[Analysis of Foetal Heart Rate Data using Complex Software: Comparison of Recurrence Plot of Foetal Heart Rate with the Course of Pregnancy -].
BACKGROUND
Is it useful to further analyse foetal heart rate to improve the prediction of pregnancy complications? The analysis of the foetal heart rate is usually based on the variability of the heart rate, i. e. the more variable the heart rate presents - except a decrease - the better the condition of the foetus is. The same concept is applied in our own analysis which differs only in the presentation of the data.


METHODS
We analysed 25 non-stress-tests from unselected third trimester pregnancies using sophisticated software. The recurrence plot (RP) is able to rearrange data from foetal heart rate monitoring in order to make the heart rate variability visible. We developed criteria for a normal and an abnormal test result describing the structure of the diagram to predict an uneventful and a high-risk pregnancy, respectively.


RESULTS
11 out of 11 patients with uneventful course and outcome of pregnancy showed a coarse and blurred RP pattern. 12 out of 14 (86 %) patients developing either intrauterine growth retardation or preeclampsia and requiring caesarean section because of foetal heart rate abnormalities showed a fine and clear RP pattern.


CONCLUSIONS
Our preliminary results show that it makes sense to further evaluate foetal heart rate variability in order to predict pregnancy complications. Computer programs including the algorithms needed (calculation of the recurrence plot) are not expensive and easy to handle. A widespread use of these programs represents the basis requirement for large controlled clinical trials.
Jörn
H
H
Frauenklinik für Gynäkologie und Geburtshilfe des Universitätsklinikums der Rheinisch-Westfälischen Technischen Hochschule Aachen. post@frauenarztpraxis-joern.de
Morgenstern
B
B
Wassenberg
B
B
Rath
W
W
D000704:Analysis of Variance; D015982:Bias; D015148:Cardiotocography / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000706:statistics & numerical data; D003936:Diagnosis, Computer-Assisted / Q000706:statistics & numerical data*; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D010865:Pilot Projects; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011263:Pregnancy Trimester, Third / Q000502:physiology; D018566:Pregnancy, High-Risk / Q000502:physiology*; D012008:Recurrence; D012016:Reference Values; D018570:Risk Assessment / Q000706:statistics & numerical data; D012815:Signal Processing, Computer-Assisted; D012984:Software