Spectral analysis of fetal heart rate variability as a predictor of intrapartum fetal distress.
OBJECTIVE
To evaluate the usefulness of power spectral analysis on fetal heart rate variability as a new diagnostic method of fetal distress.


METHODS
Among 76 pregnant women who underwent computerized electronic fetal monitoring and cord blood gas analysis, we divided them into three groups: normal fetus group (36); presumed distress group (26); and acidemic distress group (14). In order to perform linear analysis on the raw data of the fetal heart rate, after resampling, we performed Fourier transformation and investigated power distributions among very low frequency (VLF), low frequency (LF), high frequency (HF) bands, and autonomic balance (LF/HF).


RESULTS
The results of the spectral analysis showed that in normal fetus group, the difference in the distribution of power spectrums of VLF, LF and HF was significantly higher than in presumed distress group and acidemic distress group. In fetal distress, the LF and VLF value (< or = 0.0023, > or = 0.0437) were good predictors (sensitivity 97.5%, 75.0% and specificity 86.1%, 94.4%). The LF value (< or = 0.0013) was a good predictor in fetal acidemia (sensitivity 97.5% and specificity 86.1%).


CONCLUSIONS
A computerized spectral analysis of fetal heart rate variation is a good predictor of fetal distress, which is made automatically and objectively.
Chung
D Y
DY
Department of Obstetrics and Gynecology, Medical College, Catholic University, Seoul, South Korea. csimon@cmc.cuk.ac.kr
Sim
Y B
YB
Park
K T
KT
Yi
S H
SH
Shin
J C
JC
Kim
S P
SP
D000328:Adult; D003936:Diagnosis, Computer-Assisted / Q000592:standards*; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000592:standards*; D006340:Heart Rate, Fetal; D006801:Humans; D007744:Obstetric Labor Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity