PURPOSE: Sleep Disordered Breathing has been reported to have a high incidence in women with Pregnancy induced Hypertension, and has been suggested as a possible cause. Fetal heart monitoring is an integral part of obstetrical assessment and adding it to the regular polysomography montage may have clinical and research value. However, it also adds a level of complexity to testing. We therefore assessed the feasibility of performing continuous fetal heart monitoring during overnight polysomnography in pregnant women.
METHODS: All studies were conducted in the Royal University Hospital Sleep Lab. Subjects had either the diagnosis of pregnancy induced hypertension or had uncomplicated pregnancies. Routine polysomnography monitoring was conducted, with one exeption: the abdominal belt was eliminated, so as not to interfere with the fetal heart monitor. An obstetrics nurse was present for the set up of the fetal heart monitor. Once an acceptable signal was established, the sleep technician maintained the fetal monitor for ther remainder of the study for the uncomplicated pregnancy group. For the hypertensive group, the obstetrics nurse attended the entire study. Adjustments to the monitor were made only at times when subjects were awake. All fetal strips were reviewed by author #3, for quality and interpretation.
RESULTS: Fetal monitoring was successful in all subjects. Although there were periods of time during each study when the fetal heart signal was temporarily lost, all but one of the strips were considered to be of acceptable quality. Two fetal strips from the hypertensive group were interpreted as ‘non-reassuring’. All others were ‘reassuring’.
CONCLUSION: Fetal heart monitoring is an important part of antenatal assessment and may have merrit as part of polysomnography of pregnant women in the third trimester. With simple modification of the routine polysomnogram, reasonably good fetal heart monitoring can be achieved.
CLINICAL IMPLICATIONS: Continuous fetal monitoring may play a valuable role in polysomnography of pregnant women.
DISCLOSURE: John Reid, No Financial Disclosure Information; No Product/Research Disclosure Information