INESC TEC, Porto, Portugal.
INESC TEC, Porto, Portugal; Center for Health Technology and Services Research - CINTESIS, University of Porto, Porto, Portugal.
Comput Biol Med. 2019 Jun;109:235-241. doi: 10.1016/j.compbiomed.2019.04.041. Epub 2019 May 4.
A computational analysis of physiological systems has been used to support the understanding of how these systems work, and in the case of foetal heart rate, many different approaches have been developed in the last decades. Our objective was to apply a new method of classification, which is based on spectral analysis, in foetal heart rate (FHR) traces to predict foetal acidosis diagnosed with umbilical arterial blood pH ≤ 7.05. Fast Fourier transform was applied to a real database for the classification approach. To evaluate the models, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were used. Sensitivity equal to 1, specificity equal to 0.85 and an area under the ROC curve of 0.94 were found. In addition, when the definition of metabolic acidosis of umbilical arterial blood pH ≤ 7.05 and base excess ≤ -10 mmol/L was used, the proposed methodology obtained sensitivity = 1, specificity = 0.97 and area under the ROC curve = 0.98. The proposed methodology relies exclusively on the spectral frequency decomposition of the FHR signal. After further successful validation in more datasets, this approach can be incorporated easily in clinical practice due to its simple implementation. Likewise, the incorporation of this novel technique in an intrapartum monitoring station should be straightforward, thus enabling the assistance of labour professionals in the anticipated detection of acidaemia.
已经应用计算分析生理系统的方法来支持对这些系统工作原理的理解,在胎儿心率的情况下,过去几十年来已经开发出许多不同的方法。我们的目的是应用一种新的分类方法,该方法基于频谱分析,应用于胎儿心率(FHR)迹线,以预测通过脐动脉血 pH 值≤7.05 诊断的胎儿酸中毒。快速傅里叶变换(Fast Fourier Transform)被应用于真实数据库,以进行分类方法。为了评估模型,使用了灵敏度、特异性和接收器工作特征(Receiver Operating Characteristic,ROC)曲线下的面积。发现灵敏度等于 1、特异性等于 0.85 和 ROC 曲线下的面积为 0.94。此外,当使用脐动脉血 pH 值≤7.05 和碱剩余值≤-10 mmol/L 的代谢性酸中毒定义时,所提出的方法获得了灵敏度=1、特异性=0.97 和 ROC 曲线下的面积=0.98。所提出的方法完全依赖于 FHR 信号的频谱频率分解。在更多数据集上进一步成功验证后,由于其简单的实现方式,该方法可以很容易地纳入临床实践。同样,将这项新技术纳入产时监测站也应该很简单,从而使劳动专业人员能够协助预期发现酸中毒。