Predictive value of the baseline T-QRS ratio of the fetal electrocardiogram in intrapartum fetal monitoring: A prospective cohort study

Jeroen H. Becker, Lidewij J M Kuipers, Ewoud Schuit, Gerard H A Visser, Eline S A Van Den Akker, Erik Van Beek, Antoinette C. Bolte, Robert J P Rijnders, Ben Willem J Mol, Martina M. Porath, Addy P. Drogtrop, Nico W E Schuitemaker, Christine Willekes, Michelle E M H Westerhuis, Karel G M Moons, Anneke Kwee

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6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)189-197
Number of pages9
JournalActa Obstetricia et Gynecologica Scandinavica
Volume91
Issue number2
DOIs
Publication statusPublished - Feb 2012
Externally publishedYes

Keywords

  • ST-analysis
  • STAN®
  • T-QRS ratio
  • fetal electrocardiogram
  • intrapartum monitoring
  • metabolic acidosis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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