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Role of Maternal Artifact in Fetal Heart Rate Pattern Interpretation

From the Department of Obstetrics and Gynecology at Harvard Medical School, Beth Israel Hospital, Boston, Massachusetts

Abstract

Electronic fetal heart rate monitoring has been accepted as the best means of, assessing fetal well-being in utero. Nevertheless, characteristics of the fetal monitoring equipment may lead to errors in diagnosing the condition of the fetus. Three cases illustrative of such shortcomings are presented. In 2 cases, maternal QRS complexes which were detectable at the fetal scalp electrode were counted, resulting in misleading recordings. In one of these, the heart rate of the mother was obtained from a dead fetus. In the other, the instrument produced an incomprehensible record as a result of counting both maternal and fetal complexes. In the third case, a heart rate recording thought to demonstrate fetal distress was obtained with the ultrasound probe of the monitor. Subsequent investigation demonstrated that the monitor was detecting the maternal pulse. With either direct or indirect monitoring technics the suspicion of fetal death, apparent fetal bradycardia, or apparent fetal arrhythmia requires simultaneous maternal and fetal heart rate and/or ECG recordings.

This article has been cited by other articles:

				D. J. Sherman, E. Frenkel, Y. Kurzweil, A. Padua, S. Arieli, and M. Bahar Characteristics of Maternal Heart Rate Patterns During Labor and Delivery Obstet. Gynecol., April 1, 2002; 99(4): 542 - 547. [Abstract] [Full Text] [PDF]