536

Correspondence

Feta! electrocardiogram changes related to heart patterns during labor To the Editors: I have read with interest a paper by Dr. Pardi and associates entitled "Fetal electrocardiogram changes in relation to fetal heart rate patterns during labor" ( A11r. J. 0BSTET. GYNECOL. 118: 243, 1974). The authors described changes in the P and T waves and the S-T segment. The fact that they made no mention of similar results described by other researchers gave the impression that they considered their findings to be new and original. Toward the end of 1963, my colleagues and I studied the morphologic changes in the fetal electrocardiogram during bradycardia induced by uterine contractions and

june l'l, 197'' Am. j. ObstE"t. Gynecol

during the bradycardia "vhich accompanies expulsion nf the fetus. Among the morphologic changes we observed were those described as new findings by Pardi and associates. Our observations were published as part of a larger work in the Reuista de Obstetricia y Ginecologia de Venezuela (29: 271, 1969). The title of our paper was "Electrocardiograma Fetal Durante el Embarazo y Trabajo de Parto." This paper was listed in the Cumulated Index Medicus (11: 5159, 1970). Figs. 1 to 8 are fetal electrocardiogram tracings which relate to the work of Dr. Pardi and his associates. Mario Zilianti, M.D. Apartado del Este 62320 Caracas, Venezuela

Fig. 1. No. 58, H. 35962, December 17, 1963. The patient is in advanced labor with the fetus in a breech position. Morphologic changes of P waves during mild bradycardia induced by uterine contractions are shown.

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Fig. 2. No. 58, H. 35962, December 17, 1963. The patient is in advanced labor with the fetus in a breech position. The fetal heart rate is 200 beats per minute. "Pulmonar" P waves and tall T waves are present. Fig. 3. Fetal electrocardiogram recorded during labor (Rev. Obstet. Gynecol. Venezuela 29: 271, 1969, Fig. 41: A. V. block 3:1-taii T waves-breech in expuision.).

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Fig. 4. Fetal electrocardiogram recorded during labor (Rev. Obstet. Gynecol. Venezuela 29: 271, 1969, Fig. 40: Nodal rhythm. Breech in expulsion.).

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Volume 122 Number4

Correspondence 537

l'lg. 5. Fetai eiectrocardiogram recorded during iabor (Kev. uostet. Gynecoi. Venezueia 29: 271, 1969, Fig. 59: Tall T and P waves. Breech in advanced labor.).

Fig. 6. Fetal electrocardiogram recorded during labor (Rev. Obstet. Gynecol. Venezuela 29: 271, 1969, Fig. 58: "Pulmonar" P wave in a case of congenital diaphragmatic hernia.).

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Fig. 7. Fetal electrocardiogram recorded during labor (Rev. Obstet. Gynecol. Venezuela 29: 271, 1969, Fig. 57: Noda.l rhythm during bradycardia induced by uterine contraction. P waves reappear when uterine contraction ceases and FHR normalizes. Vertex presentation. Station 0.).

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