Fetal Heart Rate Fragmentation

被引:1
作者
Costa, Matilde [1 ]
Xavier, Mariana [1 ]
Nunes, Ines [2 ,3 ,4 ]
Henriques, Teresa S. [3 ,5 ]
机构
[1] Univ Porto, Dept Biomed Engn, Fac Engn, Porto, Portugal
[2] Ctr Hosp & Univ Porto, Ctr Materno Infantil Norte, Porto, Portugal
[3] Univ Porto, Ctr Hlth Technol & Serv Res CINTESIS, Fac Med, Porto, Portugal
[4] Univ Porto, ICBAS Sch Med & Biomed Sci, Porto, Portugal
[5] Univ Porto, Dept Hlth Informat & Decis Sci MEDCIDS, Fac Med, Porto, Portugal
来源
FRONTIERS IN PEDIATRICS | 2021年 / 9卷
关键词
fetal heart rate; fragmentation; symbolic dynamics; short-term variability; acidemia; umbilical cord pH; FIGO CONSENSUS GUIDELINES; INTRAPARTUM; SYSTEM; LABOR;
D O I
10.3389/fped.2021.662101
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Intrapartum fetal monitoring's primary goal is to avoid adverse perinatal outcomes related to hypoxia/acidosis without increasing unnecessary interventions. Recently, a set of indices were proposed as new biomarkers to analyze heart rate (HR), termed HR fragmentation (HRF). In this work, the HRF indices were applied to intrapartum fetal heart rate (FHR) traces to evaluate fetal acidemia. The fragmentation method produces four indices: PIP-Percentage of inflection points; IALS-Inverse of the average length of acceleration/deceleration segments; PSS-Percentage of short segments; PAS-Percentage of alternating segments. On the other hand, the symbolic approach studied the existence of different patterns of length four. We applied the measures to 246 selected FHR recordings sampled at 4 and 2 Hz, where 39 presented umbilical artery's pH <= 7.15. When applied to the 4 Hz FHR, the PIP, IASL, and PSS showed significantly higher values in the traces from acidemic fetuses. In comparison, the percentage of "words " W1h and W2s showed lower values for those traces. Furthermore, when using the 2 Hz, only IASL, W-0, and W2m achieved significant differences between traces from both acidemic and normal fetuses. Notwithstanding, the ideal sampling frequency is yet to be established. The fragmentation indices correlated with Sisporto variability measures, especially short-term variability. Accordingly, the fragmentation indices seem to be able to detect pathological patterns in FHR tracings. These indices have the advantage of being suitable and straightforward to apply in real-time analysis. Future studies should combine these indexes with others used successfully to detect fetal hypoxia, improving the power of discrimination in a larger dataset.</p>
引用
收藏
页数:9
相关论文
共 31 条
  • [11] Heart Rate Fragmentation: A New Approach to the Analysis of Cardiac Interbeat Interval Dynamics
    Costa, Madalena D.
    Davis, Roger B.
    Goldberger, Ary L.
    [J]. FRONTIERS IN PHYSIOLOGY, 2017, 8
  • [12] CRITERIA FOR THE DESIGN OF FETAL HEART-RATE ANALYSIS SYSTEMS
    DAWES, GS
    MOULDEN, M
    REDMAN, CWG
    [J]. INTERNATIONAL JOURNAL OF BIO-MEDICAL COMPUTING, 1990, 25 (04): : 287 - 294
  • [13] A comparison of visual analyses of intrapartum fetal heart rate tracings according to the new National Institute of Child Health and Human Development guidelines with computer analyses by an automated fetal heart rate monitoring system
    Devoe, L
    Golde, S
    Kilman, Y
    Morton, D
    Shea, K
    Waller, J
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2000, 183 (02) : 361 - 365
  • [14] Review of the first 1502 cases of ECG-ST waveform analysis during labour in a teaching hospital
    Doria, V.
    Papageorghiou, At
    Gustafsson, A.
    Ugwumadu, A.
    Farrer, K.
    Arulkumarana, S.
    [J]. BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2007, 114 (10) : 1202 - 1207
  • [15] Druzen M., 1979, 26 ANN M SOC GYN INV
  • [16] Freeman R. K., 2012, Fetal heart rate monitoring, V4th
  • [17] PhysioBank, PhysioToolkit, and PhysioNet - Components of a new research resource for complex physiologic signals
    Goldberger, AL
    Amaral, LAN
    Glass, L
    Hausdorff, JM
    Ivanov, PC
    Mark, RG
    Mietus, JE
    Moody, GB
    Peng, CK
    Stanley, HE
    [J]. CIRCULATION, 2000, 101 (23) : E215 - E220
  • [18] Internal versus external intrapartum foetal heart rate monitoring:: the effect on linear and nonlinear parameters
    Gonçalves, H
    Rocha, AP
    Ayres-de-Campos, D
    Bernardes, J
    [J]. PHYSIOLOGICAL MEASUREMENT, 2006, 27 (03) : 307 - 319
  • [19] Comparison of real beat-to-beat signals with commercially available 4 Hz sampling on the evaluation of foetal heart rate variability
    Goncalves, Hernani
    Costa, Antonia
    Ayres-de-Campos, Diogo
    Costa-Santos, Cristina
    Rocha, Ana Paula
    Bernardes, Joao
    [J]. MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 2013, 51 (06) : 665 - 676
  • [20] A MULTICENTER COMPARATIVE-STUDY OF 17 EXPERTS AND AN INTELLIGENT COMPUTER-SYSTEM FOR MANAGING LABOR USING THE CARDIOTOCOGRAM
    KEITH, RDF
    BECKLEY, S
    GARIBALDI, JM
    WESTGATE, JA
    IFEACHOR, EC
    GREENE, KR
    [J]. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1995, 102 (09): : 688 - 700