Electrocardiograms in the fetus as early as 12 weeks and frequent or continuous ECG monitoring during labor and delivery may detect congenital heart disease or obstetrical complications. Further, these procedures serve as a valuable adjunct in the management of the newborn child.
John R. Urbach, MD, Philadelphia, reports that the most clinically significant arrhythmias are those originating in the sino-atrial node in the fetus and neonate.
"They are important because they reflect central nervous system (CNS) response to changes in the internal and external environment which threaten the fetus' well-being, and thus serve as monitors."
At Woman's Medical College of Pennsylvania, in Philadelphia, approximately 20 fetal electro- and phonocardiograms are made and five to ten patients in labor are monitored each week for research purposes. Urbach estimated that from 15 to 20 institutions in the United States use similar procedures.
For this study, 600 patients were observed during gestation; 440 had differentially