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ECG monitoring in the delivery room is not reliable for all patients
  1. Kate Alison Hodgson1,
  2. Camille Omar Farouk Kamlin1,2,3,
  3. Sheryle Rogerson1,
  4. Marta Thio1,2,3,4
  1. 1 Newborn Research Centre, Royal Women’s Hospital, Parkville, Victoria, Australia
  2. 2 University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
  4. 4 PIPER - Neonatal Retrieval, Royal Children’s Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Kate Alison Hodgson, Newborn Research Centre, Royal Women’s Hospital, Melbourne, VIC 3052, Australia; Kate.Hodgson{at}

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We would like to use a case of a newly born infant with hydrops fetalis requiring extensive resuscitation to draw the readers’ attention to potential limitations of ECG monitoring of heart rate (HR) in the delivery room (DR).

Following an antenatal diagnosis of non-immune hydrops fetalis, with bilateral pleural effusions, ascites, subcutaneous oedema and estimated birth weight of 4240 g (>99th centile), an infant was delivered by caesarean section at 33 weeks’ gestation following antenatal corticosteroid administration. Experienced neonatal resuscitation team members were assembled with additional equipment (ultrasound machine) as a difficult transition was expected.

Immediately after birth, pulse oximetry (PO) and ECG leads were applied while the infant received …

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  • Contributors KAH drafted and edited the letter. COFK, SR and MTL revised and edited the letter.

  • Competing interests None declared.

  • Patient consent Obtained from the parents/guardian.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Correction notice This paper has been amended since it was published Online First. The last author’s surname has been corrected.