Comput. Biol. Med. - Development and evaluation of an algorithm for computer analysis of maternal heart rate during labor.

Tópicos

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Resumo

CKGROUND: Maternal heart rate (MHR) recordings are morphologically similar and sometimes coincident with fetal heart rate (FHR) recordings and may be useful for maternal-fetal monitoring if appropriately interpreted. However, similarly to FHR, visual interpretation of MHR features may be poorly reproducible.METHODS: A computer algorithm for on-line MHR analysis was developed based on a previously existing version for FHR analysis. Inter-observer and computer-observer agreement and reliability were assessed in 40 one-hour recordings obtained from 20 women during the last 2h of labor. Agreement and reliability were evaluated for the detection of basal MHR, long-term variability (LTV), accelerations and decelerations, using proportions of agreement (PA) and Kappa statistic (K), with 95% confidence intervals (95% CI). Changes in MHR characteristics between the first and the second hour of the tracings were also evaluated.RESULTS: There was a statistically significant inter-observer and computer-observer agreement and reliability in estimation of basal MHR, accelerations, decelerations and LTV, with PA values ranging from 0.72 (95% CI: 0.62-0.79) to 1.00 (95% CI: 0.99-1.00), and K values ranging from 0.44 (95% CI: 0.28-0.60) to 0.89 (95% CI: 0.82-0.96). Moreover, basal MHR, number of accelerations and LTV were significantly higher in the last hour of labor, when compared to the initial hour.DISCUSSION: The developed algorithm for on-line computer analysis of MHR recordings provided good to excellent computer-observer agreement and reliability. Moreover, it allowed an objective detection of MHR changes associated with labor progression, providing more information about the interpretation of maternal-fetal monitoring during labor.

Resumo Limpo

ckground matern heart rate mhr record morpholog similar sometim coincid fetal heart rate fhr record may use maternalfet monitor appropri interpret howev similar fhr visual interpret mhr featur may poor reproduciblemethod comput algorithm onlin mhr analysi develop base previous exist version fhr analysi interobserv computerobserv agreement reliabl assess onehour record obtain women last h labor agreement reliabl evalu detect basal mhr longterm variabl ltv acceler deceler use proport agreement pa kappa statist k confid interv ci chang mhr characterist first second hour trace also evaluatedresult statist signific interobserv computerobserv agreement reliabl estim basal mhr acceler deceler ltv pa valu rang ci ci k valu rang ci ci moreov basal mhr number acceler ltv signific higher last hour labor compar initi hourdiscuss develop algorithm onlin comput analysi mhr record provid good excel computerobserv agreement reliabl moreov allow object detect mhr chang associ labor progress provid inform interpret maternalfet monitor labor

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