Four leads in fetal electrocardiography

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      The literature in regard to fetal electrocardiography in the last ten years is briefly reviewed. The technique of fetal electrocardiography with external electrodes used in our laboratories is described, and the concept of “chronic fetal distress” is proposed in order to focus our attention on pathology during earlier periods of pregnancy, which may be amenable to diagnosis and treatment in the near future. One hundred positive recordings are analyzed at different stages of pregnancy since 12 weeks of amenorrhea. The value of recording the fetal tracing in a single lead is analyzed, as well as the incidence of appearance of the fetal electrocardiogram in the 4 leads proposed by us. No single lead by itself is a safe indicator to conclude the absence of fetal life when a fetal complex is not present. However, the presence of a clear fetal complex in a single lead is definite in assuming fetal life. The reasons for the fetal electrocardiogram appearing in some leads and not in others in given cases is not known, which is the reason we propose routine recording of the 4 leads by our special technique. It is a good procedure to control at least one parameter of the fetal heart current starting at an early stage of pregnancy. It is an easy procedure, is not very costly, and has the advantage of not being harmful to mother or fetus. New applications are mentioned, and future uses are analyzed.
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