Gevaert-Lenain F, Vasseur B, Puech F, Beuscart A, Delecour M
Clinique Gynécologique et Obstétricale, Lille.
Rev Fr Gynecol Obstet. 1989 Mar 10;84(3):167-71.
In utero cardiotocographic recording is currently one of the best means of diagnosis of fetal distress. The purpose of automatic tracing of the fetal heart rate is to prevent inter- and intra-individual variability in order to better evaluate the condition of the fetus. This study was carried out with the assistance of a cardiotocograph HP 8040A connected to a microcomputer equipped with a clock card. The heart signal may then be continuously recorded and stored on floppy disks, which are then reread and processed by microcomputer. The data are divided into time intervals (3, 5 or 10 seconds), selected by the physician. At each stage, mean, median and sample variation are calculated. Losses of signal are read. In a second stage, the use of a digital, linear and predictive filter (Kalman filter) applied to heart rates, allows baseline extraction as well as the detection of variations about this baseline (accelerations, decelerations). With the use of this filter on sample variations, it is possible to detect various variability periods, via two different approaches: classification of variability values in three groups: 0-5 bpm, 5-10 bpm, greater than 10 bpm, detection of increases or decreases of the variability as compared to the mean variability during the recording. Comparison of automatic analysis and visual analysis by segmentation is satisfactory in terms of variability. Detection of accelerations and decelerations is more problematic, for two reasons: the notion of baseline, the accuracy of digital detection: 15 bpm, 15 sec. All these problems are discussed.
子宫内心电图记录是目前诊断胎儿窘迫的最佳方法之一。自动追踪胎儿心率的目的是防止个体间和个体内的变异性,以便更好地评估胎儿状况。本研究是在一台与配备时钟卡的微型计算机相连的惠普8040A心电图仪的协助下进行的。然后,心脏信号可以连续记录并存储在软盘上,随后由微型计算机重新读取和处理。数据被分成由医生选择的时间间隔(3秒、5秒或10秒)。在每个阶段,计算平均值、中位数和样本变异。读取信号损失。在第二阶段,对心率应用数字、线性和预测滤波器(卡尔曼滤波器),可以提取基线以及检测围绕该基线的变化(加速、减速)。通过在样本变异上使用此滤波器,可以通过两种不同方法检测各种变异期:将变异值分为三组:0-5次/分钟、5-10次/分钟、大于10次/分钟,检测记录期间与平均变异相比变异的增加或减少。在变异性方面,自动分析和通过分段进行的视觉分析的比较结果令人满意。由于两个原因,加速和减速的检测更成问题:基线的概念、数字检测的准确性:15次/分钟,15秒。所有这些问题都进行了讨论。