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 trans-abdominal 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.

Electrodiagnostic functional sensory evaluation of patients with generalized vulvodynia: a pilot study.

OBJECTIVE: To objectively evaluate vulvodynia by the current perception threshold (CPT) neurometer. METHODS: Neuroselective CPT measures of the pudendal nerve were obtained at the perineum by a neurometer (Neurotron, Inc, Baltimore, MD), using constant alternating sinusoid waveform electrical stimulus at 2,000-, 250-, and 5-Hz frequencies, in 20 healthy volunteers and 38 women with vulvodynia. The mean +/- SD CPT values in vulvodynia and healthy (control) women were analyzed with the Student t test. RESULTS: Women with vulvodynia showed lower mean CPT values (p <.01). CONCLUSIONS: Results of this study support a neuroselective sensory dysfunction in generalized vulvodynia. The field is opened for CPT measures in vulvodynia in selecting therapy strategy, monitoring response to treatment, and assessing vestibulodynia. Assessment of threshold values in a greater number of controls is needed to set a cutoff in CPT values for diagnosis and to grade the severity of the diseases.