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Fetal electrocardiogram (ECG) for fetal monitoring during labour

  1. James P Neilson*

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 31 MAY 2013

Assessed as up-to-date: 12 FEB 2013

DOI: 10.1002/14651858.CD000116.pub4


How to Cite

Neilson JP. Fetal electrocardiogram (ECG) for fetal monitoring during labour. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD000116. DOI: 10.1002/14651858.CD000116.pub4.

Author Information

  1. The University of Liverpool, Department of Women's and Children's Health, Liverpool, UK

*James P Neilson, Department of Women's and Children's Health, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK. jneilson@liverpool.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 31 MAY 2013

SEARCH

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Amer-Wahlin 2001 {published data only}
  • Amer-Wahlin I, Hellsten C, Noren H, Hagberg H, Herbst A, Kjellmer I, et al. Cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram for intrapartum fetal monitoring: a Swedish randomised controlled trial. Lancet 2001;358:534-8.
  • Amer-Wahlin I, Kallen K, Herbst A, Rydhstroem H, Sundstrom AK, Marsal K. Implementation of new medical techniques: experience from the Swedish randomized controlled trial on fetal ecg during labor. Journal of Maternal-Fetal & Neonatal Medicine 2005;18(2):93-100.
  • Amer-Wahlin I, Kjellmer I, Marsal K, Olofsson P, Rosen KG. Swedish randomized controlled trial of cardiotocography versus cardiotocography plus ST analysis of fetal electrocardiogram revisited: analysis of data according to standard versus modified intention-to-treat principle. Acta Obstetrica et Gynecologica Scandinavica 2011;90(9):990-6.
  • Amer-Wahlin I, Marsal K, Noren H, Hellsten C. Randomized controlled trial of CTG versus CTG + ST analysis of the fetal ECG. XVI FIGO World Congress of Obstetrics and Gynecology (Book 3); 2000 Sept 3-8; Washington DC, USA. 2000:35.
  • Hagberg H, Amer-Wahlin I, Hellsten C, Noren H, Herbst A, Lilja H, et al. Intrapartum fetal monitoring: cardiotocography versus cardiotocography plus fetal ECG ST waveform analysis. A Swedish randomized controlled trial. American Journal of Obstetrics and Gynecology 2001;184(1):S19.
  • Hanson J. Cardiotocography and ST analysis for intrapartum fetal monitoring. Lancet 2011;378(9797):1137-8.
  • Lund University. Decision 16 September 2010.
  • Marsal K. Personal communication 7th January 2011.
  • Marsal K. Cardiotocography and ST analysis for intrapartum fetal monitoring - author's reply. Lancet 2011;378(9797):1138.
  • Noren H, Amer-Wahlin I, Hagberg H, Herbst A, Kjellmer I, Marsal K, et al. Fetal electrocardiography in labor and neonatal outcome: data from the Swedish randomized controlled trial on intrapartum fetal monitoring. American Journal of Obstetrics and Gynecology 2003;188(1):183-92.
  • Noren H, STAN study group. Randomised controlled trial of CTG versus CTG + ST analysis of the fetal ECG. Prenatal and Neonatal Medicine 2000;5(Suppl 2):37.
  • Sundstrom AK, Swedish STAN Group. Randomised controlled trial CTG versus CTG + ST analysis of the fetal ECG. Journal of Obstetrics and Gynecology 2001;21(Suppl 1):S18-S19.
  • Swedish Research Council. Opinion provided on request for investigation of suspected misconduct in research - the STAN study. Log no 312-2008-7602.
Ojala 2006 {published data only}
Strachan 2000 {published data only}
  • Strachan BK, van Wijngaarden WJ, Sahota D, Chang A, James DK, for the FECG Study Group. Cardiotocography only versus cardiotocography plus PR-interval analysis in intrapartum surveillance: a randomised, multicentre trial. Lancet 2000;355:456-9.
  • van Wijngaarden WJ, Sahota DS, James DK, Farrell T, Mires GJ, Wilcox M, et al. Improved intrapartum surveillance with PR interval analysis of the fetal electrocardiogram: a randomised trial showing a reduction in fetal blood sampling. American Journal of Obstetrics and Gynecology 1996;174:1295-9.
  • van Wijngaarden WJ, Sahota DS, James DK, Symonds EM, Farrell T, Mires G. Does the fetal ECG improve intrapartum surveillance? II: A prospective evaluation. International Journal of Gynecology & Obstetrics 1994;46(Suppl 2):102.
Vayssiere 2007 {published data only}
  • Vayssiere C, David E, Haberstich R, Sebahoun V, Roth E, Meyer N, et al. A French randomized controlled trial on ST analysis in a population with abnormal FHR in labor. American Journal of Obstetrics and Gynecology 2006;195(6 Suppl 1):S222.
  • Vayssiere C, David E, Meyer N, Haberstich R, Sebahoun V, Roth E, et al. A French randomized controlled trial of ST-segment analysis in a population with abnormal cardiotocograms during labor. American Journal of Obstetrics and Gynecology 2007;197(3):299.e1-e6.
Westerhuis 2010 {published data only}
  • Becker J, Westerhuis M, Sterrenburg K, Kwee A, Visser G. Fetal blood sampling in the Dutch STAN-trial: reason to adjust the clinical guidelines?. American Journal of Obstetrics and Gynecology 2009;201(6 Suppl 1):S240.
  • Becker JH, Westerhuis ME, Sterrenburg K, van den Akker ES, van Beek E, Bolte AC, et al. Fetal blood sampling in addition to intrapartum ST-analysis of the fetal electrocardiogram: evaluation of the recommendations in the Dutch STAN(R) trial. BJOG: an international journal of obstetrics and gynaecology 2011;118(10):1239-46.
  • Kwee A. Cardiotocography plus ST-analysis of the fetal electrocardiogram versus cardiotocography only for intrapartum monitoring: a Dutch randomized trial. Journal of Perinatal Medicine 2009;37(Suppl 1):66.
  • Kwee A, Visser GHA. The cost-effectiveness of ST-analysis of the fetal electrocardiogram as compared to fetal blood sampling for intrapartum monitoring: a randomised controlled trial. Netherlands Trial Register (http://www.trialregister.nl) (accessed 1 November 2005).
  • Vijgen SMC, Westerhuis MEMH, Opmeer BC, Visser GHA, Moons KGM, Porath MM, et al. Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography alone. Acta Obstetrica et Gynecologica Scandinavica 2011;90(7):772-8.
  • Westerhuis ME, Moons KG, van Beek E, Bijvoet SM, Drogtrop AP, van Geijn HP, et al. A randomised clinical trial on cardiotocography plus fetal blood sampling versus cardiotocography plus ST-analysis of the fetal electrocardiogram (STAN) for intrapartum monitoring. BMC Pregnancy and Childbirth 2007;7:13.
  • Westerhuis ME, Visser GH, Moons KG, van Beek E, Benders MJ, Bijvoet SM, et al. Cardiotocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial. Obstetrics & Gynecology 2010;115(6):1173-80.
  • Westerhuis MEMH, Porath MM, Becker JH, Van Den Akker ESA, Van Beek E, Van Dessel HJHM, et al. Identification of cases with adverse neonatal outcome monitored by cardiotocography versus ST analysis: Secondary analysis of a randomized trial. Acta Obstetricia et Gynecologica Scandinavica 2012;91(7):830-7.
  • Westerhuis MEMH, Visser GHA, Moons KGM, Zuithoff NPA, Mol BWJ, Kwee A. Cardiotocography plus ST analysis of fetal electrocardiogram compared with cardiotocography only for intrapartum monitoring: a randomized controlled trial. Obstetrics & Gynecology 2011;117:406-7; 412.
Westgate 1993 {published data only}
  • Westgate J, Harris M, Curnow J, Greene K. Plymouth randomised controlled trial of 2400 cases - ST waveform plus CTG vs CTG alone for intrapartum monitoring. Proceedings of 26th British Congress of Obstetrics and Gynaecology; 1992; Manchester, UK. 1992:177.
  • Westgate J, Harris M, Curnow JSH, Greene KR. Plymouth randomized trial of cardiotocogram only vs ST waveform plus cardiotocogram for intrapartum monitoring in 2400 cases. American Journal of Obstetrics and Gynecology 1993;169:1151-60.
  • Westgate J, Harris M, Curnow JSH, Greene KR. Plymouth randomized trial of CTG vs ST waveform analysis plus CTG for intrapartum monitoring: 2400 cases. Journal of Perinatal Medicine 1992;20(1):268.
  • Westgate J, Harris M, Curnow JSH, Green KR. Randomized trial of cardiotocography alone or with ST waveform analysis for intrapartum monitoring. Lancet 1992;340:194-8.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Hruban 2006 {published data only}
  • Hruban L, Janku P, Zahradnickova J, Kurecova B, Roztocil A, Kachlík P, et al. Role of ST-analysis of fetal ECG in intrapartal fetus monitoring with presumed growth retardation. Ceska Gynekologie 2006;71(4):268-72.
Janku 2006 {published data only}
  • Janku P, Hruban L, Kurecova B, Roztocil A, Kachlik P, Zahradnickova J. ST analysis of fetal ECG in premature deliveries during 30th-36th week of pregnancy. Ceska Gynekologie 2006;71(3):163-8.
Olofsson 2003 {published data only}
  • Olofsson P. Current status of intrapartum fetal monitoring: cardiotocography versus cardiotocography + ST analysis of the fetal ECG. European Journal of Obstetrics & Gynecology and Reproductive Biology 2003;110:S113-S118.
Prieto 2008 {published data only}
  • Prieto AP, Pareja MV, Zuniga IV, Romero TA, Leon MDR, Ventoso FM. Pulse oximetry compared with fetal electrocardiogram to control intrapartum fetal wellbeing. Journal of Maternal-Fetal and Neonatal Medicine 2008;21(Suppl 1):141.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Spong 2013 {published data only}
  • Spong C. Fetal ST segment and T wave analysis in labor (STAN). ClinicalTrials.gov 2010.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Alfirevic 2006
Amer-Wahlin 2011
  • Amer-Wahlin I, Kjellmer I, Marsal K, Olofsson P, Rosen KG. Swedish randomized controlled trial of cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram revisited: Analysis of data according to standard versus modified intention-to-treat principle. Acta Obstetrica et Gynecologica Scandinavica 2011;90(9):990-6.
Dawes 1994
Elbourne 2002
Greene 1987
  • Greene KG. The ECG waveform. In: Whittle M editor(s). Baillieres Clinical Obstetrics and Gynaecology. Vol. 1, London: Bailliere Tindall, 1987:131-55.
Greene 1999
  • Greene K. Intrapartum fetal monitoring: CTG, ECG and fetal blood sampling. In: Rodeck CH, Whittle MJ editor(s). Fetal Medicine: Basic Science and Clinical Practice. London: Churchill Livingstone, 1999:985-1004.
Higgins 2011
  • Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Marsal 2011
  • Marsal K. Cardiotocography and ST analysis for intrapartum fetal monitoring - author's reply. Lancet 2011;378(9797):1138.
RevMan 2011
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Rosen 1989
  • Rosen KG, Lindecrantz K. STAN - the Gothenburg model for fetal surveillance during labour by ST analysis of the fetal ECG. Clinical Physics and Physiological Measurement 1989;10(Suppl B):51-6.
Rosen 1991
  • Rosen KG, Arulkumaran S, Greene KR, Lilja H, Lindecrantz K, Seneviratne H, et al. Clinical validity of fetal ECG waveform analysis. In: Saling E editor(s). Perinatology. Nutrition Workshop Series. Vol. 26, New York: Raven Press, 1991:95-110.
Swedish Research Council 2010
  • Swedish Research Council. Opinion provided on request for investigation of suspected misconduct in research - the STAN study. Log no 312-2008-7602.

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Neilson 1995
  • Neilson JP. Intrapartum fetal ECG plus heart rate recording. [revised 12 May 1994]. In: Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds) Pregnancy and Childbirth Database [database on disk and CDROM]. The Cochrane Collaboration; Issue 2, Oxford: Update Software; 1995.
Neilson 2003
  • Neilson JP Reviews. Fetal electrocardiogram (ECG) for fetal monitoring during labour. Cochrane Database of Systematic Reviews 2003, Issue 2. [DOI: 10.1002/14651858.CD000116]
Neilson 2006
Neilson 2012