Salamalekis E, Hintipas E, Salloum I, Vasios G, Loghis C, Vitoratos N, Chrelias Ch, Creatsas G
2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Greece.
J Matern Fetal Neonatal Med. 2006 Mar;19(3):165-9. doi: 10.1080/14767050500233290.
To determine whether the computerized analysis of fetal heart rate variability with the new matching pursuit technique can indicate fetal distress during labor.
Eighty women were studied during the intrapartum period with external cardiotocography. In all cases, cord arterial pH and 5-min Apgar Scores were evaluated. Six cases that presented large segments of missing data were excluded from the study. The remaining 74 women were divided into two groups; 32 women with normal (Group A) and 42 women with non-reassuring FHR tracings (group B). Group B was divided in subgroup BI, including 24 women with pH > 7.20, and BII, including 18 women with pH < 7.20. In order to evaluate the FHR fluctuations, in different frequency ranges, we applied an adaptive time-frequency method, called Matching Pursuit. We estimated the power of the FHR signal in four frequency ranges.
The 5-min Apgar Scores were significantly lower in both subgroup BI and subgroup BII (p = 0.003 and p = 0.003 respectively). The Low Low Frequency (LLF) parameter appears to recognize better the cases with lower pH (sensitivity 78.5%, specificity 52.3%) than the cases with non-reassuring FHR (66.6%, 56.2). The sensitivity and specificity of the Very Low Frequency (VLF) parameter were 72.2% and 59% respectively in recognizing the cases with lower pH and 64.2% and 53.1% in recognizing non-reassuring FHR.
Fetal hypoxia during labor can be recognized using the MP technique for the analysis of FHR signal power in the VLF and LLF frequency ranges. Since the analysis is feasible in real-time, it can be a useful tool for the intrapartum evaluation of fetal well-being.
确定采用新的匹配追踪技术对胎儿心率变异性进行计算机分析是否能够在分娩期间提示胎儿窘迫。
对80名妇女在分娩期进行外部胎心监护研究。所有病例均评估脐动脉pH值和5分钟阿氏评分。6例存在大量缺失数据的病例被排除在研究之外。其余74名妇女分为两组；32名胎儿心率正常的妇女（A组）和42名胎儿心率监护结果不令人放心的妇女（B组）。B组又分为B1亚组，包括24名pH值>7.20的妇女，以及B2亚组，包括18名pH值<7.20的妇女。为了评估不同频率范围内的胎儿心率波动，我们应用了一种称为匹配追踪的自适应时频方法。我们估计了胎儿心率信号在四个频率范围内的功率。
B1亚组和B2亚组的5分钟阿氏评分均显著较低（分别为p = 0.003和p = 0.003）。低频（LLF）参数似乎比胎儿心率监护结果不令人放心的病例（敏感性66.6%，特异性56.2%）能更好地识别pH值较低的病例（敏感性78.5%，特异性52.3%）。极低频（VLF）参数在识别pH值较低病例时的敏感性和特异性分别为72.2%和59%，在识别胎儿心率监护结果不令人放心的病例时分别为64.2%和53.1%。
采用匹配追踪技术分析极低频和低频频率范围内的胎儿心率信号功率，可识别分娩期间的胎儿缺氧情况。由于该分析可实时进行，它可能成为分娩期评估胎儿健康状况的有用工具。
