title: Antenatal cardiotocogram quality and interpretation using computers.
abstract: OBJECTIVE
  To test the application in practice of computerized fetal heart rate (FHR) analysis in pregnancy.
  
  
  METHODS
  Randomized distribution of subjects with computerized analysis automatically revealed or concealed.
  
  
  METHODS
  A district general hospital and a teaching hospital outside London.
  
  
  METHODS
  2869 pregnant women studied within a year.
  
  
  METHODS
  Quality and duration of the cardiotocogram; quantitative measurement of FHR variation; number of stillbirths.
  
  
  RESULTS
  With interactive advice to the operator, records were of improved quality (up to 28% without signal loss) with potentially much reduced recording time. The short-term FHR variation measured in the last records before intervention is reported for the first time.
  
  
  CONCLUSIONS
  The benefits of using the computers include improvement in record quality and saving of time. In addition, where interpretation depended on estimation of FHR variation there was prima facie evidence of observer misinterpretation; visual analysis was unreliable. A larger trial is now required with more rigorous constraints on intervention.
authors.affiliation: Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK.
authors.forename: G S
authors.initials: GS
authors.lastname: Dawes
authors.forename: M
authors.initials: M
authors.lastname: Lobb
authors.forename: M
authors.initials: M
authors.lastname: Moulden
authors.forename: C W
authors.initials: CW
authors.lastname: Redman
authors.forename: T
authors.initials: T
authors.lastname: Wheeler
mesh_terms: D015148:Cardiotocography / Q000379:methods / Q000592:standards*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000592:standards; D011787:Quality of Health Care; D011897:Random Allocation; D013997:Time Factors