Phase‐rectified signal averaging for intrapartum electronic fetal heart rate monitoring is related to acidaemia at birth

Georgieva, Antoniya; Papageorghiou, Aris T.; Payne, Stephen J.; Moulden, M.; Redman, C.W.G.

doi:10.1111/1471-0528.12568

Cited by 62 publications

(82 citation statements)

References 16 publications

(43 reference statements)

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“…Some studies found that new computerized measures like phase-rectified signal averaging could also predict acidemia at birth with slightly higher predictive ability and better predictive performance than STV [20]. The combination of STV and other computerized features could be a possibility to improve the efficiency of computerized FHR.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Variation of the Fetal Heart Rate for Predicting Neonatal Acidosis in Preeclampsia

et al. 2015

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Introduction: The aim of this study was to measure the performance of short-term variation (STV) in predicting the onset of neonatal acidosis in fetuses at risk due to maternal preeclampsia. Material and Methods: This retrospective study examined data from a series of 159 women with singleton pregnancies, hospitalized for preeclampsia in a level 3 reference maternity hospital in northern France, with an STV measurement in the 24 h preceding cesarean delivery and a measurement of the newborn's arterial cord pH at birth. The main outcome was determined by a correlation between STV and neonatal pH. Results: The last computerized fetal heart rate analysis took place a mean of 7.9 ± 6.3 h before birth, and neonatal acidosis was diagnosed in 38 newborns (23.9%). Although STV and umbilical artery pH at birth were significantly correlated (ρ = 0.16, p < 0.05), the performance of STV in predicting neonatal acidosis was poor, with an area under the ROC curve of 0.63. The sensitivity reached only 50.0% and the specificity 71.9% at the best STV threshold for predicting acidosis. Conclusion: The performance of STV for screening for neonatal acidosis is poor in women with preeclampsia. The divergent results between studies are probably due to the variable intervals between STV measurement and birth.

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Section: Discussionmentioning

confidence: 99%

Short-Term Variation of the Fetal Heart Rate for Predicting Neonatal Acidosis in Preeclampsia

et al. 2015

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“…From a number of monitoring sessions performed for each patient, we selected only one recording acquired around 1 week before delivery, with a length of at least 30 min (Georgieva et al, 2014). All the recordings are accompanied by information on fetal outcome: gestational age at birth, blood gas parameters pH and BE, percentile of fetal birth weight, Apgar score, information about a possible stay in the NICU.…”

Section: Methodsmentioning

confidence: 99%

Is Abdominal Fetal Electrocardiography an Alternative to Doppler Ultrasound for FHR Variability Evaluation?

et al. 2017

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Great expectations are connected with application of indirect fetal electrocardiography (FECG), especially for home telemonitoring of pregnancy. Evaluation of fetal heart rate (FHR) variability, when determined from FECG, uses the same criteria as for FHR signal acquired classically—through ultrasound Doppler method (US). Therefore, the equivalence of those two methods has to be confirmed, both in terms of recognizing classical FHR patterns: baseline, accelerations/decelerations (A/D), long-term variability (LTV), as well as evaluating the FHR variability with beat-to-beat accuracy—short-term variability (STV). The research material consisted of recordings collected from 60 patients in physiological and complicated pregnancy. The FHR signals of at least 30 min duration were acquired dually, using two systems for fetal and maternal monitoring, based on US and FECG methods. Recordings were retrospectively divided into normal (41) and abnormal (19) fetal outcome. The complex process of data synchronization and validation was performed. Obtained low level of the signal loss (4.5% for US and 1.8% for FECG method) enabled to perform both direct comparison of FHR signals, as well as indirect one—by using clinically relevant parameters. Direct comparison showed that there is no measurement bias between the acquisition methods, whereas the mean absolute difference, important for both visual and computer-aided signal analysis, was equal to 1.2 bpm. Such low differences do not affect the visual assessment of the FHR signal. However, in the indirect comparison the inconsistencies of several percent were noted. This mainly affects the acceleration (7.8%) and particularly deceleration (54%) patterns. In the signals acquired using the electrocardiography the obtained STV and LTV indices have shown significant overestimation by 10 and 50% respectively. It also turned out, that ability of clinical parameters to distinguish between normal and abnormal groups do not depend on the acquisition method. The obtained results prove that the abdominal FECG, considered as an alternative to the ultrasound approach, does not change the interpretation of the FHR signal, which was confirmed during both visual assessment and automated analysis.

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“…More recently, various computerised systems for objective FHR analysis have been developed, one of the most validated and used being the Oxford-system 6 , devised by Dawes, Redman and colleagues in 1982 7 . Currently in use today in many antenatal clinics and Day assessment Units, computerised systems eliminate observer variability, improve the reproducibility of EFM, and determine FHR parameters such as short-term variation (STV) that cannot be assessed visually 8 .…”

Section: Introductionmentioning

confidence: 99%

“Does short-term variation in fetal heart rate predict fetal acidaemia?” A systematic review and meta-analysis

Kapaya¹,

Jacques

Rahaim³

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

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Phase‐rectified signal averaging for intrapartum electronic fetal heart rate monitoring is related to acidaemia at birth

Cited by 62 publications

References 16 publications

Short-Term Variation of the Fetal Heart Rate for Predicting Neonatal Acidosis in Preeclampsia

Short-Term Variation of the Fetal Heart Rate for Predicting Neonatal Acidosis in Preeclampsia

Is Abdominal Fetal Electrocardiography an Alternative to Doppler Ultrasound for FHR Variability Evaluation?

“Does short-term variation in fetal heart rate predict fetal acidaemia?” A systematic review and meta-analysis

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