Influence of intrauterine growth restriction on cardiac time intervals evaluated by fetal magnetocardiography

Grimm, Barbara; Kaehler, Christiane; Schleußner, E; Schneider, Uwe; Haueisen, Jens; Seewald, Hans-Joachim

doi:10.1016/s0378-3782(03)00079-3

Cited by 28 publications

(39 citation statements)

References 24 publications

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“…However, that for T wave was rather low, since higher detection rates for T wave, e.g. over than 90%, have been recently reported (13,14). This is partly because we excluded cases with ambiguous onset or endpoint of T wave as unsuccessful and because our study included a considerable number of fetuses at early stages of development (22% of the fetuses were between 22 and 28 wk of gestation) than the subjects in the above studies.…”

Section: Discussionmentioning

confidence: 90%

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

et al. 2006

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Fetal magnetocardiography (fMCG) is useful for analysis of fetal cardiac events. However, fetal presentation and movement affect the fMCG waveform, making it difficult to standardize the waveform. The aim of this study was to investigate whether the use of vector magnetometers can compensate for these limitations. We studied 59 fetuses (gestational age, 22-40 wk, median, 32), including 41 with uncomplicated pregnancies and 18 with fetal cardiac disease. fMCG was recorded twice in each case, and the two waveforms were compared with each other in uncomplicated subjects to investigate the effects of fetal presentation. The superconducting quantum interference device (SQUID) system used in this study was a 12-channel vector magnetometer, by which the three components of the magnetic field (Bx, By, Bz) could be detected simultaneously at four recording points. By constructing the three components, a composite waveform (Bxyz) was obtained. The configuration of the composite waveforms was similar among normal fetuses always with positive polarity, independent of fetal presentation and movement. The difference in the time intervals (PR, QRS, and ventricular activation time [VAT]) between the first and second measurements was minimal in the composite waveforms (Bxyz) compared with that in each channel (Bx, By, Bz). Even before signal averaging, waveforms with high time resolution were recorded in at least one of the three components, making it possible to analyze fetal arrhythmias precisely. Our results indicate that vector magnetocardiography is potentially useful for standardization of the fMCG waveforms and to provide a more complete and accurate analysis of fetal arrhythmias. fMCG has gathered increasing interest in recent years, particularly its potential clinical application (1-5). fMCG has an advantage over fetal electrocardiography recorded on the maternal abdomen in detecting fetal heart signals because magnetic fields are far less insulated by vernix caseosa and less interfered by maternal signals (6). fMCG may also be advantageous to fetal echocardiography for precise analysis of arrhythmias because it reflects the electric not mechanical properties of the heart (3), although the latter is a more prevalent and valuable method with relevant time resolution. Several studies have already reported the usefulness of fMCG in the diagnosis and management of fetal arrhythmias (5,7). Since fMCG provides detailed diagnosis of fetal arrhythmias, it is feasible to administer antiarrhythmic agents transplacentally based on accurate fMCG-based diagnosis (5,7,8).One disadvantage of the fMCG waveforms is their tendency to be largely affected by fetal orientation and movement, making it difficult to compare the waveforms among fetuses in various presentations. fMCG waveforms even fluctuate during measurement in the same fetus. Furthermore, fMCG data somewhat vary depending on the superconducting quantum interference device (SQUID) system used and the protocol of data acquisition (9). Nevertheless, the magnetic field ...

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Section: Discussionmentioning

confidence: 90%

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

et al. 2006

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“…Studies using FMCG (Leuthold et al, 1999; Kähler et al, 2002; Grimm et al, 2003; Bolin et al, 2016) have shown that in the normal fetus ECG parameters lengthen as gestational age increases. The prevailing theory for this is that prolongation is caused by the increase in size of the fetal heart.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast ST analysis (STAN) (Ross et al, 2004), requires rupturing the amniotic membranes and transcervically attaching needles into the fetal scalp. Mobility is achieved using a simple ensemble of portable equipment, laptop and signal extractor, unlike other immobile complex systems, such as in fetal magnetocardiography (FMCG) (Leuthold et al, 1999; Kähler et al, 2002; Grimm et al, 2003). …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Abdominal Fetal Electrocardiography in Early Intrauterine Growth Restriction

et al. 2017

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Objectives: This descriptive study was performed to evaluate the capability of a non-invasive transabdominal electrocardiographic system to extract clear fetal electrocardiographic (FECG) measurements from intrauterine growth restricted (IUGR) fetuses and to assess whether abdominal FECG parameters can be developed as markers for evaluating the fetal cardiac status in IUGR.Methods: Transabdominal FECG was attempted in 20 controls and 15 IUGR singleton pregnancies at 20+0−33+6 weeks gestation. Standard ECG parameters were compared between the study groups and evaluated for their correlation. Accuracy for the prediction of IUGR by cut off values of the different FECG parameters was also determined.Results: Clear P-QRST complexes were recognized in all cases. In the IUGR fetuses, the QT and QTc intervals were significantly prolonged (p = 0.017 and p = 0.002, respectively). There was no correlation between ECG parameters and Doppler or other indices to predict IUGR. The generation of cut off values for detecting IUGR showed increasing sensitivities but decreasing specificities with the prolongation of ECG parameters.Conclusion: The study of fetal electrocardiophysiology is now feasible through a non-invasive transabdominal route. This study confirms the potential of FECG as a clinical screening tool to aid diagnosis and management of fetuses after key limitations are addressed. In the case of IUGR, both QT and QTc intervals were significantly prolonged and thus validate earlier study findings where both these parameters were found to be markers of diastolic dysfunction. This research is a useful prelude to a test of accuracy and Receiver Operating Characteristics (ROC) study.

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“…The separation of fetal magnetocardiographic traces and the monitoring of fetal cardiac rhythms will allow extending to twin pregnancy all the possible clinical indications for fMCG, first of all the characterization of fetal arrhythmias (van Leeuwen et al 1999, Wakai et al 2000, 2003, Kandori et al 2003, Menendez et al 2001, Hosono et al 2002, Quartero et al 2002, Comani et al 2004a, but also situations still under evaluation, such as fetal intra-uterine growth retardation (Grimm et al 2003), cardiac hypertrophy in the fetus of diabetic mother (Horigome et al 2001), congenital heart defects (Kahler et al 2002) and monitoring of fetal oxygenation during labor (Lowery et al 2003).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous monitoring of separate fetal magnetocardiographic signals in twin pregnancy

et al. 2005

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Fetal magnetocardiography (fMCG) allows the non-invasive recording of fetal cardiac electrical activity with increasing efficacy as gestation progresses. Many reports on the successful extraction of reliable fetal magnetocardiographic traces in singleton pregnancies exist in the literature, whereas there is only one report on the reconstruction of averaged fetal cardiac signals obtained in a twin pregnancy with the use of a double sensor array system. In this paper, we aimed at assessing the effectiveness of an ICA-based procedure to reconstruct the time course of fetal cardiac signals recorded with a single-shot multi-channel fMCG device in an uncomplicated twin pregnancy at 27 weeks. The evaluation of heart rate and beats synchronicity permitted the differentiation of fetal components; the quality of reconstructed fetal signals allowed visual inspection on single cycles and the simultaneous monitoring of separate fetal heart rate patterns. The proposed technique might be applied in twin pregnancies not only to characterize fetal arrhythmias, but also in all cases of discordant fetal growth, either in the case of intra-uterine growth retardation affecting one fetus, or in the case of twin-twin transfusion syndrome, a lifethreatening condition where both fetuses are at risk of heart failure.

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Influence of intrauterine growth restriction on cardiac time intervals evaluated by fetal magnetocardiography

Cited by 28 publications

References 24 publications

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

Evaluation of Abdominal Fetal Electrocardiography in Early Intrauterine Growth Restriction

Simultaneous monitoring of separate fetal magnetocardiographic signals in twin pregnancy

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