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- Electrocardiography versus photoplethysmography in assessment of maternal heart rate variability during laborPublication . Gonçalves, Hernâni; Pinto, Paula; Silva, Manuela; Ayres-de-Campos, Diogo; Bernardes, JoãoEvaluation of maternal heart rate (MHR) variability provides useful information on the maternal-fetal clinical state. Electrocardiography (ECG) is the most accurate method to monitor MHR but it may not always be available, and pulse oximetry using photoplethysmography (PPG) can be an alternative. In this study we compared ECG and PPG signals, obtained with conventional fetal monitors, to evaluate signal loss, MHR variability indices, and the ability of the latter to predict fetal acidemia and operative delivery.