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A Case of Intrapartum Fetal Arrhythmia Creating Difficulties in Cardiotocograph Interpretation
Author(s) -
Gray J.
Publication year - 1989
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1989.tb01737.x
Subject(s) - fetal heart rate , heart rate , auscultation , medicine , artifact (error) , cardiology , scalp , fetal distress , fetus , fetal heart , tracing , computer science , surgery , blood pressure , artificial intelligence , pregnancy , biology , genetics , operating system
EDITORIAL COMMENT: We have accepted this case for publication to show readers a problem that can occur with the interpretation of a cardiotocograph when the fetus had cardiac arrhythmia. The pattern shown in the 3 figures is an artifact caused by the machine being unable to trace a heart rate that is changing and is irregular. The Hewlett Packard fetal monitor registers the fetal heart rate only if the impulses (fetal heart rate) come in an orderly sequence. Should there be a break in the sequence, the monitor will reject it and then ‘scan’ the range for new sequential impulses — hence the broad dark tracing between 80–140 beats/minute when the irregular auscultated heart rate was 105 beats/minute. Later on when the irregular fetal heart rate rose to 140 beats/minute, the scanning range broadened to between 80–200 beats/minute. In such cases the clinician should rely on clinical auscultation of the fetal heart rate and other signs of distress such as the presence ofmeconium or fetal scalp blood sampling if this is available.