Computerised analysis of the fetal heart rate and relation to acidaemia at delivery.
OBJECTIVE
To identify the individual features of the computerised analysis of the cardiotocograph that relate to arterial pH and base deficit at delivery.


METHODS
Retrospective observational study.


METHODS
Teaching hospital labour wards.


METHODS
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.


METHODS
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 < 0.001, respectively). Tachycardia, accelerations and variability did not.


CONCLUSIONS
The individual components of the computerised analysis of the fetal heart rate that predict acidaemia at delivery are identified.
Strachan
B K
BK
Division of Obstetrics and Gynaecology, School of Human Development, Queen's Medical Centre, Nottingham, UK.
Sahota
D S
DS
van Wijngaarden
W J
WJ
James
D K
DK
Chang
A M
AM
D000138:Acidosis / Q000175:diagnosis* / Q000503:physiopathology; D000465:Algorithms; D015148:Cardiotocography / Q000379:methods*; D036861:Delivery, Obstetric; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D011247:Pregnancy; D012189:Retrospective Studies