Startseite The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol

  • Tomasz Fuchs EMAIL logo , Michał Pomorski , Krzysztof Grobelak und Mariusz Zimmer
Veröffentlicht/Copyright: 19. August 2014

Abstract

Aims: To evaluate values of foetal T/QRS ratios in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol using non-invasive methods with transabdominal electrodes.

Materials and Methods: The study group consisted of 451 Caucasian women (63 preterm pregnancies and 327 healthy controls) whose pregnancies ranged from 28 to 37 gestational weeks. Foetal electrocardiograms were recorded and T/QRS ratios were calculated by KOMPOREL software (ITAM, Zabrze, Poland). The first recording was performed 30 min after the start of fenoterol infusion and the second 2 days after finishing tocolysis. T/QRS ratio variables were calculated. One-way analysis of variance was carried out.

Results: Significantly higher mean values of the T/QRS ratio were observed in pregnancies during tocolytic treatment in comparison to controls and pregnancies after tocolysis (P=0.0158 and P=0.0071, respectively). The T/QRS ratio values fall again shortly after finishing intravenous tocolysis.

Conclusions: The T/QRS ratio is one of the methods used for non-invasive foetal distress assessment that can be used in antepartum foetal monitoring in complicated pregnancies. Raised values of the T/QRS ratio in the foetus during tocolysis with fenoterol and next its fall to values observed in physiological pregnancies may indicate transient worsening of fetal well-being, however, additional research is required.


Corresponding author: Tomasz Fuchs, MD, PhD, ul. Rajska 71, 54-028 Wroclaw, Poland, Phone: +48501 739838, E-mail:

References

[1] Abdelhak Y, Roque H, Young BK. Terbutaline: effects on the fetal heart at term. J Perinat Med. 2011;40:69–71.10.1515/JPM.2011.095Suche in Google Scholar

[2] Adamcova M, Kokstein Z, Palicka V, Vavrova J, Kostal M, Podholova M, et al. Cardiac troponin T in pregnant women having intravenous tocolytic therapy. Arch Gynecol Obstet. 1999;262:121–6.10.1007/s004040050239Suche in Google Scholar

[3] Anotayanonth S, Subhedar NV, Garner P, Neilson JP, Harigopal S. Betamimetics for inhibiting preterm labour. Cochrane Database Syst Rev. 2004;CD004352.10.1002/14651858.CD004352.pub2Suche in Google Scholar

[4] Barros-Silva J, Pedrosa AC, Matias A. Sonographic measurement of cervical length as a predictor of preterm delivery: a systematic review. J Perinat Med. 2014;42:281–93.10.1515/jpm-2013-0115Suche in Google Scholar

[5] Bastek JA, Sammel MD, Srinivas SK, McShea MA, Foreman MN, Elovitz MA, et al. Clinical prediction rules for preterm birth in patients presenting with preterm labor. Obstet Gynecol. 2012;119:1119–28.10.1097/AOG.0b013e31825503e5Suche in Google Scholar

[6] Berghella V, Owen J, MacPherson C, Yost N, Swain M, Dildy GA, III, et al. Natural history of cervical funneling in women at high risk for spontaneous preterm birth. Obstet Gynecol. 2007;109:863–9.10.1097/01.AOG.0000258276.64005.ceSuche in Google Scholar

[7] Berkman ND, Thorp Jr JM, Lohr KN, Carey TS, Hartmann KE, Gavin NI, et al. Tocolytic treatment for the management of preterm labor: a review of the evidence. Am J Obstet Gynecol. 2003;188:1648–59.10.1067/mob.2003.356Suche in Google Scholar

[8] FIGO. Figo news. Int J Gynaecol Obstet. 1987;25:159–67.10.1016/0020-7292(87)90012-9Suche in Google Scholar

[9] Gemelli M, Luca F, Manganaro R, Leonardi R, Rando F, Agnetti A, et al. Transient electrocardiographic changes suggesting myocardial ischaemia in newborn infants following tocolysis with beta-sympathomimetics. Eur J Pediatr. 1990;149:730–3.10.1007/BF01959533Suche in Google Scholar

[10] Greene KR, Dawes GS, Lilja H, Rosen KG. Changes in the ST waveform of the fetal lamb electrocardiogram with hypoxemia. Am J Obstet Gynecol. 1982;144:950–8.10.1016/0002-9378(82)90190-9Suche in Google Scholar

[11] Hamela-Olkowska A, Szymkiewicz-Dangel J, Wlasienko P, Majewska U, Bokiniec R. [Right ventricular hypertrophic cardiomyopathy in the fetus – may it be caused by chronic oral tocolysis with fenoterol?]. Ginekol Pol. 2012;83:145–8. Polish.Suche in Google Scholar

[12] Iams JD, Goldenberg RL, Meis PJ, Mercer BM, Moawad A, Das A, et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med. 1996;334:567–72.10.1056/NEJM199602293340904Suche in Google Scholar PubMed

[13] Junge HD, Kords H, Rodt C. Maternal and fetal ECG alterations during and after infusion of fenoterol. Eur J Obstet Gynecol Reprod Biol. 1978;8:269–76.10.1016/0028-2243(78)90077-1Suche in Google Scholar

[14] Kast A, Hermer M. Beta-adrenoceptor tocolysis and effects on the heart of fetus and neonate. A review. J Perinat Med. 1993;21:97–106.10.1515/jpme.1993.21.2.97Suche in Google Scholar

[15] Mayer M, Minichmayr A, Klement F, Hroncek K, Wertaschnigg D, Arzt W, et al. Tocolysis with the β-2-sympathomimetic hexoprenaline increases occurrence of infantile haemangioma in preterm infants. Arch Dis Child Fetal Neonatal Ed. 2013;98:F108–11.10.1136/archdischild-2011-301030Suche in Google Scholar

[16] Morales WJ, Smith SG, Angel JL, O’Brien WF, Knuppel RA. Efficacy and safety of indomethacin versus ritodrine in the management of preterm labor: a randomized study. Obstet Gynecol. 1989;74:567–72.Suche in Google Scholar

[17] Moutquin JM, Sherman D, Cohen H, Mohide PT, Hochner-Celnikier D, Fejgin M, et al. Double-blind, randomized, controlled trial of atosiban and ritodrine in the treatment of preterm labor: a multicenter effectiveness and safety study. Am J Obstet Gynecol. 2000;182:1191–9.10.1067/mob.2000.104950Suche in Google Scholar

[18] Neri I, Monari F, Valensise H, Vasapollo B, Facchinetti F, Volpe A. Computerized evaluation of fetal heart rate during tocolytic treatment: comparison between atosiban and ritodrine. Am J Perinatol. 2009;26:259–63.10.1055/s-0028-1103153Suche in Google Scholar

[19] Ness A, Visintine J, Ricci E, Berghella V. Does knowledge of cervical length and fetal fibronectin affect management of women with threatened preterm labor? A randomized trial. Am J Obstet Gynecol. 2007;197:426–7.10.1016/j.ajog.2007.07.017Suche in Google Scholar

[20] Nordstrom L, Chua S, Persson B, Aka K, Rulkumaran S. Intrapartum tocolysis has no effect on fetal lactate concentration. Eur J Obstet Gynecol Reprod Biol. 2000;89:165–8.10.1016/S0301-2115(99)00211-0Suche in Google Scholar

[21] Norwitz ER, Robinson JN. A systematic approach to the management of preterm labor. Semin Perinatol. 2001;25:223–35.10.1053/sper.2001.26417Suche in Google Scholar

[22] Papatsonis DN, van Geijn HP, Ader HJ, Lange FM, Bleker OP, Dekker GA. Nifedipine and ritodrine in the management of preterm labor: a randomized multicenter trial. Obstet Gynecol. 1997;90:230–4.10.1016/S0029-7844(97)00182-8Suche in Google Scholar

[23] Papatsonis DN, van Geijn HP, Bleker OP, Ader HJ, Dekker GA. Maternal admission characteristics as risk factors for preterm birth. Eur J Obstet Gynecol Reprod Biol. 2004;112:43–8.10.1016/S0301-2115(03)00272-0Suche in Google Scholar

[24] Parant O, Maillard F, Tsatsaris V, Delattre M, Subtil D, Goffinet F. Management of threatened preterm delivery in France: a national practice survey (the EVAPRIMA study). Br J Obstet Gynaecol. 2008;115:1538–46.10.1111/j.1471-0528.2008.01929.xSuche in Google Scholar

[25] Pryde PG, Besinger RE, Gianopoulos JG, Mittendorf R. Adverse and beneficial effects of tocolytic therapy. Semin Perinatol. 2001;25:316–40.10.1053/sper.2001.27547Suche in Google Scholar

[26] Rauf Z, O’Brien E, Stampalija T, Ilioniu FP, Lavender T, Alfirevic Z. Home labour induction with retrievable prostaglandin pessary and continuous telemetric trans-abdominal fetal ECG monitoring. PLoS One 2011;6:e28129.10.1371/journal.pone.0028129Suche in Google Scholar

[27] Rosen KG, Lindecrantz K. STAN – the Gothenburg model for fetal surveillance during labour by ST analysis of the fetal electrocardiogram. Clin Phys Physiol Meas. 1989;10 (Suppl B):51–6.10.1088/0143-0815/10/4B/008Suche in Google Scholar

[28] Rosen KG, Luzietti R. The fetal electrocardiogram: ST waveform analysis during labour. J Perinat Med. 1994;22:501–12.Suche in Google Scholar

[29] Southern EM. Electrocardiography and phonocardiography of the foetal heart. J Obstet Gynaecol Br Emp. 1954;61:231–7.10.1111/j.1471-0528.1954.tb07472.xSuche in Google Scholar

[30] Valdés E, Salinas H, Toledo V, Lattes K, Cuellar E, Perucca E, et al. Nifedipine versus fenoterol in the management of preterm labor: a randomized, multicenter clinical study. Gynecol Obstet Invest. 2012;74:109–15.10.1159/000338856Suche in Google Scholar

[31] Westgate J, Harris M, Curnow JS, Greene KR. Plymouth randomized trial of cardiotocogram only versus ST waveform plus cardiotocogram for intrapartum monitoring in 2400 cases. Am J Obstet Gynecol. 1993;169:1151–60.10.1016/0002-9378(93)90273-LSuche in Google Scholar

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2014-2-5
Accepted: 2014-7-22
Published Online: 2014-8-19
Published in Print: 2015-7-1

©2015 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Erich Saling – The Father of Prenatal and Perinatal Medicine—Dedication to his 90th birthday
  4. Original articles - Obstetrics
  5. A transcervical amniotic fluid collector: a new medical device for the assessment of amniotic fluid in patients with ruptured membranes
  6. Advanced cervical dilatation and spontaneous preterm labor: a comparison between twin and singleton gestations
  7. Comparison of a novel test for placental alpha microglobulin-1 with fetal fibronectin and cervical length measurement for the prediction of imminent spontaneous preterm delivery in patients with threatened preterm labor
  8. Does recent sexual intercourse during pregnancy affect the results of the fetal fibronectin rapid test? A comparative prospective study
  9. Usefulness of maternal serum C-reactive protein with vaginal Ureaplasma urealyticum as a marker for prediction of imminent preterm delivery and chorioamnionitis in patients with preterm labor or preterm premature rupture of membranes
  10. Effect of blood on ROM diagnosis accuracy of PAMG-1 and IGFBP-1 detecting rapid tests
  11. Single versus combination tocolytic regimen in the prevention of preterm births in women: a prospective cohort study
  12. Recommendations of activity restriction in high-risk pregnancy scenarios: a Danish national survey
  13. Is pharmacologic research on pregnant women with psychoses ethically permissible?
  14. Women’s knowledge and attitude towards pregnancy in a high-income developing country
  15. Impact of maternal body mass index on the cesarean delivery rate in Germany from 1990 to 2012
  16. Justified skepticism about Apgar scoring in out-of-hospital birth settings
  17. The effect of the use of oxytocin on blood loss during different postpartum periods
  18. Original articles - Fetus
  19. The T/QRS ratio values in pregnancies complicated by threatened preterm labour treated with intravenous infusions of fenoterol
  20. Cardiotocography patterns and risk of intrapartum fetal acidemia
  21. Combined spinal epidural analgesia for labor using sufentanil epidurally versus intrathecally: a retrospective study on the influence on fetal heart trace
  22. Original articles - Newborn
  23. Predicting fetal growth deviation in parous women: combining the birth weight of the previous pregnancy and third trimester ultrasound scan
  24. Letter to the Editor
  25. A cerclage is not a modified total cervical occlusion!
  26. Letter Reply
  27. Reply to: a cerclage is not a modified Total Cervical Occlusion!
  28. Congress Calendar
  29. Congress Calendar
Heruntergeladen am 16.11.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpm-2014-0042/html?lang=de
Button zum nach oben scrollen