THE T QRS RATIO OF THE ELECTROCARDIOGRAM DOES NOT RELIABLY REFLECT WELL-BEING IN FETAL LAMBS/

OBJECTIVE: Our purpose was to determine the diagnostic power of the T/ QRS ratio of the electrocardiogram to predict fetal well-being. STUDY DESIGN: In 47 fetal lambs (3 to 5 days after surgery, gestational age 123.5 +/- 3.0 days) asphyxia was induced by restriction of uterine per fusion. Fetuses were either pretreated with an adenosine transport inh ibitor (n = 16) or a calcium channel blocker (n = 12) or served as con trols (n = 19). Arterial oxygen content greater than or equal to 1.5 m mol/L or pH greater than or equal to 7.15 were chosen as limits for fe tal well-being. RESULTS: Arterial oxygen content was reduced from 3.3 (+/- 1.0) to 1.3 (+/- 0.5) mmol/L, and pH decreased to 7.03 (+/- 0.10) . Mortality was 53%. Both drugs did not affect well-being, survival, o r the T/QRS ratio. Maximum T/QRS ratios were reached at the peak of as phyxia. Sensitivity and specificity of the T/QRS ratio were 24.0% and 42.6% to predict hypoxemia and 25.1% and 45.3% to predict acidemia. Pe arson correlation coefficients for T/QRS ratio versus oxygen content a nd pH were 0.169 and 0.192, respectively. CONCLUSIONS: (1) In fetal la mbs the T/QRS ratio failed to predict hypoxemia or acidemia. (2) Fetal survival was not correlated with the height of the T/QRS ratio during or after asphyxia.