Geburtshilfe Frauenheilkd 2014; 74(8): 721-732
Georg Thieme Verlag KG Stuttgart · New York
S1-Guideline on the Use of CTG During Pregnancy and Labor
Long version – AWMF Registry No. 015/036 S1-Leitlinie Anwendung des CTG während Schwangerschaft und Geburt Langfassung – AWMF-Register-Nr. 015/036
K. T. M. Schneider (corresponding author)
,
German Society of Gynecology and Obstetrics (DGGG) , Maternal Fetal Medicine Study Group (AGMFM) , German Society of Prenatal Medicine and Obstetrics (DGPGM) , German Society of Perinatal Medicine (DGPM)
11 References
1 Agrawal SK, Doucette F, Gratton R et al. Intrapartum computerized fetal heart rate parameters and metabolic acidosis at birth. Obstet Gynecol 2003; 102: 731-738
2 Alfirevic Z, Neilson JP. Biophysical profile for fetal assessment in high risk pregnancies. Cochrane Database Syst Rev 2008; (1) CD000038
3 Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic foetal monitoring (EFM) for foetal assessment during labour. Cochrane Database Syst Rev 2006; (3) CD006066
4 ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring. nomenclature, interpretation, and general management principles. Obstet Gynecol 2009; 114: 192-202
5 ACOG Practice Bulletin No. 116: Management of intrapartum fetal heart rate tracings. Obstet Gynecol 2010; 116: 1232-1240
6 Ashkenazi S, Metzker A, Merlob P et al. Scalp changes after fetal monitoring. Arch Dis Child 1985; 60: 267-269
7 Beckley S, Stenhouse E, Greene K. The development and evaluation of a computer-assisted teaching programme for intrapartum fetal monitoring. BJOG 2000; 107: 1138-1144
8 Berger R, Bender S, Sefkow S et al. Peri/intraventricular haemorrhage: a cranial ultrasound study on 5286 neonates. Eur J Obstet Gynecol Reprod Biol 1997; 75: 191-203
9 Bernardes J, Costa Pereira A, Ayres de Campos D et al. Evaluation of interobserver agreement of cardiotocograms. Int J Gynaecol Obstet 1997; 57: 33-37
10 Bloom SL, Spong CY, Thom E et al. Fetal pulse oximetry and caesarean delivery. New Engl J Med 2006; 355: 195-202
11 Brown VA, Sawers RS, Parsons RJ et al. The value of antenatal cardiotocography in the management of high risk pregnancy: a randomized controlled trial. Br J Obstet Gynaecol 1982; 89: 716-722
12 Butterwegge M, Gonser M, Roemer VM. Stellungnahme zu einem Gutachten der BQS über geburtshilfliche Qualitätsindikatoren. Z Geburtsh Neonatol 2005; 209: 69-75
13 Carbonne B, Langer B, Goffinet F et al. Clinical importance of fetal pulse oximetry. II. Comparative predictive values of oximetry and scalp pH. Multicenter study. J Gynecol Obstet Biol Reprod (Paris) 1999; 28: 137-144
14 Cibilis LA. On intrapartum fetal monitoring. Am J Obstet Gynecol 1996; 174: 1382-1389
15 Chow O, Larbig A, Kabartas B et al. Pitfalls of external FHR-monitoring in the second stage of labor. J Mat Fet Neonat Med 2010; 23 (Suppl.) 236
16 Dawes GS, Moulden M, Redman CWG. Short term fetal heart rate variation, decelerations, and umbilical flow velocity waveforms before labour. Obstet Gynecol 1992; 80: 673-678
17 Daumer M, Scholz M, Boulesteix AL et al. The normal fetal heart rate study: analysis plan. Nature Proceedings 2007;
18 Devoe LD, Ross M, Wilde C et al. United States multicenter clinical usage study of the STAN 21 electronic fetal monitoring system. Am J Obstet Gynecol 2006; 195: 729-734
19 DKG Leitfaden: Aufbewahrungsverpflichtungen und -fristen von Dokumenten im Krankenhaus. NKG Mitteilung 2006; 394
20 Drogtrop AP, Ubels R, Nijhuis JG. The association between fetal body movements, eye movements, and heart rate patterns in pregnanccies between 25 and 30 weeks of gestation. Early Hum Dev 1990; 23: 67-73
21 Dudenhausen JW, Luhr C, Dimer JS. Umbilical artery blood gases in healthy term newborn infants. Int J Gynaecol Obstet 1997; 57: 251-258
22 East CE, Colditz PB. Fetal pulse oximetry for fetal assessment in labour. Cochrane Database Syst Rev 2007; (2) CD004075
23 Elliott C, Warrick PA, Graham E et al. Graded classification of fetal heart rate tracings: association with neonatal metabolic acidosis and neurologic morbidity. Am J Obstet Gynecol 2010; 202: 258.e1-258.e8
24 Fedorkow DM, Stewart TJ, Parboosingh J. Fetal heart rate changes associated with general anestesia. Am J Perinat 1989; 6: 287-288
25 Ferrazzi E, Rigano S, Bozzo M et al. Umbilical vein blood flow in growth-restricted fetuses. Ultrasound Obstet Gynecol 2000; 16: 432-438
26 FDA. Dear Healthcare Provider Letter 3–09/04/2009. Online: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm181503.htm Stand: 08/2013
27 Flynn AM, Kelly J, Mansfield H et al. A randomized controlled trial of non-stress-antepartum cardiotocography. Br J Obstet Gynaecol 1982; 89: 427-433
28 Gaffney G, Flavell V, Johnson A et al. Cerebral palsy and neonatal encephalopathy. Arch Dis Child Fetal Neonat Ed 1994; 70: F195-F200
29 Gaffney G, Sellers S, Flavell V et al. A case-control study of intrapartum care, cerebral palsy, and perinatal death. Br Med J 1994; 308: 743-750
30 Garcia J, Corry M, MacDonald D et al. Mothersʼ views of continuous electronic fetal heart monitoring and intermittent auscultation in a randomized controlled trial. Birth 1985; 12: 79-86
31 Garite TJ, Dildy GA, McNamara H et al. A multicenter controlled trial of fetal pulse oximetry in the intrapartum management of nonreassuring fetal heart rate patterns. Am J Obstet Gynecol 2000; 183: 1049-1058
32 Garnier Y, Coumans A, Berger R et al. Endotoxemia severely affects circulation during normoxia and asphyxia in immature fetal sheep. J Soc Gynecol Invest 2001; 8: 134-142
33 Gnirs J, Schelling M, Kolben M et al. Referenzkurven für das fetale Bewegungsprofil. Geburtsh Frauenheilk 1998; 58: 355-362
34 Gonser M, König M, Marzusch K. Schema zur CTG-Interpretation nach den FIGO-Richtlinien. Gynäkol Prax 1995; 19: 649-659
35 Graatsma EM, Jacod BC, van Egmond LAJ et al. Fetal electrocardiotocography: feasibility of long-term fetal heart rate recordings. BJOG 2009; 116: 334-337
36 Grant A, OʼBrien N, Joy MT et al. Cerebral palsy among children born during the Dublin randomised trial of intrapartum monitoring. Lancet 1989; 8674: 1233-1236
37 Grivel RM, Alfirevic Z, Gyte GM et al. Antenatal cardiotocography for foetal assessment. Cochrane Database Syst Rev 2010; (1) CD007863
38 Hansen PK, Smith SF, Nim J et al. Maternal attitudes to fetal monitoring. Eur J Obstet Gynecol Reprod Biol 1985; 20: 43-51
39 Haverkamp AD, Thompson HE, McFee JG et al. The evaluation of continuous fetal heart rate monitoring in high-risk pregnancy. Am J Obstet Gynecol 1976; 125: 310-317
40 Haverkamp AD, Orleans M, Langendoerfer S et al. A controlled trial of the differential effects of intrapartum fetal monitoring. Am J Obstet Gynecol 1979; 134: 399-412
41 Herbst A, Ingemarsson I. Intermittent versus continuous electronic fetal monitoring in labour: a randomized study. Br J Obstet Gynaecol 1994; 101: 663-668
42 Hod M, Kerner R. Telemedicine for antenatal surveillance of high-risk pregnancies with ambulatory and home fetal heart monitoring–an update. J Perinat Med 2003; 31: 195-200
43 Impey L, Reynolds M, MacQuillan K et al. Admission cardiotocography: a randomised controlled trial. Lancet 2003; 361: 465-470
44 Jensen A, Martius G. Überwachung und Leitung der Entbindung. In: Martius G, Rath W, Hrsg. Geburtshilfe und Perinatologie. Stuttgart: Thieme; 1991: 386-442
45 Jensen A, Roman C, Rudolph AM. Effects of reducing uterine blood flow distribution and oxygen delivery. J Dev Physiol 1991; 15: 309-323
46 Keith RD, Beckley S, Garibaldi JM et al. A multicentre comparative study of 17 experts and an intelligent computer system for managing labour using the cardiotocogram. Br J Obstet Gynaecol 1995; 102: 688-700
47 Kelso AM, Parsons RJ, Lawrence GF et al. An assessment of continuous fetal heart rate monitoring in labor. Am J Obstet Gynecol 1978; 131: 526-532
48 Kidd L, Patel N, Smith R. Non-stress antenatal cardiotocography – a prospective randomized clinical trial. Br J Obstet Gynaecol 1985; 92: 1156-1159
49 Killien MG, Shy K. A randomized trial of electronic fetal monitoring in preterm labor: motherʼs views. Birth 1989; 16: 7-12
50 Kühnert M, Schmidt S. Intrapartum management of nonreassuring fetal heart rate patterns: a randomized controlled trial of fetal pulse oximetry. Am J Obstet Gynecol 2004; 191: 1989-1995
51 Kühnert M, Hellmeyer L, Stein W et al. Twenty-four-hour CTG monitoring: comparison of normal pregnancies of 25-30 weeks of gestation versus 36-42 weeks of gestation. Arch Gynecol Obstet 2007; 275: 451-460
52 Langendoerfer S, Haverkamp AD, Murphy J et al. Pediatric follow up of a randomised controlled trial of intrapartum fetal monitoring techniques. J Ped 1980; 97: 103-107
53 Leveno KJ, Cunningham FG, Nelson S et al. A prospective comparison of selective and universal electronic fetal monitoring in 34,995 pregnancies. N Engl J Med 1986; 315: 615-619
54 Liston R, Sawchuck D, Young D. Fetal health surveillance: antepartum and intrapartum consensus guideline. J Obstet Gynecol Canada 2007; 29 (Suppl. 04) 3-56
55 Lotgering FK, Wallenburg HC, Schouten HJ. Interobserver and intraobserver variation in the assessment of antepartum cardiotocograms. Am J Obstet Gynecol 1982; 144: 701-705
56 Lumley J, Lester A, Anderson I et al. A randomized trial of weekly cardiotocography in high-risk obstetric patients. Br J Obstet Gynaecol 1983; 90: 1018-1026
57 Luthy DA, Shy KK, van Belle G. A randomized trial of electronic fetal heart monitoring in premature labor. Obstet Gynecol 1987; 69: 687-695
58 MacDonald D, Grant A, Sheridan-Perreira M. The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. Am J Obstet Gynecol 1985; 152: 524-539
59 Maeda K. FIGO News: Report of the FIGO Study Group on the Assessment of New Technology. Evaluation and standardization of fetal monitoring. Int J Gynaecol Obstet 1997; 59: 169-173
60 Mahomed K, Nyoni R, Mulambo T et al. Randomised controlled trial of intrapartum fetal heart rate monitoring. Br Med J 1994; 308: 497-500
61 Macones GA, Hankins GD, Spong CY et al. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation and research guidelines. Obstet Gynecol 2008; 112: 661-666
62 Mardirosoff C, Dumont L, Boulvain M et al. Fetal bradycardia due to intrathecal opioids for labour analgesia: a systematic review. BJOG 2002; 109: 274-281
63 Miller DA, Rabello YA, Paul RH. The modified biophysical profile: antepartum testing in the 1990s. Am J Obstet Gynecol 1996; 174: 812-817
64 Morgenstern J, Abels T, Somville T et al. Accuracy of fetal heart rate monitoring. Gynäkologe 1994; 27: 123-129
65 Murray ML, Higgins P. Computer versus lecture: strategies for teaching fetal monitoring. J Perinatol 1996; 16: 15-19
66 National Health and Medical Research Council. How to review the Evidence: systematic Identification and Review of the scientific Literature. Canberra: Biotext; 1999
67 Neilson JP. Fetal electrocardiogram (ECG) for fetal monitoring during labour. Cochrane Database Syst Rev 2012; (4) CD000116
68 Neilson jr. DR, Freeman RK, Mangan S. Signal ambiguity resulting in unexpected outcome with external fetal heart rate monitoring. Am J Obstet Gynecol 2008; 199: 717-724
69 Neldam S, Osler M, Hansen PK et al. Monitoring labor with cardiotocography and stethoscopic examination in normal and risk deliveries. Ugeskr Laeger 1985; 147: 2901-2907
70 Neldam S, Osler M, Hansen PK et al. Intrapartum fetal heart rate monitoring in a combined low- and high-risk population: a controlled clinical trial. Eur J Obstet Gynecol Reprod Biol 1986; 23: 1-11
71 Nelson KB, Dambrosia JM, Ting TY et al. Uncertain value of electronic fetal monitoring in predicting cerebral palsy. N Engl J Med 1996; 334: 613-618
72 NICHD (National Institute of Child Health and Human Development). Electronic fetal heart rate monitoring: Research guidelines for interpretation. Research Planning Workshop. Am J Obstet Gynecol 1997; 177: 1385-1390
73 Nijhuis JG, van de Pas M. Behavioral states and their ontogeny: human studies. Semin Perinatol 1992; 16: 206-210
74 Noren H, Blad S, Carlsson A et al. STAN in clinical practice – The outcome of 2 years of regular use in the city of Gothenburg. Am J Obstet Gynecol 2006; 195: 7-15
75 OLG Oldenburg 15.5.90 5 U 114/89; OLG Karlsruhe 28.11.97 U 28/79; OLG Hamburg 30.03.79 1 U 115/77; BGH NJW 1992, 1560=VersR 1992: 745.
76 Parer JT, King TL. Fetal heart rate monitoring: the next step?. Am J Obstet Gynecol 2010; 202: 520-521
77 Pattison N, McCowan L. Cardiotocography for antepartum fetal assessment (Cochrane Review). Cochrane Database Syst Rev 2010; (1) CD001068
78 Petrie RH, Yeh SY, Murata Y et al. The effects of drugs on fetal heart rate variability. Am J Obstet Gynecol 1987; 130: 294-299
79 Renou P, Chang A, Anderson I. Controlled trial of fetal intensive care. Am J Obstet Gynecol 1976; 126: 470-476
80 Roemer VM. Quantitative CTG-Bewertung sub partu mit einem neuen CTG-Score: Wie gut sind die Korrelationen mit den Parametern des fetalen Säure-Basen-Haushaltes im Nabelschnurblut?. Z Geburtshilfe Neonatol 2003; 207: 121-126
81 Rooth G. Perinatal Acid-base Balance. Lund: Studentlitteratur; 1988
82 Rooth G, Huch A, Huch R. FIGO News: Guidelines for the use of fetal monitoring. Int J Gynaecol Obstet 1987; 25: 159-167
83 Rosen KG. Fetal electrocardiogram waveform analysis in labour. Curr Opin Obstet Gynecol 2005; 17: 147-150
84 Royal College of Obstetricians and Gynaecologists. Intrapartum care. London/UK, Sept. 2007.
85 Rüttgers H. Kardiotokographie. Standards in der Perinatalmedizin. Perinat Med 1989; 1: 9-14
86 Samueloff A, Langer O, Berkus M et al. Is fetal heart rate variability a good predictor of fetal outcome?. Acta Obstet Gynecol Scand 1994; 73: 39-44
87 Saling E. Das Kind im Bereich der Geburtshilfe. Stuttgart: Thieme; 1966
88 Schiermeier S, Westhof G, Daumer M et al. Die Kurzzeitvariation der fetalen Herzfrequenz und der FIGO-CTG-Score. Erste Erfahrungen in der Kombination dieser Überwachungsparameter. Geburtsh Frauenheilk 2006; 66: 752-755
89 Schindler T. Delayed Moving Window Algorithm for Online Cardiotocogram Analysis: aComparison of computerized CTG Analysis. 1st ed. Aachen: Verlag Mainz; 2002
90 Schneider KTM. Die Überwachung der Geburt aus forensischer Sicht. Gynäkologe 1994; 27: 212-221
91 Schneider KTM, Bung P, Weber S et al. An orthostatic uterovascular syndrome – a prospective, longitudinal study. Am J Obstet Gynecol 1993; 169: 183-189
92 Shy KK, Luthy DA, Bennett FC et al. Effects of electronic fetal heart rate monitoring, as compared with periodic auscultation, on neurologic development of premature infants. N Engl J Med 1990; 322: 588-593
93 Spencer JA, Badawi N, Burton P et al. The intrapartum CTG prior to neonatal encephalopathy at term: a case-control study. Br J Obstet Gynaecol 1997; 104: 25-28
94 Staisch KJ, Westlake JR, Bashore RA. Blind oxytocin challenge test and perinatal outcome. Am J Obstet Gynecol 1980; 138: 399-403
95 Street P, Dawes GS, Moulden M et al. Short term variation in abnormal antenatal fetal heart rate records. Am J Obstet Gynecol 1991; 165: 515-523
96 Tan KH, Smyth R. Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing (Cochrane Review). Cochrane Database Syst Rev 2013; (12) CD002963
97 Thacker SB, Berkelman RL. Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques. Obstet Gynecol Surv 1986; 41: 121-141
98 Thacker SB, Stroup D, Chang M. Continuous electronic heart rate monitoring for fetal assessment during labor (Cochrane Review). Cochrane Database Syst Rev 2013; (5) CD006066
99 Trimbos JB, Keirse MJ. Observer variability in assessment of antepartum cardiotocograms. Br J Obstet Gynaecol 1978; 85: 900-906
100 Van Geijn HP, Jongsma HW, Doesburg WH et al. The effect of diazepam administration during pregnancy or labor on the heart rate variability of the newborn infant. Eur J Obstet Gynecol Reprod Biol 1980; 10: 187-201
101 Van Woerden EE, van Geijn HP. Factors influencing the fetal Heart Rate. In: van Geijn HP, Copray FJA, eds. A critical Appraisal of fetal Surveillance. Amsterdam: Excerpta Medica; 1994: 211-220
102 Vintzileos AM, Antsaklis A, Varvarigos I et al. A randomized trial of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation. Obstet Gynecol 1993; 81: 899-907
103 Vintzileos AM, Nochimson DJ, Antsaklis A et al. Comparison of intrapartum electronic fetal heart rate monitoring versus intermittent auscultation in detecting fetal acidemia at birth. Am J Obstet Gynecol 1995; 173: 1021-1024
104 Vintzileos AM, Nochimson DJ, Guzman ER et al. Intrapartum electronic fetal heart rate monitoring versus intermittent auscultation: a meta-analysis. Obstet Gynecol 1995; 85: 149-155
105 Visser GH, Dawes GS, Redman CW. Numerical analysis of the normal human antenatal fetal heart rate. Br J Obstet Gynaecol 1981; 88: 792-802
106 Voigt M, Schneider KT, Jahrig K. Analyse des Geburtengutes des Jahrgangs 1992 der Bundesrepublik Deutschland. Teil 1: Neue Perzentilwerte für die Körpermaße von Neugeborenen. Geburtsh Frauenheilk 1996; 56: 550-558
107 Westergaard HB, Langhoff-Roos J, Lingman G et al. A critical appraisal in high-risk pregnancies: use of meta-analysis in evidence-based obstetrics. Ultrasound Obstet Gynecol 2001; 17: 466-476
108 Westerhuis ME, Moons KG, van Beek E et al. A randomised clinical trial on cardiotocography plus fetal blood sampling versus cardiotocography plus ST-analysis of the fetal electrocardiogram (STAN(R)) for intrapartum monitoring. BMC Pregnancy Childbirth 2007; 26: 13
109 Wood C, Renou P, Oats J et al. A controlled trial of fetal heart rate monitoring in a low-risk obstetric population. Am J Obstet Gynecol 1981; 141: 527-534
110 The Society of Obstetricians and Gynaecologists of Canada. Clinical Practice Guideline Fetal Health Surveillance: Antepartum and Intrapartum Consensus Guideline No. 197 (Replaces No. 90 and No. 112), Ottawa/Kanada: SOGC; September 2007.
111 Young DC, Gray JH, Luther ER et al. Fetal scalp blood sampling: its value in an active obstetric unit. Am J Obstet Gynecol 1980; 136: 276-281
112 Zalar jr. RW, Quilligan EJ. The influence of scalp sampling on the cesarean section rate for fetal distress. Am J Obstet Gynecol 1979; 135: 239-246
