Novel Possibilities for the Diagnosis of Fetal Distress in Pre-eclamptic Women

Abstract

Objective Fetal deterioration has been known as a result of acute or chronic disturbances in the system of ‘motherplacenta- fetus’. Pre-eclampsia (PE) is a maternal gestational disease caused by abnormal placentation that could provoke fetal distress. Aim The aim of the investigation was to survey the accuracy of fetal distress diagnostics in case of traditional cardiotocography (CTG) waveform evaluation and electrocardiography (ECG) parameters analysis obtained from maternal abdominal signal before and during labor in pre-eclamptic patients. Materials and methods One hundred and thirty-nine pregnant ladies at 32 to 40 weeks of gestation were enrolled in the study. There were 30 women with physiological pregnancy and normal fetal condition according to hemodynamic Doppler values and fetal ECG parameters in group I. In group II, 64 patients with mild and moderate PE were involved whom were performed fetal ECG noninvasive monitoring and hemodynamic Doppler. In group III, 45 patients with severe PE were monitored with fetal noninvasive ECG and hemodynamic Doppler. Results It was determined that fetal autonomic tone was suppressed with the relative increase of low frequency branch in pre-eclamptic patients. The increased value of the amplitude of mode and stress index was associated with abnormal myocardial adrenergic stimulation. It has induced pQ and QT shortening, increased T/QRS ratio. Fetal cardiac response was determined as gradual reduce of autonomic regulation. The most considerable negative correlation was determined in pair Apgar score 1 vs T/QRS (R = – 0.48; p < 0.05). The QT interval duration has revealed positive correlation with Apgar score 1 (R = 0.44; p < 0.05). Additional to the conventional CTG analysis evaluation of noninvasive fetal ECG parameters has contributed to better diagnostic of distress. Conclusion Fetal noninvasive ECG has showed sensitivity 100.0% and specificity 93.8% and, therefore, was more accurate and convenient method for fetal monitoring than conventional CTG.