Jones Gabriel Davis, Cooke William R, Vatish Manu, Redman Christopher W G
Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, United Kingdom.
Matern Fetal Med. 2022 Jan 31;4(2):130-140. doi: 10.1097/FM9.0000000000000141. eCollection 2022 Apr.
Cardiotocography measures the human fetal heart rate and uterine activity using ultrasound. While it has been a mainstay in antepartum care since the 1960s, cardiotocograms consist of complex signals that have proven difficult for clinicians to interpret accurately and as such clinical inference is often difficult and unreliable. Previous attempts at codifying approaches to analyzing the features within these signals have failed to demonstrate reliability or gain sufficient traction. Since the early 1990s, the Dawes-Redman system of automated computer analysis of cardiotocography signals has enabled robust analysis of cardiotocographic signal features, employing empirically-derived criteria for assessing fetal wellbeing in the antepartum. Over the past 30 years, the Dawes-Redman system has been iteratively updated, now incorporating analyses from over 100,000 pregnancies. In this review, we examine the history of cardiotocography, signal processing methodologies and feature identification, the development of the Dawes-Redman system, and its clinical applications.
胎心监护使用超声测量胎儿心率和子宫活动。自20世纪60年代以来，它一直是产前护理的主要手段，但胎心监护图由复杂信号组成，临床医生很难准确解读，因此临床推断往往困难且不可靠。以往对这些信号特征分析方法进行编码的尝试未能证明其可靠性，也未获得足够的认可。自20世纪90年代初以来，用于胎心监护信号自动计算机分析的道斯-雷德曼系统能够对胎心监护信号特征进行有力分析，并采用经验性标准评估产前胎儿健康状况。在过去30年里，道斯-雷德曼系统不断迭代更新，目前纳入了超过10万例妊娠的分析数据。在本综述中，我们将审视胎心监护的历史、信号处理方法和特征识别、道斯-雷德曼系统的发展及其临床应用。
