title: Evaluation of the Acceleration and Deceleration Phase-Rectified Slope to Detect and Improve IUGR Clinical Management.
abstract: OBJECTIVE
  This study used a new method called Acceleration (or Deceleration) Phase-Rectified Slope, APRS (or DPRS) to analyze computerized Cardiotocographic (cCTG) traces in intrauterine growth restriction (IUGR), in order to calculate acceleration- and deceleration-related fluctuations of the fetal heart rate, and to enhance the prediction of neonatal outcome.
  
  
  METHODS
  Cardiotocograms from a population of 59 healthy and 61 IUGR fetuses from the 30th gestation week matched for gestational age were included. APRS and DPRS analysis was compared to the standard linear and nonlinear cCTG parameters. Statistical analysis was performed through the t-test, ANOVA test, Pearson correlation test and receiver operator characteristic (ROC) curves (p < 0, 05).
  
  
  RESULTS
  APRS and DPRS showed high performance to discriminate between Healthy and IUGR fetuses, according to gestational week. A linear correlation with the fetal pH at birth was found in IUGR. The area under the ROC curve was 0.865 for APRS and 0.900 for DPRS before the 34th gestation week.
  
  
  CONCLUSIONS
  APRS and DPRS could be useful in the identification and management of IUGR fetuses and in the prediction of the neonatal outcome, especially before the 34th week of gestation.
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, 5 Pansini Street, 80131 Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tagliaferri
authors.affiliation: Computational Physiology and Clinical Inference Group, Research Laboratory of Electronics, Massachusetts Institute of Technology, 25 Carleton Street, Cambridge, MA 02139, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fanelli
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, 5 Pansini Street, 80131 Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Esposito
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, 5 Pansini Street, 80131 Naples, Italy.
authors.forename: Francesca Giovanna
authors.initials: FG
authors.lastname: Esposito
authors.affiliation: Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 5 Ferrata Street, 27100 Pavia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Magenes
authors.affiliation: Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Signorini
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, 5 Pansini Street, 80131 Naples, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Campanile
authors.affiliation: Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, 5 Pansini Street, 80131 Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Martinelli
mesh_terms: D000328:Adult; D000465:Algorithms; D015148:Cardiotocography / Q000379:methods* / Q000706:statistics & numerical data; D016022:Case-Control Studies; D019295:Computational Biology; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology* / Q000628:therapy; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D017711:Nonlinear Dynamics; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted