Computerized Analysis of Antepartum Cardiotocography: A Review

Jones, Gabriel Davis; Cooke, William R.; Vatish, Manu; Redman, Christopher W.G.

doi:10.1097/fm9.0000000000000141

Cited by 10 publications

(37 citation statements)

References 86 publications

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“…Dawes et al highlighted the advantages of such a computerized analysis 19 . In 2022, Jones et al published a review of computerized CTG with a focus on the Dawes‐Redman system 20 . Then, in the following decades, other computerized systems based on similar methodologies have been built 8,21–23 to be used during labor.…”

Section: Computerized Ctg Analysis During Labormentioning

confidence: 99%

“… 19 In 2022, Jones et al published a review of computerized CTG with a focus on the Dawes‐Redman system. 20 Then, in the following decades, other computerized systems based on similar methodologies have been built 8 , 21 , 22 , 23 to be used during labor. The Omniview‐SisPorto system (Speculum S.A., Portugal) developed by Ayres‐de‐Campos et al consists of a quantitative adaptation of the FIGO's guidelines.…”

Section: Computerized Ctg Analysis During Labormentioning

confidence: 99%

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Computerized cardiotocography analysis during labor – A state‐of‐the‐art review

M’Barek

Jauvion²,

Ceccaldi

2022

Acta Obstet Gynecol Scand

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Cardiotocography is defined as the recording of fetal heart rate and uterine contractions and is widely used during labor as a screening tool to determine fetal wellbeing. The visual interpretation of the cardiotocography signals by the practitioners, following common guidelines, is subject to a high interobserver variability, and the efficiency of cardiotocography monitoring is still debated. Since the 1990s, researchers and practitioners work on designing reliable computer‐aided systems to assist practitioners in cardiotocography interpretation during labor. Several systems are integrated in the monitoring devices, mostly based on the guidelines, but they have not clearly demonstrated yet their usefulness. In the last decade, the availability of large clinical databases as well as the emergence of machine learning and deep learning methods in healthcare has led to a surge of studies applying those methods to cardiotocography signals analysis. The state‐of‐the‐art systems perform well to detect fetal hypoxia when evaluated on retrospective cohorts, but several challenges remain to be tackled before they can be used in clinical practice. First, the development and sharing of large, open and anonymized multicentric databases of perinatal and cardiotocography data during labor is required to build more accurate systems. Also, the systems must produce interpretable indicators along with the prediction of the risk of fetal hypoxia in order to be appropriated and trusted by practitioners. Finally, common standards should be built and agreed on to evaluate and compare those systems on retrospective cohorts and to validate their use in clinical practice.

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Section: Computerized Ctg Analysis During Labormentioning

confidence: 99%

Section: Computerized Ctg Analysis During Labormentioning

confidence: 99%

Computerized cardiotocography analysis during labor – A state‐of‐the‐art review

M’Barek

Jauvion²,

Ceccaldi

2022

Acta Obstet Gynecol Scand

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“…Computer‐aided analysis of the antenatal cardiotocography (CTG) was developed by the group of Dawes and Redman from Oxford in the 1980s. Criteria for normality were developed, and a detailed description of these has been published 4,5 . An antenatal CTG trace is deemed to be normal if the Dawes–Redman criteria for normality are met 6 .…”

Section: Introductionmentioning

confidence: 99%

“…published. 4,5 An antenatal CTG trace is deemed to be normal if the Dawes-Redman criteria for normality are met. 6 When the criteria of normality are not met, a review with an experienced clinician is suggested.…”

mentioning

confidence: 99%

The significance of meeting Dawes–Redman criteria in computerised antenatal fetal heart rate assessment

Bhide

Meroni

Frick

et al. 2023

BJOG

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ObjectiveTo investigate the significance of not meeting Dawes–Redman criteria on computerised cardiotocography in high‐risk pregnancies.DesignRetrospective observational study.SettingUK university hospital.PopulationHigh‐risk pregnancies undergoing antenatal assessment.MethodsWe interrogated the database for records of computerised fetal heart rate assessment and pregnancy outcomes.Main outcome measuresNeonatal outcome and stillbirths.ResultsExcluding duplicate assessment in the same pregnancy, 14 025 records with complete information on the criteria of normality having been met and the outcome of the pregnancy were available. Criteria were not met for 907 records (6.46%). The gestational age of assessment was lower in the group not meeting criteria of normality. Overall, 32 stillbirths occurred in normally formed fetuses (2.28/1000). Stillbirths were more frequent in the group not meeting criteria (odds ratio [OR] 8.78, 95% CI 4.28–18.02). This finding persisted even after records with abnormally low short‐term variation (STV) were excluded. The confidence intervals around the rate of stillbirth in the two groups overlapped beyond an STV of 8 ms.ConclusionsApproximately 1:16 pregnancies do not meet the criteria of normality. The criteria are not met more often at preterm gestation than at term. The risk of stillbirth was higher in the group not meeting criteria of normality, even if cases with low STV are excluded. Cases not meeting criteria should be followed up closely, unless the STV is ≥8 ms. Stillbirths still occurred in the group meeting criteria, but the rate was lower than in the general population.

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“…[3][4][5] These CTG patterns, however, are difficult for human visual interpretation to reliably and consistently identify. 1,6,7 It is well-established that subjective assessment of the CTG patterns suffers from poor inter-observer and intra-observer reproducibility 1,[8][9][10][11][12][13] and is associated with increased operative vaginal delivery and caesarean section rates without improving perinatal outcomes. 14,15 Computerised cardiotocography (cCTG) has been considered to be superior to conventional CTG because this approach provides more reliable and consistent interpretation of the CTG tracing.…”

Section: Introductionmentioning

confidence: 99%

Prediction of labour outcomes using prelabour computerised cardiotocogram and maternal and fetal Doppler indices: A prospective cohort study

Moungmaithong,

Lam,

Kwan

et al. 2023

BJOG

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ObjectivesTo investigate the association and the potential value of prelabour fetal heart rate short‐term variability (STV) determined by computerised cardiotocography (cCTG) and maternal and fetal Doppler in predicting labour outcomes.DesignProspective cohort study.SettingThe Prince of Wales Hospital, a tertiary maternity unit, in Hong Kong SAR.PopulationWomen with a term singleton pregnancy in latent phase of labour or before labour induction were recruited during May 2019–November 2021.MethodsPrelabour ultrasonographic assessment of fetal growth, Doppler velocimetry and prelabour cCTG monitoring including Dawes–Redman CTG analysis were registered shortly before induction of labour or during the latent phase of spontaneous labour.Main outcome measuresUmbilical cord arterial pH, emergency delivery due to pathological CTG during labour and neonatal intensive care unit (NICU)/special care baby unit (SCBU) admission.ResultsOf the 470 pregnant women invited to participate in the study, 440 women provided informed consent and a total of 400 participants were included for further analysis. Thirty‐four (8.5%) participants underwent emergency delivery for pathological CTG during labour. A total of 6 (1.50%) and 148 (37.00%) newborns required NICU and SCBU admission, respectively. Middle cerebral artery pulsatility index (MCA‐PI) and MCA‐PI z‐score were significantly lower in pregnancies that required emergency delivery for pathological CTG during labour compared with those that did not (1.23 [1.07–1.40] versus 1.40 [1.22–1.64], p = 0.002; and 0.55 ± 1.07 vs. 0.12 ± 1.06), p = 0.049]. This study demonstrated a weakly positive correlation between umbilical cord arterial pH and prelabour log10 STV (r = 0.107, p = 0.035) and the regression analyses revealed that the contributing factors for umbilical cord arterial pH were smoking (p = 0.006) and prelabour log10 STV (p = 0.025).ConclusionsIn pregnant women admitted in latent phase of labour or for induction of labour at term, prelabour cCTG STV had a weakly positive association with umbilical cord arterial pH but was not predictive of emergency delivery due to pathological CTG during labour.

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Computerized Analysis of Antepartum Cardiotocography: A Review

Cited by 10 publications

References 86 publications

Computerized cardiotocography analysis during labor – A state‐of‐the‐art review

Computerized cardiotocography analysis during labor – A state‐of‐the‐art review

The significance of meeting Dawes–Redman criteria in computerised antenatal fetal heart rate assessment

Prediction of labour outcomes using prelabour computerised cardiotocogram and maternal and fetal Doppler indices: A prospective cohort study

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