title: Selective heart rate variability analysis to account for uterine activity during labor and improve classification of fetal distress.
abstract: Cardiotocography (CTG) is currently the most often used technique for detection of fetal distress. Unfortunately, CTG has a poor specificity. Recent studies suggest that, in addition to CTG, information on fetal distress can be obtained from analysis of fetal heart rate variability (HRV). However, uterine contractions can strongly influence fetal HRV. The aim of this study is therefore to investigate whether HRV analysis for detection of fetal distress can be improved by distinguishing contractions from rest periods. Our results from feature selection indicate that HRV features calculated separately during contractions or during rest periods are more informative on fetal distress than HRV features that are calculated over the entire fetal heart rate. Furthermore, classification performance improved from a geometric mean of 69.0% to 79.6% when including the contraction-dependent HRV features, in addition to HRV features calculated over the entire fetal heart rate.
authors.forename: G J J
authors.initials: GJ
authors.lastname: Warmerdam
authors.forename: R
authors.initials: R
authors.lastname: Vullings
authors.forename: J O E H
authors.initials: JO
authors.lastname: Van Laar
authors.forename: M B
authors.initials: MB
authors.lastname: Van der Hout-Van der Jagt
authors.forename: J W M
authors.initials: JW
authors.lastname: Bergmans
authors.forename: L
authors.initials: L
authors.lastname: Schmitt
authors.forename: S G
authors.initials: SG
authors.lastname: Oei
mesh_terms: D000465:Algorithms; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis* / Q000503:physiopathology*; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D011247:Pregnancy; D012815:Signal Processing, Computer-Assisted; D014590:Uterine Contraction / Q000502:physiology*