Електронний моніторинг плода: користь, побоювання та можливі перспективи

Diagnosis of pathological fetal status using the processing of cardiac signals is based on the registration and evaluation of parameters of heart rhythm changes. Non-invasive fetal electrocardiography (FECG) is a prospective method of studying its functional state. This method makes it possible to obtain the characteristics of the primary electrophysiological processes occurring in the fetal myocardium. It is known that the introduction of electronic fetal monitoring led to a significant increase in the level of abdominal delivery.The objective: to test the hypothesis regarding the possible influence of FECG parameters on the delivery method.Materials and methods. A total of 39 women between 24 and 38 weeks of pregnancy, between October 1, 2022 and October 1, 2024, were examined.FECG recording was performed using the “Cardiolab Baby Card” equipment (SRC “KHAI-Medica”, Kharkiv, Ukraine) in the abdominal abduction for 30–60 minutes. The following HRV indicators were studied:– STV (short term variations);– LTV (long term variations);– AC / DC (acceleration capacity / deceleration capacity);– SI (stress index; SI = AMo (%) / (2 × Mo × Var), Var = NNmax – NNmin, where AMo is most often the value of the NN interval in the highest column on the histogram).AC / DC and SI indicators were determined both in the fetus and in the mother. The women were followed up and the delivery date, weight, body length, head circumference and Apgar score of the newborns were studied.Results. Maternal and fetal HRV, term of delivery, neonatal anthropometric data, and Apgar score were not significantly different among women according to mode of delivery. The study of the linear correlation among the obtained characteristics of the examined contingent of women made it possible to establish certain regularities. This work revealed a moderately strong correlation between the fetal HRV indicators obtained on the basis of the analysis of phase-rectified signals – AC / DC and the Apgar score. The results of the multivariate regression analysis of the model with the way of delivery did not establish any relationship with the indicators of HRV of the mother and fetus, the term of delivery, anthropometric parameters and Apgar score, determined in the work. Among other data obtained by logistic regression, it was worth noting the presence of a strong relationship between:– the Apgar score and the weight of the newborn (p = 0.04);– the Apgar score and the head circumference (p = 0.04);– as well as trends towards relationships correlation in pairs of maternal AC vs weight (p = 0.05);– maternal AC vs fetal body length (p = 0.05);– fetal SI vs delivery term (p = 0.05).Logistic regression data give a hope for the prospect of further studies of the role of the maternal AC in the diagnosis of fetal growth restriction, as well as the fetal SI as a marker of neurological maturation and a criterion of the state of the fetus.Conclusions. Electronic monitoring based on non-invasive FECG had no influence on the choice of the mode of delivery, which allows us to consider the prospect of creating systems for remote fetal monitoring.