Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals

Costa, Antónia; Ayres-de-Campos, Diogo; Costa, Fabíola; Costa-Santos, Cristina; Bernardes, João

doi:10.1016/j.ajog.2009.04.033

Cited by 60 publications

(41 citation statements)

References 25 publications

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“…6,8 The databases were searched and cases were consecutively selected if they fulfilled the following criteria: singleton pregnancies, more than 36 completed gestational weeks, fetus in a cephalic presentation, absence of known fetal malformations, active phase of labour, generally accepted indication for internal fetal heart rate (FHR) monitoring (poor signal quality, heavy meconium staining, high-risk pregnancy, etc. ), a minimum of 60 minutes of tracing duration, signal loss in the last hour <20%, no complications with the potential to influence fetal oxygenation occurring between tracing end and delivery (difficult vaginal or abdominal fetal extractions, cord prolapse, maternal hypotension, shoulder dystocia, etc.…”

Section: Methodsmentioning

confidence: 99%

“…5 Pathological alerts elicited by the Omniview-SisPorto 3.5 system have been shown to be highly predictive of fetuses born with umbilical blood artery (UAB) acidaemia. 6 Despite such promising results it is unlikely in the near future that computerised systems will replace healthcare professionals in intrapartum management decisions. Not only would a more extensive evaluation of their validity and effectiveness be required, but also several medico-legal issues need to be adequately addressed.…”

Section: Introductionmentioning

confidence: 99%

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Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH

Costa

Costa-Santos²,

Ayres-de-Campos

et al. 2010

BJOG

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Objective To evaluate the impact of access to computerised cardiotocograph (CTG) analysis on reproducibility and accuracy of clinicians' predictions of umbilical artery blood pH (UAB pH) and 5-minute Apgar score.Design Prospective evaluation of pre-recorded cases.Setting A tertiary-care university hospital.Population From databases of intrapartum CTGs acquired in singleton term pregnancies, 204 tracings with low signal loss and short time interval to delivery were consecutively selected.Methods Tracings were randomly assigned to computer analysis by the Omniview-SisPorto 3.5 Ò system (study group n = 104) or to no analysis (control group n = 100). Three experienced clinicians evaluated all tracing printouts independently and were asked to predict the newborns' UAB pH and 5-minute Apgar scores from them. Conclusions Prediction of UAB pH is more reproducible and accurate when clinicians have access to computerised analysis of CTGs.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH

Costa

Costa-Santos²,

Ayres-de-Campos

et al. 2010

BJOG

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“…All cases of neonatal acidemia displayed red alerts in the last hour of the tracing, for a sensitivity of 1.00 (95 % CI 0.56 -1.00) and a specifi city of 0.94 (95 % CI 0.89 -0.97) [11] .…”

Section: Omniview-sisporto ® (Speculum Lisbon Portugal)mentioning

confidence: 99%

An overview of central fetal monitoring systems in labour

Nunes¹,

Ayres-de-Campos²,

Figueiredo

et al. 2012

Journal of Perinatal Medicine

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A variety of systems for centralised viewing of fetal signals during labour are currently available, allowing simultaneous monitoring of multiple tracings in one or more locations. Display of maternal vital signs, ST signals and an electronic partogram are available in the majority of these systems. A few of them have incorporated computer analysis of cardiotocographic signals or combined cardiotocographic and ST data analysis. Computer analysis may elicit real-time alerts for healthcare professionals when changes associated with fetal hypoxia are detected. Central fetal monitoring systems have been installed in a large number of maternity hospitals in industrialised countries, but there is still limited evidence of their impact on perinatal indicators, on the behaviour of healthcare professionals and on related health costs.

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“…A later study by Costa et al [16] examined the last hour of tracing in 148 term patients. Tracings were analyzed and classifi ed using a computerized EFM pattern recognition program, Omniview Sis Porto 3.5 (Speculum SA, Alfragide, Amadora, Portugal), before applying the STAN algorithm.…”

Section: St Segment Analysis (Stan)mentioning

confidence: 99%

New perspectives in electronic fetal surveillance

Hamilton¹,

Warrick²

2012

Journal of Perinatal Medicine

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Despite its recognized limitations, fetal heart rate monitoring is a mainstay of intrapartum care. Although the basic technology in standard electronic fetal monitors has changed little in recent decades, clinical behavior in response to heart rate monitoring has changed considerably. In addition to clearly defi ned nomenclature and clinical guidelines, there is an increased awareness that environmental and human factors can impair clinical judgment, resulting in delayed intervention and, consequently, birth-related injury. This review examines three essential steps that affect clinical outcome: (1) signal acquisition, (2) associations with physiological outcome, and (3) clinical intervention. Only the third step is directly responsible for changing clinical outcome. However, timely initiation of interventions is dependent upon the second step, which is dependent upon the fi rst step. Thus, defi ciencies at each step tend to accumulate and contribute to the worsening of overall clinical outcome. This review article summarizes advances occurring at each step. The synergy and convergence of innovations in engineering, mathematics, and behavioral science shows considerable promise in intrapartum fetal surveillance.

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Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals

Cited by 60 publications

References 25 publications

Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH

Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH

An overview of central fetal monitoring systems in labour

New perspectives in electronic fetal surveillance

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