006250-197803000-00025 .
Fukushima T, Flores CA, Hon EH, et al. Limitations of autocorrelation in fetal heart rate monitoring. American journal of obstetrics and gynecology, 1985;153:685. doı: 10.1016/s0002-9378(85)80261-1 .
Amato J: Fetal heart rate monitoring. American journal of obstetrics and gynecology, 1983;147:967. doı: 10.1016/0002-9378(83)90255-7.
Cremer M. Über die direkte Ableitung der Aktionsströme des menschlichen Herzens vom Oesophagus und über das Elektrokardiogramm des Fötus. Münch Med Wschr. 1906;53:811–13. doi:10.1016/0002-8703(58)90213-8.
Larks SD, Dasgupta K. Fetal electrocardiography with special reference to early pregnancy. American Heart Journal, 56(5), 701-714. doı: 10.1016/0002-8703(58)90213-8 .
Hon EH, Hess OW. The clinical value of fetal electrocardigraphy. American journal of obstetrics and gynecology.1960;79(5):1012-1023. doı: 10.1016/0002-9378(60)90699-2 .
Nageotte MP, Freeman RK, Freeman AG, et al. Short term variability assessment from abdominal electrocardiogram during the antenatal period. American Journal of Obstetrics and Gynecology. 1983;145(5):566-569. doı: 10.1016/0002-9378(83)91197-3 .
Oldenburg JT, Macklin M. Changes in the conduction of the fetal electrocardiogram to the maternal abdominal surface during gestation. American journal of obstetrics and gynecology. 1977;129(4): 425-433. doı: 10.1016/0002-9378(77)90589-0.
Devoe LD, Gardner P, Dear C, et al. Monitoring intrauterine pressure during active labor:A prospective comparison of two methods. The Journal of Reproductive Medicine.1989; 34(10): 811-814.PMID: 2795563.
Murata Y, Martin CB. Systolic time intervals of the fetal cardiac cycle.Obstetrics & Gynecology: 1974; 44(2): 224-232. PMID: 4422839.
Wolfson R, Zador I, Pillay S, et al. Antenatal investigation of human fetal systolic time intervals. American Journal of Obstetrics and Gynecology. 1977;129(2):203-207. doı: 10.1016/0002-9378(77)90745-1 .
Murata Y, Martin C, Ikenoue T,et al. Antepartum evaluation of the pre-ejection period of the fetal cardiac cycle. Journal of Obstetrics and Gynecology. 1978;132(3):278-284. doı: 10.1016/0002-9378(78)90893-1 .
Murata Y, Martin C, Ikenoue T,et al. Cardiac systolic intervals in fetal monkeys: pre-ejection period. American Journal of Obstetrics and Gynecology. 1978:132(3): 285-293. doı: 10.1016/0002-9378(78)90894-3 .
Murata Y, Miyake K, Quilligan E.Pre-ejection of cardiac cycles in fetal lamb.- American Journal of Obstetrics and Gynecology. 133(5), 509-514. doı: 10.1016/0002-9378(79)90285-0 .
Greene KR, Dawes GS, Lilja H, et al. Changes in the ST waveform of the lamb electrocardiogram with hypoxia. American Journal of Obstetrics and Gynecology. 1982;144(8):950-958. doı: 10.1016/0002-9378(82)90190-9 .
Windmark C, Jansson T, Lindecrantz K, et al. ECG waveform, short term heart rate variability and plasma catecholamine concentrations in response to hypoxia in intrauterine growth retarded guinea pig fetuses. Journal of Developmental Physiology.1991; 15(3):161-168.PMID: 1940143.
Lijia H, Karlsson K, Lindecrantz K, et al. Microprocessor based waveform analysis of the fetal electrocardiogram during labor. International Journal of Gynecology & Obstetrics. 1989;30(2):109-116. doı: 10.1016/0020-7292(89)90304-4 .
Arulkumaran S, Lijia H, Lindecrantz K, et al. Fetal ECG waveform analysis should improve fetal surveillance in labor. Journal of Perinatal Medicine. 1990;18:13-22. doı: 10.1515/jpme.1990.18.1.13 .
Westgate J, Harris M, Curnow JSH, et al. Plymouth randomized trial of cardiotocogram only versus ST waveform plus cardiotocogram for intrapartum monitoring: 2400 cases. American journal of obstetrics and gynecology. 169(5), 1151-1160. doı: 10.1016/0002-9378(93)90273-l .
Amer-Wahlin I, Hellsten C, Noren H, et al. Cardiotocogram only versus cardiotocography plus ST analysis of the fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomized controlled trial.The Lancet. 358;(9281):534-538. doı: 10.1016/s0140-6736(01)05703-8.
