Fetal and maternal heart rate confusion during intra-partum monitoring: comparison of trans-abdominal fetal electrocardiogram and Doppler telemetry

Objective: To compare intra-partum performance of transabdominal electrocardiogram with Doppler telemetry. Methods: In this prospective longitudinal study, simultaneous monitoring with trans-abdominal ECG and Doppler telemetry was performed in 41 uncomplicated term singleton pregnancies during labour. Results: The overall success rate for FHR monitoring was similar between trans-abdominal ECG and Doppler telemetry (88.5 +/- 16.7% vs 89.4 +/- 7.6%), except for the second stage of labour. A significantly higher rate of confusion (p < 0.001) between fetal and maternal heart was found for Doppler telemetry (4.5 +/- 4.5%) compared with trans-abdominal ECG (1.3 +/- 1.9%), especially in the second stage and during maternal movements. Conclusions: Trans-abdominal ECG monitoring is feasible, with comparable success rate to traditional Doppler telemetry, without interfering with maternal mobility or requiring midwife intervention. The reduction in maternal\fetal heart rate confusion from trans-abdominal ECG could reduce incorrect obstetric interpretation.