Role of antepartum computerized fetal heart rate analysis in the prediction of fetal distress during labor.
OBJECTIVE
To ascertain the diagnostic ability of a computerized fetal heart rate (FHR) analysis system in the identification of patients at risk of fetal distress in labor.


METHODS
Five-hundred and seventy-seven healthy term pregnancies were enrolled in a prospective, cross-sectional study and subdivided into two groups, with (n = 90) or without (n = 487) fetal distress in labor. Computerized FHR recordings were performed periodically and regression analysis was performed in a univariate and multivariate way to assess the ability of the last FHR recordings in the prediction of subsequent fetal distress.


RESULTS
The two groups showed a significant difference in almost all of the FHR parameters studied. The multivariate analysis showed that only the FHR baseline and the percentage of small acceleration were independently and significantly related to the labor outcome. The combination of these two parameters reaches a sensitivity of 45%, specificity of 91%, positive predictive value of 48% and negative predictive value of 90%, with an overall accuracy of 84%.


CONCLUSIONS
The increase in FHR baseline and in small FHR accelerations can be major factors in the prediction of subsequent fetal distress in healthy term fetuses.
Valensise
H
H
Clinica Ostetrica e Ginecologica, Università di Roma, Tor Vergata, Policlinico nuovo S. Eugenio Piazzale dell'Umanesimo, Italy.
Arduini
D
D
Giannini
F
F
Conforti
R
R
Giacomello
F
F
Romanini
C
C
D003201:Computers; D003430:Cross-Sectional Studies; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis / Q000503:physiopathology*; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity