BACKGROUND:Non-invasive fetal electrocardiogram (NIFECG) is an evolving technology in fetal surveillance which is attracting increasing research interest. There is however, only limited data outlining the reference ranges for normal cardiac time intervals (CTIs). The objective of our group was to carry out a systematic review to outline normal fetal CTIs using NIFECG. METHODS:A systematic review of peer reviewed literature was performed, searching PUBMED,Ovid MEDLINE and EMBASE. The outcomes of interest included fetal CTIs (P wave duration, PR interval, QRS duration and QT interval) and a descriptive summary of relevant studies as well. The outcomes were grouped as early pre-term (≤ 32 weeks), moderate to late pre-term (32-37 weeks) and term (37-41 weeks). RESULTS:8 studies were identified as suitable for inclusion. Reference ranges of CTIs were generated. Both PR interval and QRS duration demonstrated a linear correlation with advancing gestation. Several studies also demonstrated a reduction in signal acquisition between 27 and 32 weeks due to the attenuation by vernix caseosa. In this group, both the P wave and T waves were difficult to detect due to signal strength and interference. CONCLUSION:NIFECG demonstrates utility to quantify CTIs in the fetus, particularly at advanced gestations. Larger prospective studies should be directed towards establishing reliable CTIs across various gestations.

译文

背景:无创胎儿心电图(NIFECG)是一种在胎儿监护中不断发展的技术,正引起越来越多的研究兴趣。但是,只有有限的数据概述了正常心脏时间间​​隔(CTI)的参考范围。我们小组的目的是对使用NIFECG进行的正常胎儿CTI进行系统的综述。
方法:对同行评审文献进行系统综述,检索PUBMED,Ovid MEDLINE和EMBASE。感兴趣的结果包括胎儿CTI(P波持续时间,PR间隔,QRS持续时间和QT间隔)以及相关研究的描述性摘要。结果分为早产期(≤32周),中至早产期(32-37周)和足月期(37-41周)。
结果:确定了8项适合纳入的研究。生成了CTI的参考范围。 PR间期和QRS持续时间均与妊娠进展呈线性相关。几项研究还表明,由于酪蛋白感染的衰减,信号采集在27至32周之间减少了。在该组中,由于信号强度和干扰,P波和T波均难以检测。
结论:NIFECG证明了定量胎儿中CTI的实用性,尤其是在晚期妊娠时。较大的前瞻性研究应针对在各种妊娠中建立可靠的CTI。

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