Fetal cardiac time intervals in healthy pregnancies – an observational study by fetal ECG (Monica Healthcare System)
Abstract
Background: Fetal electrocardiogram (fECG) can detect QRS signals in fetuses from as early as 17 weeks’ gestation; however, the technique is limited by the minute size of the fetal signal relative to noise ratio. The aim of this study was to evaluate precise fetal cardiac time intervals (fCTIs) with the help of a newly developed fetal ECG device (Monica Healthcare System). Methods: In a prospective manner we included 15–18 healthy fetuses per gestational week from 32 weeks onwards. The small and wearable Monica AN24 monitoring system uses standard ECG electrodes placed on the maternal abdomen to monitor fECG, maternal ECG and uterine electromyogram (EMG). Fetal CTIs were estimated on 1000 averaged fetal heart beats. Detection was deemed successful if there was a global signal loss of less than 30% and an analysis loss of the Monica AN24 signal separation analysis of less than 50%. Fetal CTIs were determined visually by three independent measurements. Results: A total of 149 fECGs were performed. After applying the requirements 117 fECGs remained for CTI analysis. While the onset and termination of P-wave and QRS-complex could be easily identified in most ECG patterns (97% for P-wave, PQ and PR interval and 100% for QRS-complex), the T-wave was detectable in only 41% of the datasets. The CTI results were comparable to other available methods such as fetal magnetocardiography (fMCG). Conclusions: Although limited and preclinical in its use, fECG (Monica Healthcare System) could be an additional useful tool to detect precise fCTIs from 32 weeks’ gestational age onwards.
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The Novii Wireless Patch System can acquire fetal ECG but cannot monitor nonsingleton pregnancies and is limited to term pregnancies (at least 37 wk of gestation).
“Other systems, such as the Novii Wireless Patch System from Monica Healthcare, are available to acquire fetal ECG, but such systems alone cannot monitor nonsingleton pregnancies and are limited to term pregnancies (at least 37 wk of gestation) (17).”
From Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings (2021) · cites this paper as [17]
Use of newer fetal ECG systems in multiple-gestation or preterm fetuses has not been validated extensively and would be considered off-label.
“Use of these newer systems in multiple-gestation or preterm fetuses have not been validated extensively and would be considered off-label if used in these clinical scenarios.”
From Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings (2021) · cites this paper as [17]
Newer platforms that assess fetal ECG still require bulky systems adhered to the body or wired to base units.
“While there are newer platforms that assess fetal ECG (17, 36), these still require bulky systems adhered to the body or wired to base units.”
From Comprehensive pregnancy monitoring with a network of wireless, soft, and flexible sensors in high- and low-resource health settings (2021) · cites this paper as [17]
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- Authors
- Wacker-Gussmann, A., Plankl, C., Sewald, M., Schneider, K.-T. M., Oberhoffer, R., & Lobmaier, S. M.
- Affiliations
- TUM Klinikum (DE)
- Deutsches Herzzentrum München (DE)
- Venue
- Journal of Perinatal Medicine
- Publisher
- Walter de Gruyter GmbH
- Published
- 2018-08-28
- Volume
- 46
- Issue
- 6
- Pages
- 587-592
- ISSN
- 0300-5577 (ISSN-L)
- 1619-3997
- OpenAlex
- W2607528739
- Cited by
- 25
- References
- 22
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 3 · 2019: 4 · 2018: 4
- FWCI
- 1.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Perinatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- fetal electrocardiogram, fetal heart rate, QRS complex, P wave, T wave, fetal magnetocardiography, maternal ECG, fetal heart rate monitoring, normal pregnancy
- MeSH terms
- Heart Rate Determination, Adult, Female, Fetal Heart, Gestational Age, Heart Rate, Fetal, Humans, Middle Aged, Pregnancy, Prospective Studies, Reference Values, Cardiotocography, Electrocardiography, Ambulatory, Young Adult, Signal-To-Noise Ratio
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