Prediction of neonatal state by computer analysis of fetal heart rate tracings: the anteparturn arm of the SisPorto (R) multicentre validation study

• Type: Article in International Scientific Journal
• Date: 2005

Authors

Ayres de Campos, D (Author) FMUP; Costa Santos, C (Author) FMUP; Bernardes, J (Author) FMUP

Journal

Title: European Journal of Obstetrics & Gynecology and Reproductive Biology

Vol. 118

Pages: 52-60

ISSN: 0301-2115

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 43 Citations

Scopus - 65 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-000-51Q

DOI: 10.1016/j.ejogrb.2004.04.013

Abstract (EN): Objective: To evaluate the capacity of computer analysis of antepartum cardiotocographs performed by SisPorto(R) 2.0 in predicting neonatal outcome. Study design: A prospective observational study was conducted in eight tertiary care centres in Europe and Australia, involving pregnant women in the absence of labor, scheduled for elective caesarean section, whose last fetal heart rate (FHR) tracing was performed within 4 h of delivery. After exclusion of fetal malformations, multiple pregnancies, tracings with less than 30 min, tracings with more than 15% signal loss, difficult fetal extractions, and anesthesia complications, a total of 345 cases were analyzed. Computer quantification of cardiotocographic parameters was compared with newborn Agar score, umbilical artery PH, metabolic acidosis and neonatal hypoxic-ischemic encephalopathy, by means of receiver operating characteristic (ROC) curves. Results: Acceleration number, mean short-term variability, percentage of abnormal short-term variability and percentage of abnormal long-term variability had an excellent discriminative capacity to predict 1-min Apgar scores under or equal to 4 (areas under the ROC curve 0.96-1.00). The same parameters showed a slightly lower capacity to predict 5-min Apgar scores under or equal to 6 (areas under the ROC curve 0.81-0.89). The best cut-off values for these parameters, derived from the previously referred calculations, detected all cases of hypoxic-ischemic encephalopathy (n = 2). Cardiotocographic parameters showed a lower discriminative capacity in prediction of umbilical artery pH <7.20 (maximum area under the ROC curve 0.66) and <7.15 (maximum area under the ROC curve 0.69). Conclusions: Computerized quantification of accelerations and variability in the antepartum allows a good prediction of I and 5-min Apgar scores, and to a much lesser degree umbilical artery pH.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9