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Table 1 Descriptive summary of studies included in review

From: A systematic review of cardiac time intervals utilising non-invasive fetal electrocardiogram in normal fetuses

Characteristics

Abboud et al.

Taylor et al.

Chia et al.

Taylor et al.

Hayashi et al.

Arya et al.

Yilmaz et al.

Wacker-Gussman. et al.

Study design and methods

 Year of Publication

1990

2003

2005

2005

2009

2015

2015

2017

 Study design

Cross sectional study

Cross sectional study

Prospective cohort study

Cross sectional study

Cross sectional study

Cross sectional study

Prospective observation cohort study

Cross sectional study

 Inclusion criteria

None reported

Random sampling

Healthy women and fetuses only

Women in labour or threatened labour

None reported

Referred for fetal echocardiography

Fetuses with normal cardiac anatomy or CHD

Healthy fetuses only

 Gestational Age [weeks]

32 to 41

15 to 41

18 to 41

24 to 41

32 to 41

16 to 42

20 to 38

32 to 40

 Time interval examined

PR, QRS, QT

PR, QRS, QT, QTc

P, PR, QRS, QT, T

PR, PQ, QRS, QT, QTc

P, QRS, T

PR, QRS, RR, QT

PR, QRS, QT

PR, PQ, QRS, QT, QTc

 Number of patients

Not described

241

100

15

48

50

92

149

 Number of acquired FECG

21

250

374

15

48

60

177

149

Signal acquisition

 Number of electrodes

2

14

3

14

5

5

5

5

 Electrodes placement

Not described

12 evenly over abdomen, 1 ground ref. near navel, 1 common ref. on right ankle

Equilateral triangle formation: 1 right + 1 left hypochondriac area, 1 above symphysis pubis

12 evenly over abdomen, 2 references near umblicus

2 higher abdomen (right/left), 2 lower abdomen (right/left), 1 at distinct fetal heart sound location

2 along midline, 2 at each side of uterus, 1 on left flank

2 along midline, 2 at each side of uterus, 1 on left flank

2 along midline, 2 at each side of uterus, 1 on left flank

 Dermabrasion & impedance

None described

Yes (< 5 kΩ)

Yes(< 5 k Ω)

Yes (< 5 kΩ)

None reported

Yes

Yes

Yes

 Reported difficulty in signal acquisition

None reported

Between 27 and 36 weeks

Between 27 and 32 weeks

None reported

None reported

Between 26 and 30 weeks

Between 24 and 34 weeks

Lowest at 32 weeks

Signal processing

 FECG analysed

21

199

374

12

35

20

132

117

 Signal averaging for analysis

100 beats

1 min

2.5 min

1 min

300–500 beats

1 min

yes - not described

1000 beats

 Digital filters

4-pole Butterworth non-recursive 10 Hz Highpass

1–2 Hz Highpass, 150 Hz lowpass

1st & 2nd derivative template removal

1 Hz Highpass, 150 Hz Low pass

0.5 Hz low-level an 25 Hz high level removal

[0.5–70 Hz] Butterworth bandpass

Automated with Monica DK V1.8 software

Not reported

 MECG removal

Digital subtraction of averaged signal

See Patent appl. GB2002/004410

Template subtraction

See Patent appl. GB2002/004410

Template subtraction

Template matching and digital subtraction

Automated with Monica DK V1.8 software

Template subtraction

 Success rates in CTI detection

QT-80%

P,Q, R, S-100%; T-78%

P-74.6%, QRS-91.0%, T-79.3%

P, QRS-100%, T-92%

72.9%

100% due to strict FECG excl. Criteria

PR-77%, QRS-98%, QT-30%

P, PQ, PR-97%, QRS-100%, T-41%

  1. CTI Cardiac time intervals, FECG fetal electrocardiogram, MECG Maternal electrocardiogram