Limitations of autocorrelation in fetal heart rate monitoring

Fukushima, Teiichiro; Flores, Carlos A.; Hon, Edward H.; Davidson, Ezra C.

doi:10.1016/s0002-9378(85)80261-1

Cited by 37 publications

(19 citation statements)

References 7 publications

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“…It has been assumed since the introduction of autocorrelation techniques to cardiotachometer software that US‐derived FHR patterns can be assumed to display true FHR variability. Although this may be a reasonable generalization, it is not always correct . On the contrary, our results show that the representation of FHR variability may be altered considerably by US‐based monitoring, and should be interpreted with considerable caution.…”

Section: Discussioncontrasting

confidence: 60%

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Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection

Hayes‐Gill

Martin²,

Liu

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Noninvasive fetal heart rate monitoring using transabdominal fetal electrocardiographic detection is now commercially available and has been demonstrated to be an effective alternative to traditional Doppler ultrasonographic techniques. Our objective in this study was to compare the results of computerized identification of fetal heart rate patterns generated by ultrasound‐based and transabdominal fetal electrocardiogram‐based techniques with simultaneously obtained fetal scalp electrode‐derived heart rate information. Material and methods We applied an objective computer‐based analysis for recognition of fetal heart rate patterns (Monica Decision Support) to data obtained simultaneously from a direct fetal scalp electrode, Doppler ultrasound, and the abdominal‐fetal electrocardiogram techniques. This allowed us to compare over 145 hours of fetal heart rate patterns generated by the external devices with those derived from the scalp electrode in 30 term singleton uncomplicated pregnancies during labor. The direct fetal scalp electrode is considered to be the most accurate and reliable technique used in current clinical practice, and was, therefore, used as the standard for comparison. The program quantified the baseline heart rate, long‐ and short‐term variability. It indicated when an acceleration or deceleration was present and whether it was large or small. Results Ultrasound was associated with significantly greater deviations from the fetal scalp electrode results than the abdominal fetal electrocardiogram technique in recognizing the correct baseline heart rate, its variability, and the presence of small and large accelerations and small decelerations. For large decelerations the two external methods were each not significantly different from the scalp electrode results. Conclusions Noninvasive fetal heart rate monitoring using maternal abdominal wall electrodes to detect fetal cardiac activity more reliably reproduced the computerized analysis of heart rate patterns derived from a direct fetal scalp electrode than did traditional ultrasound‐based monitoring. Abdominal‐fetal electrocardiogram should, therefore, be considered a primary option for externally monitored patients.

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Section: Discussioncontrasting

confidence: 60%

“…Although this may be a reasonable generalization, it is not always correct [31][32][33][34]. On the contrary, our results show that the representation of FHR variability may be altered considerably by US-based monitoring, and should be interpreted with considerable caution.…”

contrasting

confidence: 67%

Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection

Hayes‐Gill

Martin²,

Liu

et al. 2019

Acta Obstet Gynecol Scand

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“…The most common cardiotocography method for external fetal heart rate monitoring utilizes Doppler ultrasound devices. It was reported that Doppler ultrasound techniques may lead to a wrong interpretation due to the fact that the resultant heart rate tracing may contain spurious data (Divon et al, 1985;Fukushima et al, 1985).…”

Section: Introductionmentioning

confidence: 99%

Fetal magnetocardiography: development of the fetal cardiac time intervals

et al. 2002

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“…Concerning the accuracy of the FHR calculations, numerous authors have compared results of simultaneously derived FHR records using Doppler ultrasound and either direct scalp electrocardiogram (ECG) signals (LAWSON et al, 1983;AMATO, 1983;FUKUSHIMA et al, 1985;SPENCER et al, 1987;DAWES et al, 1990) or the transabdominal ECG (SoMVILLE and MORGENSTERN, 1994). in summary these results show that for the majority of the time the DUS provides an adequate (albeit averaged) measure of FHR.…”

mentioning

confidence: 99%

The information content of Doppler ultrasound signals from the fetal heart

Shakespeare

Crowe

Hayes‐Gill

et al. 2001

Med. Biol. Eng. Comput.

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Knowledge of the content of Doppler ultrasound signals from the fetal heart is essential if the performance of fetal heart rate (FHR) monitors based upon this technology is to be improved. For this reason instrumentation was constructed to enable the simultaneous collection of Doppler audio signals and the transabdominal fetal ECG (for signal registration), with a total of 22 recordings being made with an average length of around 20 minutes. These data demonstrate the transient nature of the Doppler audio data with wide variations in the signal content observable on a beat-to-beat basis. Short-time Fourier analysis enabled the content of the Doppler signals to be linked to six cardiac events, four valve and two wall motions, with higher frequency components being associated with the latter. This differing frequency content together with information regarding the direction of movement that can be discerned from Doppler signals provided a potential means of discriminating between these six events (which are unlikely to all contribute to the Doppler signal within the same cardiac cycle). Analysis of 100 records showed that wall contractions generate the most prominent signals, with atrial contraction recognisable in all records and ventricular wall contraction in 95% (although its amplitude is only around 30% of that of the atrial signal). Valve motion, with amplitudes between 15 and 25% that of the atrial wall signal, were visible in 75% of records. These results suggest means by which the six events that contribute to the Doppler signal may be distinguished, providing information that should enable an improvement in the current performance of Doppler ultrasound-based FHR monitors.

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Limitations of autocorrelation in fetal heart rate monitoring

Cited by 37 publications

References 7 publications

Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection

Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection

Fetal magnetocardiography: development of the fetal cardiac time intervals

The information content of Doppler ultrasound signals from the fetal heart

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