Principles and limits of clinical methods in the diagnosis of fetal hypoxia

Czech version

Authors: M. Hrtánková; J. Siváková; P. Šumichrastová; P. Lukáč; J. Višňovský
Authors‘ workplace: Gynekologicko-pôrodnícka klinika Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Slovenská republika, prednosta prof. MUDr. J. Danko, CSc.
Published in: Ceska Gynekol 2014; 79(4): 326-331

Overview

Objective:
An overview of electronic fetal monitoring methods (EFM), and an analysis of their physical and technical limits.

Design:
A review article.

Setting:
Department of Gynecology and Obstetrics Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovak Republic.

Methods:
An analysis of the literature using database search engines PubMed, and SCOPE in the years 2000 – 2013 in field of diagnostic methods of fetal status in utero.

Results:
The essential aim of modern perinatology is the birth of a live and healthy newborn. This aim is strongly related to the abilities of the diagnostic methods to evaluate the intrauterine fetal status and with the professional skills of obstetricians to analyze these methods accurately. Nowadays, EFM is exposed to criticism, in spite of its widespread use. It is associated with some degree of failure in terms of an over-evaluation and under-evaluation. An over-evaluation of results can lead to unnecessary, often surgical, intervention. An under-evaluation of results can lead to an adverse fetal outcome with a neurologic handicap or intrauterine death. The long-term efforts currently underway to improve the reliability of EFM still remain to show any great progress.

Keywords:
cardiotocography, intermittent auscultation, pulse oximetry, ST analysis, fetal electrocardiography

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