This non-invasive fECG presents an alternative, reliable and accurate assessment for fetal well-being during the 1(st) stage of labor.

Objective/Aims: To investigate the presence of signal ambiguity of intrapartum fetal heart rate (FHR) monitoring during delivery by comparing simultaneous cardiotocogram (CTG), abdominal fetal electrocardiogram (ECG) with continuous maternal ECG. Methods: A total of 144 simultaneous CTG (Corometrics^© 250 series), abdominal fetal ECG (Monica -AN24™) and maternal ECG (Monica AN24™) recordings were evaluated. Main Outcome Measures: When the FHR is within 5 bpm of the maternal heart rate (MHR) acquired from the ECG, it is classified as ‘MHR/FHR ambiguity'. Statistical analyses were performed with Fisher's exact test and the Wilcoxon signed-rank test. Results: Comparison of abdominal fetal ECG against CTG demonstrates significantly less ‘MHR/FHR ambiguity' in both the first stage (mean 0.70 vs. 1.22%, p < 0.001) and second stage of labour (mean 3.30 vs. 6.20%, p < 0.001). Conclusion: Intrapartum FHR monitoring in daily practice via the CTG modality provides significantly more ‘MHR/FHR ambiguity' than abdominal fetal ECG, which also provides additional information on the MHR.

Objective: To evaluate and compare the computer analyzing software system with subjective interpretation using the FIGO classification of intrapartum cardiotocograms. Methods: Twenty-four obstetricians and 19 midwives from 3 hospitals [19 junior (≤3 years) and 24 senior (>3 years) experience] participated in this study. Forty-three doctors and midwifes interpreted intrapartum cardiotocographic (CTG) readings from 12 parturients without knowing the clinical outcome. Two CTG readings were repeated for evaluation of the intraobserver variability. Inter- and intraobserver agreement in CTG interpretation using the FIGO score and the computer analyzing software was assessed via proportions of agreement (Pa), with 95% confidence intervals. The level of inter- and intraobserver agreement was analyzed by calculating Pa values for CTG baseline, variability, accelerations and decelerations. Results: In total, for all parameters of the FIGO classification, Pa was very low. The highest 95% confidence level of Pa was found for the baseline parameter (0.49–1.01), and the lowest for the parameter acceleration. No significant difference was seen between obstetricians and midwifes as well as between junior and senior experience. In assessments of normal cases, the Pa were significantly higher than in pathological readings. Conclusion: Computer analyzing software can reduce the high inter- and intraobserver variability; however, further studies are needed to find out whether this can improve fetal outcome and reduce the number of Cesarean sections.