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Title of Journal: Med Biol Eng Comput

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Abbravation: Medical & Biological Engineering & Computing

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Springer-Verlag

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1741-0444

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Relation of fetal heart rate signals with unassign

Authors: A Georgieva S J Payne M Moulden C W G Redman
Publish Date: 2012/06/08
Volume: 50, Issue: 7, Pages: 717-725
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Abstract

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 7568 labours the association between unassignable baseline and umbilical arterial blood pH ≤ 705 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 199 15 min unassignable to 49 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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