Regional and International Prenatal Telemedicine Network for Computerized Antepartum Cardiotocography

Abstract

The objective of this work was to review the activity of TOCOMAT, a system for antepartum cardiotocographic telemonitoring. Nine peripheral units recorded the traces, transmitted them via modem to the University operation center, where the computerized analysis was performed, and received the medical report within a few minutes, via fax or e-mail. Traces were classified as reassuring, nonreassuring, or pathological. The parameters of computerized analysis were grouped together for each week of gestation. The perinatal outcome was also evaluated. In 5 years, 5830 traces were analyzed: 4372 (75%) from 1344 high-risk patients and 1458 (25%) from 529 patients at apparent low risk. The system allowed the identification of high-risk patients (32.8% with nonreassuring traces and 7.1% with pathologic traces) and lowrisk patients (16.3% with nonreassuring traces and 4.3% with pathologic traces) that required further evaluation. The neonatal outcome was good overall. At each week of pregnancy, the mean values of computerized parameters resulted in normal ranges. The TOCOMAT system allowed a decentralization of prenatal surveillance and improved the patients quality of life and the level of prenatal care.

Design Methodology of a New Wavelet Basis Function for Fetal Phonocardiographic Signals

“…It is also capable of recognizing additional potential dysfunctional signals of the fetal heart such as those related to cardiac murmurs, split effect, and breathing movements, which can be detected from the analysis of abdominal sound (fPCG) signals. However these cardiac anomalies are impossible to detect with the widely accepted fCTG technique due to its principle of operation [21]. Additionally, phonocardiography provides a permanent and lasting record of fetal heart sounds which by comparison at a later stage may prove to be of great prognostic importance.…”

Diagnostic equivalency of mobile CTG devices and remote analysis to conventional on-site nonstress test

“…Moore and Sill 15 showed that the number and duration of hospital admissions for fetal surveillance were reduced in a homemonitored, high-risk patient group, without an increase in C-section and forceps delivery rates. Di Lieto et al 16,17 described the clinical results of the first 5 working years of a telemedicine project based on computerized telecardiotocography. The project embraced 1,873 low-and highrisk patients who delivered 5,830 CTG tracings.…”

Wireless data acquisition system for fetal phonocardiographic signals using Bluetooth<SUP align="right">&trade;</SUP>

“…The fPCG signal is a linear summation of vibrations produced by the fetal heart, maternal organs and external sources. However, these cardiac anomalies are impossible to detect with the fCTG technique due to its principle of operation (Di Lieto et al, 2008). A long duration FHR variability analysis provides up-to-date assessment of fetal wellbeing (Mantel et al, 1990a(Mantel et al, , 1990b.…”