FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography

Ayres-de-Campos, Diogo; Spong, Catherine Y.; Chandraharan, Edwin

doi:10.1016/j.ijgo.2015.06.020

Cited by 650 publications

(610 citation statements)

References 57 publications

(89 reference statements)

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“…Sixty eight FHR intrapartum tracings consecutively selected from a pre-existing database of term singleton gestations, with at most 60 min of tracing, were analyzed according to FIGO (The International Federation of Gynecology and Obstetrics) guidelines [16] using Omniview-SisPorto, version 4.0.9 [17] and the following FHR features, from the last 60 min of tracings, were registered: FHR baseline, which is the mean level of the most horizontal and less oscillatory FHR segments; percentage of abnormal short term variability (%abSTV), subsequent FHR signals differing < 1 bpm; percentage of abnormal long term variability (%abLTV), FHR signals with difference between minimum and maximum values in surrounding 1-min window < 5 bpm; mean short term variability (mean STV); number of acceleration (Acc), i.e., abrupt increases in FHR above the baseline, of more than 15 bpm in amplitude, and lasting more than 15 s, but less than 10 min per minute; number of decelerations (Dec), i.e., decreases in the FHR below the baseline, of more than 15 bpm in amplitude, and lasting more than 15 s per minute.…”

Section: Methodsmentioning

confidence: 99%

Entropy and Compression Capture Different Complexity Features: The Case of Fetal Heart Rate

Monteiro-Santos

Gonçalves

Bernardes

et al. 2017

Entropy

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Entropy and compression have been used to distinguish fetuses at risk of hypoxia from their healthy counterparts through the analysis of Fetal Heart Rate (FHR). Low correlation that was observed between these two approaches suggests that they capture different complexity features. This study aims at characterizing the complexity of FHR features captured by entropy and compression, using as reference international guidelines. Single and multi-scale approaches were considered in the computation of entropy and compression. The following physiologic-based features were considered: FHR baseline; percentage of abnormal long (%abLTV) and short (%abSTV) term variability; average short term variability; and, number of acceleration and decelerations. All of the features were computed on a set of 68 intrapartum FHR tracings, divided as normal, mildly, and moderately-severely acidemic born fetuses. The correlation between entropy/compression features and the physiologic-based features was assessed. There were correlations between compressions and accelerations and decelerations, but neither accelerations nor decelerations were significantly correlated with entropies. The %abSTV was significantly correlated with entropies (ranging between −0.54 and −0.62), and to a higher extent with compression (ranging between −0.80 and −0.94). Distinction between groups was clearer in the lower scales using entropy and in the higher scales using compression. Entropy and compression are complementary complexity measures.

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Section: Methodsmentioning

confidence: 99%

Entropy and Compression Capture Different Complexity Features: The Case of Fetal Heart Rate

Monteiro-Santos

Gonçalves

Bernardes

et al. 2017

Entropy

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“…According to the FIGO guidelines [1], [3], deviations of FHR below the baseline level, of more than 15 bpm and lasting 15 seconds are considered as decelerations. In addition, making use of the UC signal, these episodes can be classified as early, variable, late and prolonged decelerations.…”

Section: Resultsmentioning

confidence: 99%

“…For this purpose, it is indispensable to estimate a baseline as a reference level allowing the extraction of deceleration episodes in the FHR signal. According to the FIGO guidelines [1], [3] the FHR baseline is defined as "a mean level of the FHR when this is stable, in the absence of periodic events". In this context, many works have been proposed for baseline estimation and a performance comparison of these methods has been presented in [6].…”

Section: Methodsmentioning

confidence: 99%

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Analysis of the foetal heart rate in cardiotocographic recordings through a progressive characterization of decelerations

Fuentealba

Illanes

Ortmeier

2017

Current Directions in Biomedical Engineering

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Abstract:The main purpose of this work is to propose a new method for characterization and visualization of FHR deceleration episodes in terms of their depth, length and location. This is performed through the estimation of a progressive baseline computed using a median filter allowing to identify and track the evolution of decelerations in cardiotocographic CTG recordings. The proposed method has been analysed using three representative cases of normal and pathological CTG recordings extracted from the CTU-UHB database freely available on the PhysioNet Website. Results show that both the progressive baseline and the parameterized deceleration episodes can describe different time-variant behaviour, whose characteristics and progression can help the observer to discriminate between normal and pathological FHR signal patterns. This opens perspectives for classification of non-reassuring CTG recordings as a sign of foetal acidemia.

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“…2 The availability of intrapartum cardiotocographic monitoring and antenatal doppler flow studies of the umbilical and other fetal vessels have improved diagnosis of the fetuses at risk to develop fetal distress. 3 It has also increased intervention in the form of caesarean sections. Complications can occur unexpectedly even in the low risk patients for which presence of trained staff and facility for emergency caesarean must be available.…”

Section: Introductionmentioning

confidence: 99%

Antenatal risk factors in emergency caesarean sections done for fetal distress

Kohli

Singh

Dey

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Fetal distress is an important indication for emergency caesarean deliveries. The objective of this study is to identify the antenatal and intrapartum risk factors in emergency caesareans done for non-reassuring fetal status and compare with patients who underwent emergency caesareans for other indications.Methods: It was a retrospective study and data was collected from the labour room records of a tertiary care hospital. Patients undergoing emergency caesareans for fetal distress were the cases and the remaining emergency caesareans were the controls. Data was statistically analyzed.Results: There were 5184 deliveries during this period of which, 669 were emergency caesareans. 126 (18.83%) of these were due to fetal distress/ non-reassuring fetal status and 543 (81.17%) were for other indications. Caesarean due to fetal distress accounted for 2.43% of the total deliveries. There were more primigravidae (61.11% Vs 46.04%) in the fetal distress group (Odds Ratio 1.84, p=0.003). Intra uterine growth restriction (OR 5.44, p<0.0001) and antepartum haemorrhage mainly due to abruption (OR 11.19, p <0.0001) were other important antenatal risk factors. Those with neonates of birth weight between 1.5 to 2.0 kgs were more likely to undergo emergency caesarean for fetal distress (OR 1.78, p=0.0435). The risk of a lower APGAR was higher in the fetal distress group (12.59%). 28.34% neonates in this group required NICU admission.Conclusions: Primiparity, intrauterine growth restriction, antepartum hemorrhage and prematurity, have shown to significantly increase the risk of emergency cesareans due to non-reassuring fetal status. We need to improve antenatal care with a goal of early detection of the above risk factors for timely institution of appropriate intervention and thus contributing to a reduction of emergency caesareans due to fetal distress.

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FIGO consensus guidelines on intrapartum fetal monitoring: Cardiotocography

Cited by 650 publications

References 57 publications

Entropy and Compression Capture Different Complexity Features: The Case of Fetal Heart Rate

Entropy and Compression Capture Different Complexity Features: The Case of Fetal Heart Rate

Analysis of the foetal heart rate in cardiotocographic recordings through a progressive characterization of decelerations

Antenatal risk factors in emergency caesarean sections done for fetal distress

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