Relative accuracy of computerized intrapartum fetal heart rate pattern recognition by ultrasound and abdominal electrocardiogram detection

Abstract

Introduction Noninvasive fetal heart rate monitoring using transabdominal fetal electrocardiographic detection is now commercially available and has been demonstrated to be an effective alternative to traditional Doppler ultrasonographic techniques. Our objective in this study was to compare the results of computerized identification of fetal heart rate patterns generated by ultrasound‐based and transabdominal fetal electrocardiogram‐based techniques with simultaneously obtained fetal scalp electrode‐derived heart rate information. Material and methods We applied an objective computer‐based analysis for recognition of fetal heart rate patterns (Monica Decision Support) to data obtained simultaneously from a direct fetal scalp electrode, Doppler ultrasound, and the abdominal‐fetal electrocardiogram techniques. This allowed us to compare over 145 hours of fetal heart rate patterns generated by the external devices with those derived from the scalp electrode in 30 term singleton uncomplicated pregnancies during labor. The direct fetal scalp electrode is considered to be the most accurate and reliable technique used in current clinical practice, and was, therefore, used as the standard for comparison. The program quantified the baseline heart rate, long‐ and short‐term variability. It indicated when an acceleration or deceleration was present and whether it was large or small. Results Ultrasound was associated with significantly greater deviations from the fetal scalp electrode results than the abdominal fetal electrocardiogram technique in recognizing the correct baseline heart rate, its variability, and the presence of small and large accelerations and small decelerations. For large decelerations the two external methods were each not significantly different from the scalp electrode results. Conclusions Noninvasive fetal heart rate monitoring using maternal abdominal wall electrodes to detect fetal cardiac activity more reliably reproduced the computerized analysis of heart rate patterns derived from a direct fetal scalp electrode than did traditional ultrasound‐based monitoring. Abdominal‐fetal electrocardiogram should, therefore, be considered a primary option for externally monitored patients.

Ultrasound Doppler fetal heart rate detection algorithm analyzesthe correlation between twin selective fetal growth restriction and cord blood SFass fasL level

“… 7 However, because the Doppler detected by the ultrasound Doppler fetal heart rate detector often contains a large amount of messy, large variability, and uneven noise, it will cause a large degree of interference to the calculation of fetal heart rate. 8 , 9 The algorithms currently used for fetal heart rate detection by ultrasound Doppler are mainly divided into autocorrelation and short-term average amplitude difference method. 10 The autocorrelation algorithm was adopted in this study to process the ultrasound Doppler of fetal heart rate, and the results showed that it can be used for the onset of fetal growth restriction during pregnancy, which provides a reference for understanding the degree of fetal growth restriction.…”

Performance of a Maternal Abdominal Surface Electrode System for Fetal Heart Rate and Uterine Contraction Monitoring from 34 to 37 Weeks

“…An alternative noninvasive method employs a maternal surface electrode patch to detect the FHR, maternal heart rate (MHR) and UC .7 There is strong evidence that this approach is at least as accurate and reliable as US/TOCO-based electronic fetal monitoring (EFM) in term parturients, 8,9 and that it permits accurate identification of normal and pathological FHR patterns. 10 To further characterize the role of abdominal surface-based monitoring, we compared its performance to that of US/TOCO in women with preterm contractions.…”

Is short-term-variation of fetal-heart-rate a better predictor of fetal acidaemia in labour? A feasibility study

“…For the first time, a recently reported secondary analysis [25] from the previously published parent study [9] assessed whether Monica AN24 produced FHR patterns that could be interpreted and compared to those obtained by Doppler ultrasound. The parent study [9] was undertaken on 75 labouring women at three centres and compared the two modalities of monitoring (abdominal fetal ECG and Doppler ultrasound) with fetal scalp electrode.…”

“…The study [9] showed that FHR detection using abdominal fetal ECG device was more reliable and accurate than Doppler ultrasound. For the purpose of secondary analysis [25], the authors reported data on the subset of women (n = 30) instead of including all 75 women that participated in the parent study [9]. Results of this secondary analysis [25] showed that compared to Doppler ultrasound, abdominal fetal ECG reliably reproduced the computerised FHR patterns during labour.…”

“…For the purpose of secondary analysis [25], the authors reported data on the subset of women (n = 30) instead of including all 75 women that participated in the parent study [9]. Results of this secondary analysis [25] showed that compared to Doppler ultrasound, abdominal fetal ECG reliably reproduced the computerised FHR patterns during labour. However, this finding should be interpreted with caution as it was from a portion of data from a previously published parent study [9] that was not powered or designed to address the specific hypothesis of this secondary analysis.…”