Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.

Electronic fetal heart rates (FHR) are used to monitor fetal health during labour. The paper records are visually assessed by clinicians, but automated alternatives are being developed. Interpretation, visual or computerised, depends on assigning a baseline to identify key features such as accelerat...

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Main Authors: Georgieva, A, Payne, S, Moulden, M, Redman, C
Format: Journal article
Language:English
Published: 2012
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author Georgieva, A
Payne, S
Moulden, M
Redman, C
author_facet Georgieva, A
Payne, S
Moulden, M
Redman, C
author_sort Georgieva, A
collection OXFORD
description Electronic fetal heart rates (FHR) are used to monitor fetal health during labour. The paper records are visually assessed by clinicians, but automated alternatives are being developed. Interpretation, visual or computerised, depends on assigning a baseline to identify key features such as accelerations and decelerations. However, when the FHR is unstable the baseline may be unassignable, making conventional analysis unreliable. Such instability may reflect on fetal health. If true, these segments should not be discarded but quantified, for which we have developed a numerical method. In 7,568 labours, the association between unassignable baseline and umbilical arterial blood pH ≤ 7.05 at birth (evidence of poor health) was studied retrospectively. We found a consistent increase of the risk for acidaemia with longer intervals of unassignable baseline. This is detectable at the end of the first stage of labour, but stronger at the end of the second stage: in the last 30 min of labour, the odds ratios (with respect to baseline assignable throughout this period) increased from 1.99 (15 min unassignable) to 4.9 (30 min unassignable). Computerised analysis of the FHR becomes unreliable when the baseline cannot be assigned; however, this pattern is itself a pathological feature associated with acidaemia at birth.
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spelling oxford-uuid:ae8c03f6-5425-4bf7-a29a-5961f74aa5252022-03-27T03:43:19ZRelation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ae8c03f6-5425-4bf7-a29a-5961f74aa525EnglishSymplectic Elements at Oxford2012Georgieva, APayne, SMoulden, MRedman, CElectronic fetal heart rates (FHR) are used to monitor fetal health during labour. The paper records are visually assessed by clinicians, but automated alternatives are being developed. Interpretation, visual or computerised, depends on assigning a baseline to identify key features such as accelerations and decelerations. However, when the FHR is unstable the baseline may be unassignable, making conventional analysis unreliable. Such instability may reflect on fetal health. If true, these segments should not be discarded but quantified, for which we have developed a numerical method. In 7,568 labours, the association between unassignable baseline and umbilical arterial blood pH ≤ 7.05 at birth (evidence of poor health) was studied retrospectively. We found a consistent increase of the risk for acidaemia with longer intervals of unassignable baseline. This is detectable at the end of the first stage of labour, but stronger at the end of the second stage: in the last 30 min of labour, the odds ratios (with respect to baseline assignable throughout this period) increased from 1.99 (15 min unassignable) to 4.9 (30 min unassignable). Computerised analysis of the FHR becomes unreliable when the baseline cannot be assigned; however, this pattern is itself a pathological feature associated with acidaemia at birth.
spellingShingle Georgieva, A
Payne, S
Moulden, M
Redman, C
Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.
title Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.
title_full Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.
title_fullStr Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.
title_full_unstemmed Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.
title_short Relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth.
title_sort relation of fetal heart rate signals with unassignable baseline to poor neonatal state at birth
work_keys_str_mv AT georgievaa relationoffetalheartratesignalswithunassignablebaselinetopoorneonatalstateatbirth
AT paynes relationoffetalheartratesignalswithunassignablebaselinetopoorneonatalstateatbirth
AT mouldenm relationoffetalheartratesignalswithunassignablebaselinetopoorneonatalstateatbirth
AT redmanc relationoffetalheartratesignalswithunassignablebaselinetopoorneonatalstateatbirth