Computerised analysis of the fetal heart rate and relation to acidaemia at delivery

• Published in: BJOG : an international journal of obstetrics and gynaecology 2001-08, Vol.108 (8), p.848-852
• Main Authors: Strachan, Bryony K., Sahota, Daljit S., Wijngaarden, Willem J., James, David K., Chang, Allan M.Z.
• Format: Article
• Language: English
• Subjects: Acidosis - diagnosis; Acidosis - physiopathology; Algorithms; Biological and medical sciences; Cardiotocography - methods; Delivery, Obstetric; Delivery. Postpartum. Lactation; Diagnosis, Computer-Assisted - methods; Female; Fetal Diseases - diagnosis; Fetal Diseases - physiopathology; Gynecology. Andrology. Obstetrics; Heart Rate, Fetal - physiology; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Maternal, fetal and perinatal monitoring; Medical sciences; Pregnancy; Retrospective Studies
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2001.00195.x

Objective To identify the individual features of the computerised analysis of the cardiotocograph that relate to arterial pH and base deficit at delivery. Design Retrospective observational study. Setting Teaching hospital labour wards. Participants 679 women requiring continuous intrapartum fetal monitoring. Methods Fetal heart and uterine contraction data were obtained using the Nottingham Fetal ECG monitor. Fetal heart rate patterns for the last half‐hour preceding delivery were analysed using a computer algorithm developed for intrapartum application. The significance of the areas under receiver operator characteristic curves were calculated. Main outcome measures Umbilical arterial pH and base deficit at delivery. Results Three parameters, fetal bradycardia, total deceleration area and the deceleration area after a contraction had receiver operator characteristic curves that significantly predict a low umbilical arterial pH and base deficit at delivery (areas under receiver‐operator characteristic curves =0.53, SD 0.01 P= 0.03; 0.60, SD 0.03 P= 0.002; 0.62 SD 0.04 P