{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T14:20:04Z","timestamp":1777645204372,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Transabdominal electrocardiographic (TAfECG) acquisition of fetal heart rate (FHR) signals has recently been introduced into leading commercial cardiotocographic (CTG) monitors. Continuous wireless transmission of signals has raised the possibility of the technology being used during maternal mobilization in labor. This study aims to evaluate signal quality and accuracy of TAfECG acquisition of FHR signals during static and active maternal positions in labor when compared with Doppler signals and with the gold\u2010standard method of fetal scalp electrode (FSE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A total of 76 women with singleton term pregnancies in the active first stage of labor had simultaneously acquired FHR with TAfECG, Doppler, and FSE. Participants were asked to complete a supervised mobilization scheme, comprising five sequential 10\u2010min periods of lying down, standing, sitting, walking, and rocking on the birthing ball. The three FHR signals were compared, defining signal loss as the percentage of signals under 20\u2009bpm or exceeding 250\u2009bpm and accuracy as the difference with FSE values. Computer analysis was used to quantify variability, accelerations, and decelerations. Static labor positions (lying down, standing, and sitting) were compared with active labor positions (walking and rocking on the birthing ball).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Average signal loss was 5.3% with TAfECG (3.2% in static and 7.4% in active positions) and 15.5% with Doppler (8.3% in static and 30.7% in active positions). Average accuracy was 3.5\u00a0bpm with TAfECG (1.9\u00a0bpm in static and 5.04\u2009bpm in active positions) and 13.9\u00a0bpm with Doppler (3.2\u00a0bpm in static and 24.7\u00a0bpm in active positions). Average variability was similar with TAfECG and FSE in static positions but significantly higher with TAfECG in active positions (23.6 vs. 13.5\u2009bpm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In static labor positions, TAfECG provides a low signal loss, similar to that obtained with FSE, and a good signal accuracy, so the technique can be considered reliable when the mother is lying down, standing, or sitting. During maternal movement, TAfECG causes an artificial increase in FHR variability, which can cause false reassurance regarding fetal oxygenation. Doppler signals are unreliable during maternal movements.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14434","type":"journal-article","created":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T07:15:16Z","timestamp":1660288516000},"page":"1269-1275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Quality of fetal heart rate monitoring with transabdominal fetal <scp>ECG<\/scp> during maternal movement in labor: A prospective study"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5962-1560","authenticated-orcid":false,"given":"Catarina","family":"Reis\u2010de\u2010Carvalho","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical School \u2010 Santa Maria University Hospital  Lisbon Portugal"},{"name":"Medical School \u2010 Santa Maria University Hospital  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Medical School \u2010 Santa Maria University Hospital  Lisbon Portugal"},{"name":"Biomathematics Laboratory Institute for Preventive Medicine and Public Health  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diogo","family":"Ayres\u2010de\u2010Campos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical School \u2010 Santa Maria University Hospital  Lisbon Portugal"},{"name":"Medical School \u2010 Santa Maria University Hospital  Lisbon Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"CD003934","article-title":"Maternal positions and mobility during first stage labour","volume":"10","author":"Lawrence A","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjom.2000.8.9.8075"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13873"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01533.x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2413-4"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.02.012"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aem214"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1076\/apab.110.3.165.8293"},{"issue":"39","key":"e_1_2_13_10_1","first-page":"1","article-title":"The effects of asymmetric volume conductor modeling on non\u2010invasive fetal ECG extraction","volume":"1","author":"Keenan E","year":"2018","journal-title":"Physiol Meas"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12387"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1248945"},{"key":"e_1_2_13_13_1","article-title":"Monitoring fetal heart rate during labor: a comparison of three methods","volume":"5","author":"Euliano TY","year":"2017","journal-title":"J Pregnancy"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11517-018-1862-8"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-67934-1_1"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(87)90089-X"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2004.01.001"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(81)90673-6"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200304120-00004"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2014.08.003"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14434","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14434","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T16:19:34Z","timestamp":1741796374000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14434"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,12]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/aogs.14434"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14434","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,12]]},"assertion":[{"value":"2022-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}