The fetal electrocardiogram: current clinical developments in Nottingham.

The fetal electrocardiogram (FECG) has been recorded from 155 women in labor using a fetal scalp electrode and a minicomputerized enhanced averaging technique. Fetal hypoxia, acidosis, and stress have been diagnosed by analysis of blood from the fetal scalp, and post delivery from full gas analysis from blood taken from the umbilical artery and vein. Umbilical venous levels of serum lactate, adrenaline, noradrenaline, potassium and hemoglobin were also determined. A P wave was seen to be present in all cases recorded. The P-R interval correlated both with fetal autonomic nervous activity, and with the R-R interval of the healthy fetus. The P-R--R-R interval correlation altered with increasing fetal acidosis. QRS complex changes were varied and not usually related to fetal condition. ST segment changes occurred with increasing fetal acidosis. T wave analysis although incomplete, has shown no obvious correlation with fetal condition.