Signal Ambiguity and Misinterpretation of Fetal Heart Rate: A Report of Two Cases and an Overview of Suspicious Patterns

Mohamad K. Ramadan; Walaa Yamout; Mariam Kharroubi; Abir Malas; Janoub Khazaal; Georges Yared; Dominique A. Badr

doi:10.1007/s40556-020-00260-9

Journal of Fetal Medicine, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Journal of Fetal Medicine 2020; 07(03): 199-203
DOI: 10.1007/s40556-020-00260-9

Original Article

Signal Ambiguity and Misinterpretation of Fetal Heart Rate: A Report of Two Cases and an Overview of Suspicious Patterns

Mohamad K. Ramadan

¹Department of Obstetrics and Gynecology, Rafic Hariri University Hospital, Jnah, Lebanon

²Maternal-Fetal-Unit, Rafic Hariri University Hospital, Jnah, Lebanon

³Department of Obstetrics and Gynecology, Makassed General Hospital, Beirut, Lebanon

⁴Department of Obstetrics and Gynecology, Lebanese University, Beirut, Lebanon

,

Walaa Yamout

¹Department of Obstetrics and Gynecology, Rafic Hariri University Hospital, Jnah, Lebanon

⁵Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon

,

Mariam Kharroubi

¹Department of Obstetrics and Gynecology, Rafic Hariri University Hospital, Jnah, Lebanon

⁴Department of Obstetrics and Gynecology, Lebanese University, Beirut, Lebanon

,

Abir Malas

³Department of Obstetrics and Gynecology, Makassed General Hospital, Beirut, Lebanon

,

Janoub Khazaal

¹Department of Obstetrics and Gynecology, Rafic Hariri University Hospital, Jnah, Lebanon

²Maternal-Fetal-Unit, Rafic Hariri University Hospital, Jnah, Lebanon

⁴Department of Obstetrics and Gynecology, Lebanese University, Beirut, Lebanon

,

Georges Yared

¹Department of Obstetrics and Gynecology, Rafic Hariri University Hospital, Jnah, Lebanon

²Maternal-Fetal-Unit, Rafic Hariri University Hospital, Jnah, Lebanon

⁴Department of Obstetrics and Gynecology, Lebanese University, Beirut, Lebanon

⁵Department of Obstetrics and Gynecology, Lebanese American University, Beirut, Lebanon

,

Dominique A. Badr

⁴Department of Obstetrics and Gynecology, Lebanese University, Beirut, Lebanon

⁶Department of Obstetrics and Gynecology, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium

⁷Brussels, Belgium

› Institutsangaben

Abstract

als PDF herunterladen

Abstract

Electronic Fetal Heartrate Monitoring (EFHM) is the standard method for fetal well-being surveillance used during labor and delivery. There are, however, situations when tracings displayed by the EFHM are ambiguous and misleading. We present two cases where the Maternal Heart Rate (MHR) artefacts were mistaken for Fetal Heart Rate (FHR). In the first case, MHR masked the severity of fetal distress and caused a delayed and inappropriate management with subsequent poor neonatal outcome. In the second case, MHR was misinterpreted as FHR causing embarrassment of the birth attendants upon delivery of a dead macerated newborn. FHR should initially and continuously be verified as the actual origin of the signal displayed on the EFHM before any intervention is undertaken. Understanding the EFHM patterns produced by FHR or MHR and the utilization of modern EFHMs that apply concomitant recording and displaying of MHR and FHR can avert problems associated with signal ambiguity.

Keywords

Fetal Heart Monitoring - Fetal Heart Rate - Maternal Heart Rate - Neonatal outcome - Signal ambiguity

PDF (595 kb)