ST Analysis of the Fetal Electrocardiogram in Intrapartum Fetal Monitoring

Becker, Jeroen H.; Bax, Leon; Amer‐Wåhlin, Isis; Ojala, Kati; Vayssière, Christophe; Westerhuis, Michelle E.M.H.; Mol, Ben Willem J.; Visser, Gerard H.A.; Maršál, Karel; Kwee, Anneke; Moons, Karel G.M.

doi:10.1097/aog.0b013e31823d8230

Cited by 46 publications

(29 citation statements)

References 30 publications

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“…Fetal well-being evaluation is usually accomplished through cardiotocography, which provides information about the fetal status based on the fetal cardiac rhythm [4]. To reduce the number of operative deliveries possibly due to fetal distress, cardiotocography may be combined to fetal electrocardiography (FECG) [5-7] that, in addition to heart-rate monitoring, allows evaluations strictly related to the FECG morphology. Indeed, both P-wave and QRS-complex durations may be used to assess intrauterine growth restriction [8]; fetal supraventricular extrasystoles may indicate cases of congenital heart diseases to be treated during pregnancy or immediately after birth [9, 10]; eventually, fetal ST changes may indirectly indicate myocardial hypoxia [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Fetal Electrocardiography Part II: Segmented-Beat Modulation Method for Signal Denoising

Agostinelli

Sbrollini

Burattini

et al. 2017

TOBEJ

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Background:Fetal well-being evaluation may be accomplished by monitoring cardiac activity through fetal electrocardiography. Direct fetal electrocardiography (acquired through scalp electrodes) is the gold standard but its invasiveness limits its clinical applicability. Instead, clinical use of indirect fetal electrocardiography (acquired through abdominal electrodes) is limited by its poor signal quality.Objective:Aim of this study was to evaluate the suitability of the Segmented-Beat Modulation Method to denoise indirect fetal electrocardiograms in order to achieve a signal-quality at least comparable to the direct ones.Method:Direct and indirect recordings, simultaneously acquired from 5 pregnant women during labor, were filtered with the Segmented-Beat Modulation Method and correlated in order to assess their morphological correspondence. Signal-to-noise ratio was used to quantify their quality.Results:Amplitude was higher in direct than indirect fetal electrocardiograms (median:104 µV vs. 22 µV; P=7.66·10-4), whereas noise was comparable (median:70 µV vs. 49 µV, P=0.45). Moreover, fetal electrocardiogram amplitude was significantly higher than affecting noise in direct recording (P=3.17·10-2) and significantly in indirect recording (P=1.90·10-3). Consequently, signal-to-noise ratio was initially higher for direct than indirect recordings (median:3.3 dB vs. -2.3 dB; P=3.90·10-3), but became lower after denoising of indirect ones (median:9.6 dB; P=9.84·10-4). Eventually, direct and indirect recordings were highly correlated (median: ρ=0.78; P<10-208), indicating that the two electrocardiograms were morphologically equivalent.Conclusion:Segmented-Beat Modulation Method is particularly useful for denoising of indirect fetal electrocardiogram and may contribute to the spread of this noninvasive technique in the clinical practice.

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Section: Introductionmentioning

confidence: 99%

Noninvasive Fetal Electrocardiography Part II: Segmented-Beat Modulation Method for Signal Denoising

Agostinelli

Sbrollini

Burattini

et al. 2017

TOBEJ

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“…All five RCTs were performed in Europe, but they reported different outcomes and conflicting evidence. Five previous systematic reviews and one review article compared STAN with CTG alone in meta-analyses (8)(9)(10)(11)(12)(13). Three of these meta-analyses included all five RCTs (8,9,12); two (10,11) excluded the Westgate trial (3); and one (13) excluded the Vayssi ere trial (6).…”

Section: Introductionmentioning

confidence: 99%

“…Five previous systematic reviews and one review article compared STAN with CTG alone in meta-analyses (8)(9)(10)(11)(12)(13). Three of these meta-analyses included all five RCTs (8,9,12); two (10,11) excluded the Westgate trial (3); and one (13) excluded the Vayssi ere trial (6). A meta-analysis from 2012 showed no difference in perinatal outcomes between STAN and CTG alone, except for a reduction in operative vaginal deliveries (8), whereas a second meta-analysis from 2012 reported a reduction in the need for fetal blood sampling and operative vaginal deliveries (9).…”

Section: Introductionmentioning

confidence: 99%

ST waveform analysis versus cardiotocography alone for intrapartum fetal monitoring: a systematic review and meta‐analysis of randomized trials

Blix

Brurberg

Reierth

et al. 2015

Acta Obstet Gynecol Scand

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“…Then the system created a prescription list, reviewed and statistically analyzed the individual prescription or medical order. Besides, when prescription samplings were required according to "Management Standards of Hospital Prescription Evaluations", any desired sampling number or sampling rates of the prescriptions could also be set in the screening interface, allowing random samplings and samplings at equal intervals [12].…”

Section: Discussionmentioning

confidence: 99%

A Novel Clinical Pharmacy Management System in Improving the Rational Drug Use

Ren¹,

Wang²,

Ma³

2015

CMR

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Abstract:A clinical pharmacy management system (CPMS) software developed by our hospital has been described and utilized to provide drug information services, promote the rational drug use, improve the efficiency of clinical pharmacists, and carry out investigations on the counting of large sample cases taking the example of the urology department. The efficiency, normalization and accuracy of the prescription evaluations by the clinical pharmacists were improved, the quality and passing rates of the evaluation results were ensured, and the rational drug use and drug information services in the urology department of our hospital were also improved. The system could eventually promote the clinical drug information services in the whole hospital onto a new level.

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ST Analysis of the Fetal Electrocardiogram in Intrapartum Fetal Monitoring

Abstract: The additional use of ST analysis for intrapartum monitoring reduced the incidence of operative vaginal deliveries and the need for fetal blood sampling but did not reduce the incidence of metabolic acidosis at birth.

Cited by 46 publications

References 30 publications

Noninvasive Fetal Electrocardiography Part II: Segmented-Beat Modulation Method for Signal Denoising

Noninvasive Fetal Electrocardiography Part II: Segmented-Beat Modulation Method for Signal Denoising

ST waveform analysis versus cardiotocography alone for intrapartum fetal monitoring: a systematic review and meta‐analysis of randomized trials

A Novel Clinical Pharmacy Management System in Improving the Rational Drug Use

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