Early human development · 2013
Complexity-loss in fetal heart rate dynamics during labor as a potential biomarker of acidemia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Costa Madalena D, Schnettler William T, Amorim-Costa Célia, Bernardes João, Costa Antónia, Goldberger Ary L, Ayres-de-Campos Diogo
Аннотация
BACKGROUND: Continuous fetal heart rate (FHR) monitoring remains central to intrapartum care. However, advances in signal analysis are needed to increase its accuracy in diagnosis of fetal hypoxia.
AIMS: To determine whether FHR complexity, an index of multiscale variability, is lower among fetuses born with low (≤7.05) versus higher pH values, and whether this measure can potentially be used to help discriminate the two groups.
STUDY DESIGN: Evaluation of a pre-existing database of sequentially acquired intrapartum FHR signals.
SUBJECTS: FHR tracings, obtained from a continuous scalp electrocardiogram during labor, were analyzed using the multiscale entropy (MSE) method in 148 singletons divided in two groups according to umbilical artery pH at birth: 141 fetuses with pH>7.05 and 7 with pH≤7.05. A complexity index derived from MSE analysis was calculated for each recording.
RESULTS: The complexity of FHR signals for the last two hours before delivery was significantly (p<0.004) higher for non-acidemic than for acidemic fetuses. The difference between the two groups remained significant (p<0.003) when FHR data from the last 30min before delivery were excluded.
CONCLUSION: Complexity of FHR signals, as measured by the MSE method, was significantly lower for acidemic than non-acidemic fetuses. These results are consistent with previous studies showing that decreased nonlinear complexity is a dynamical signature of disrupted physiologic control systems. This analytic approach may have discriminative value in FHR analysis.
AIMS: To determine whether FHR complexity, an index of multiscale variability, is lower among fetuses born with low (≤7.05) versus higher pH values, and whether this measure can potentially be used to help discriminate the two groups.
STUDY DESIGN: Evaluation of a pre-existing database of sequentially acquired intrapartum FHR signals.
SUBJECTS: FHR tracings, obtained from a continuous scalp electrocardiogram during labor, were analyzed using the multiscale entropy (MSE) method in 148 singletons divided in two groups according to umbilical artery pH at birth: 141 fetuses with pH>7.05 and 7 with pH≤7.05. A complexity index derived from MSE analysis was calculated for each recording.
RESULTS: The complexity of FHR signals for the last two hours before delivery was significantly (p<0.004) higher for non-acidemic than for acidemic fetuses. The difference between the two groups remained significant (p<0.003) when FHR data from the last 30min before delivery were excluded.
CONCLUSION: Complexity of FHR signals, as measured by the MSE method, was significantly lower for acidemic than non-acidemic fetuses. These results are consistent with previous studies showing that decreased nonlinear complexity is a dynamical signature of disrupted physiologic control systems. This analytic approach may have discriminative value in FHR analysis.