Compelling Case for Fetal EKGs

EKGs have been a mainstay for assessing a fetus’ health since the early 1900s.  But, due to interference from the maternal EKG signal, physicians are not able to get a true waveform, which is critical in diagnosing arrhythmia or elevated ST segment in a fetus.  According to Dr. Nina Gotteiner, MD, pediatric cardiologist, associate professor of pediatrics, Feinberg School of Medicine, Northwestern University in Chicago, IL, “If we can identify a fetal arrhythmia, it is very treatable and we can affect the outcome.”

Currently, fetal EKGs are acquired through a scalp electrode, which limits the technology’s ability to acquire the data in a non-labor setting.  However, evolving noninvasive fetal EKG technology is designed to accurately separate fetal and maternal EKG signals.  Depending on the technology, the signal is acquired by 10 to 20 EKG electrodes placed on the mother’s abdomen.

When I spoke with Dr. Gotteiner about the status of noninvasive fetal EKGs, she explained, “Fetal EKGs have been a hot topic for years.  The problem is that right now it is an invasive process; therefore, it is only used during childbirth.  Now, doctors can use ultrasound to access a fetal arrhythmia, but it only looks at motion.   With an EKG waveform, you can more easily identify an arrhythmia and monitor the treatment and its effects.”  The end result is a healthier baby.

Based on studies, the technology has the ability to be extremely accurate.  Tests indicate sensitivity of 100% and specificity of 97%.  So, what does an accurate EKG waveform mean for the patient?  To find out, I spoke with Dr. Tammy Y. Euliano, MD, associate professor of medicine at the University of Florida, Gainesville, Florida, and one of the early researchers on fetal EKG.  She concluded, “The net effect is that we can better tell which babies are truly doing poorly.  Even more importantly, it should reduce cesareans significantly.”

From 1996 to 2006, the rate of caesarian deliveries has risen 50%.  To date, it is the most common surgical procedure performed, totaling over $14 billion per year.  Despite this rise, patients are also four times more likely to die during a cesarean delivery than a natural birth because of the added risks, such as infection, blood loss, and decreased bowel function.  Avoiding these risks has driven the research and development for a diagnostic technology that improves the wellness of both the mother and the baby.

James Laskaris, EE, BME
James Laskaris, EE, BME, Clinical Analyst — Mr. James Laskaris is a senior emerging technology analyst at MD Buyline and has been with the company since 1994. With over 30 years of experience in the healthcare field, Mr. Laskaris is the primary analyst of high-end OR technology. He also covers issues related to the legislative and reimbursement effect on healthcare and authors a bimonthly “Issues that Matter” publication. Mr. Laskaris received his biomedical engineering degree from Southern Illinois University. His work has been published in hfm Magazine, Radiology Manager and Healthcare Purchasing News.