Georgieva Antoniya, Payne Stephen J, Moulden Mary, Redman Christopher W G
Nuffield Department of Obstetrics and Gynaecology and with the Institute of Biomedical Engineering, University of Oxford.
Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:5888-91. doi: 10.1109/IEMBS.2011.6091456.
We applied computerized methods to assess the Electronic Fetal Monitoring (EFM) in labor. We analyzed retrospectively the last hour of EFM for 1,370 babies, delivered by emergency Cesarean sections before the onset of pushing (data collected at the John Radcliffe Hospital, Oxford, UK). There were two cohorts according to the reason for intervention: (a) fetal distress, n(1) = 524 and (b) failure to progress and/or malpresentation, n(2) = 846. The cohorts were compared in terms of classical EFM features (baseline, decelerations, variability and accelerations), computed by a dedicated Oxford system for automated analysis--OxSys. In addition, OxSys was employed to simulate current clinical guidelines for the classification of fetal monitoring, i.e. providing in real time a three-tier grading system of the EFM (normal, indeterminate, or abnormal). The computerized features and the simulated guidelines corresponded well to the clinical management and to the actual labor outcome (measured by umbilical arterial pH).
我们应用计算机化方法评估分娩期电子胎儿监护（EFM）。我们回顾性分析了1370例在开始用力前通过急诊剖宫产分娩的婴儿的最后一小时EFM情况（数据收集于英国牛津约翰拉德克利夫医院）。根据干预原因有两个队列：（a）胎儿窘迫，n(1)=524；（b）产程无进展和/或胎位异常，n(2)=846。通过专门用于自动分析的牛津系统——OxSys计算经典EFM特征（基线、减速、变异性和加速），对两个队列进行比较。此外，OxSys被用于模拟当前胎儿监护分类的临床指南，即实时提供EFM的三级分级系统（正常、不确定或异常）。计算机化特征和模拟指南与临床管理及实际分娩结局（通过脐动脉pH值衡量）吻合良好。
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