RELIABILITY OF ULTRASOUND AS COMPARED TO DIRECT FETAL ELECTROCARDIOGRAPHY FOR ANTEPARTUM CARDIOTOCOGRAPHY

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Abstract
Pairs (85) of simultaneously recorded external and internal cardiotocograms (CTG) were coded and evaluated with a 10-point scoring system routinely used for the assessment of antepartum human CTG. The highest consistency in interpretation between the external ultrasound and the internal fetal scalp CTG was for basal heart rate followed by decelerations. Oscillatory amplitude and frequency were interpreted differently in 14% of CTG and accelerations in 16%. When differences in interpretation arose, there was no tendency for the external CTG to present an optimistic image of the fetal heart rate variables. With the exception of oscillatory amplitude, all variables including oscillatory frequency and the total CTG score were more frequently underestimated than overestimated on external CTG. When accelerations were present on only 1 recording, there was an 85% chance for these to be absent on the external CTG. Apparently, routine clinical assessment of antepartum CTG of adequate technical quality does not provide overrated and more optimistic data than would be achieved by direct fetal scalp monitoring.

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