Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.

The fetal heart rate (FHR) is monitored during labor to assess fetal health. Both visual and computerized interpretations of the FHR depend on assigning a baseline to detect key features such as accelerations or decelerations. However, it is sometimes impossible to assign a baseline reliably, by eye...

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Main Authors: Georgieva, A, Payne, S, Moulden, M, Redman, C
Format: Journal article
Language:English
Published: 2011
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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 The fetal heart rate (FHR) is monitored during labor to assess fetal health. Both visual and computerized interpretations of the FHR depend on assigning a baseline to detect key features such as accelerations or decelerations. However, it is sometimes impossible to assign a baseline reliably, by eye or by numerical methods. To address this issue, we used the Oxford Intrapartum FHR Database to derive an algorithm based on the distribution of the FHR that detects heart rate intervals without a clear baseline. We aimed to recognize when a fetus cannot maintain its heart rate baseline and use this to assist computerized FHR analysis. Twenty-three FHR windows (15 min long) were used to develop the method. The algorithm was then validated by comparison with experts who classified 50 FHR windows into two groups: baseline assignable or un-assignable. The average agreement between experts (κ = 0.76) was comparable to the agreement between method and experts (κ = 0.67). The algorithm was used in 22 559 patients with intrapartum FHR records to retrospectively determine the incidence of intervals (defined as 15 min windows) that had un-assignable baselines. Sixty-six percent had one or more such episodes at some stage, most commonly after the onset of pushing (55%) and least commonly pre-labor (16%). These episodes are therefore relatively common. Their detection should improve the reliability of computerized analysis and allow further studies of what they signify clinically.
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spelling oxford-uuid:fcff4c7c-3ac9-4f55-b75e-8fa4bf21f7022022-03-27T13:25:27ZComputerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fcff4c7c-3ac9-4f55-b75e-8fa4bf21f702EnglishSymplectic Elements at Oxford2011Georgieva, APayne, SMoulden, MRedman, CThe fetal heart rate (FHR) is monitored during labor to assess fetal health. Both visual and computerized interpretations of the FHR depend on assigning a baseline to detect key features such as accelerations or decelerations. However, it is sometimes impossible to assign a baseline reliably, by eye or by numerical methods. To address this issue, we used the Oxford Intrapartum FHR Database to derive an algorithm based on the distribution of the FHR that detects heart rate intervals without a clear baseline. We aimed to recognize when a fetus cannot maintain its heart rate baseline and use this to assist computerized FHR analysis. Twenty-three FHR windows (15 min long) were used to develop the method. The algorithm was then validated by comparison with experts who classified 50 FHR windows into two groups: baseline assignable or un-assignable. The average agreement between experts (κ = 0.76) was comparable to the agreement between method and experts (κ = 0.67). The algorithm was used in 22 559 patients with intrapartum FHR records to retrospectively determine the incidence of intervals (defined as 15 min windows) that had un-assignable baselines. Sixty-six percent had one or more such episodes at some stage, most commonly after the onset of pushing (55%) and least commonly pre-labor (16%). These episodes are therefore relatively common. Their detection should improve the reliability of computerized analysis and allow further studies of what they signify clinically.
spellingShingle Georgieva, A
Payne, S
Moulden, M
Redman, C
Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.
title Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.
title_full Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.
title_fullStr Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.
title_full_unstemmed Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.
title_short Computerized fetal heart rate analysis in labor: detection of intervals with un-assignable baseline.
title_sort computerized fetal heart rate analysis in labor detection of intervals with un assignable baseline
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AT paynes computerizedfetalheartrateanalysisinlabordetectionofintervalswithunassignablebaseline
AT mouldenm computerizedfetalheartrateanalysisinlabordetectionofintervalswithunassignablebaseline
AT redmanc computerizedfetalheartrateanalysisinlabordetectionofintervalswithunassignablebaseline