Jezewski Janusz, Wrobel Janusz, Horoba Krzysztof
Department of Biomedical Informatics, Institute of Medical Technology and Equipment, Roosevelt Str 118, Zabrze 41800, Poland.
IEEE Trans Biomed Eng. 2006 May;53(5):855-64. doi: 10.1109/TBME.2005.863945.
A method for comparison of two acquisition techniques that are applied in clinical practice to provide information on fetal condition is presented. The aim of this work was to evaluate the commonly used Doppler ultrasound technique for monitoring of mechanical activity of fetal heart. Accuracy of beat-to-beat interval determination together with its influence on indices describing the fetal heart rate (FHR) variability calculated automatically using computer-aided fetal monitoring system were examined. We considered the direct fetal electrocardiography as a reference technique because it ensures the highest possible accuracy of heart interval measurement, and additionally all the definitions of popular time domain parameters quantifying FHR variability formerly have been created using the fetal electrocardiogram. We evaluated the reliability of various so called short-term and long-term variability indices, when they are calculated automatically using the signal obtained via the Doppler US from a fetal monitor. The results proved that evaluation of the acquisition technique influence on fetal well-being assessment can not be accomplished basing on direct measurements of heartbeats only. The more relevant is the estimation of accuracy of the variability indices, since analysis of their changes can significantly increase predictability of fetal distress.
本文介绍了一种用于比较两种临床应用中提供胎儿状况信息的采集技术的方法。这项工作的目的是评估常用的多普勒超声技术监测胎儿心脏机械活动的情况。研究了逐搏间期测定的准确性及其对使用计算机辅助胎儿监测系统自动计算的描述胎儿心率(FHR)变异性指标的影响。我们将直接胎儿心电图作为参考技术,因为它能确保尽可能高的心脏间期测量准确性,此外,以前所有量化FHR变异性的流行时域参数定义都是使用胎儿心电图创建的。我们评估了各种所谓的短期和长期变异性指标在使用从胎儿监护仪通过多普勒超声获得的信号自动计算时的可靠性。结果证明,仅基于心跳的直接测量无法完成对采集技术对胎儿健康评估影响的评估。变异性指标准确性的估计更为相关,因为对其变化的分析可显著提高胎儿窘迫的可预测性。