Comparison of computerized analysis and obstetrician analysis of cardiotocography

doi:10.3877/cma.j.issn.2095-3259.2015.03.011

Abstract

Abstract:

Objective

To evaluate the feasibility of computer analysis of cardiotocography in clinic by comparing the computerized analysis and obstetrician analysis.

Methods

This study collected the intrapartum cardiotocography of 1 885 pregnant patients, who were admitted to delivery room at Peking University Shenzhen Hospital from January 1, 2012 to October 24, 2014. The cardiotocography were rechecked by two obstetrical experts to compare the results of computerized analysis and obstetrician analysis.

Results

In all patients, there were 1 409 cases with type I cardiotocography, 476 cases with type II, and no one with type III. Taking the cardiotocography analysis of obstetrical experts as the golden standard, the concordance rate of fetal heart rate baseline, baseline variation, acceleration and deceleration of computer analysis and obstetrician analysis were 93.36% (1 760/1 885 cases), 92.36%(1 742/1 885 cases), 78.67%(1 483/1 885 cases) and 70.45% (1 328/1 885 cases), respectively. The sensitivity rate and specificity rate of computer analysis were 86.50% (391/452 cases) and 58.48% (817/1 397 cases).

Conclusion

Intrapartum computerized cardiotocography analysis has a high concordance rate with obstetrician analysis, which is feasible to use in clinical work.

Key words: Diagnosis, computer-assisted, Prenatal diagnosis, Cardiotocography, Fetal monitoring, Heart rate, fetal

Ping Liu, Yiheng Liang, Shangrong Fan, Yun Li. Comparison of computerized analysis and obstetrician analysis of cardiotocography[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2015, 04(03): 175-181.

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References 25

[1]	Chung TK, Mohajer MP, Yang ZJ, et al. The prediction of fetal acidosis at birth by computerised analysis of intrapartum cardiotocography[J]. Br J Obstet Gynaecol，1995, 102(6): 454-460.
[2]	Nemer DS, Nomura RM, Ortigosa C, et al. Computerized cardiotocography in pregnancies complicated by maternal asthma[J]. Matern Fetal Neonatal Med, 2012，25(7):1077-1079.
[3]	叶海慧，葛明珠，王正平．胎心率监护计算机分析在临床的应用[J]．中国妇幼保健，2007，22(7):904-906.
[4]	Macones GA, Hankins GD, Spong CY, et al. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions，interpretation, and research guidelines[J]. Obstet Gynecol，2008, 112(3): 661-666.
[5]	Donker DK, van Geijn HP, Hasman A. Interobserver variation in the assessment of fetal heart rate recordings[J]. Eur J Obstet Gynecol Reprod Biol，1993, 52(1): 21-28.
[6]	Figueras F, Albela S, Bonino S, et al. Visual analysis of antepartum fetal heart rate tracings: inter- and intra-observer agreement and impact of knowledge of neonatal outcome[J]. J Perinat Med, 2005, 33(3): 241-245.
[7]	Devoe L, Golde S, Kilman Y, et al.A comparison of visual analyses of intrapartum fetal heart rate tracings according to the new national institute of child health and human development guidelines with computer analyses by an automated fetal heart rate monitoring system[J]. Am J Obstet Gynecol, 2000, 183(2): 361-366.
[8]	Parer JT, Hamilton EF. Comparison of 5 experts and computer analysis in rule-based fetal heart rate interpretation[J]. Am J Obstet Gynecol, 2010, 203(5):451.e1-e7.
[9]	Hruban L, Spilka J, Chudáček V，et al. Agreement on intrapartum cardiotocogram recordings between expert obstetricians[J]. J Eval Clin Pract, 2015, 21(4):694-702.
[10]	Buscicchio G, Giannubilo SR, Bezzeccheri V, et al.Computerized analysis of the fetal heart rate in pregnancies complicated by preterm premature rupture of membranes(pPROM)[J]. J Matern Fetal Neonatal Med，2006, 19(1): 39-42.
[11]	Georgieva A, Payne SJ, Moulden M, et al. Computerized intrapartum electronic fetal monitoring: analysis of the decision to deliver for fetal distress[J]. Conf Proc IEEE Eng Med Biol Soc，2011, 2011:5888-5891.
[12]	Parer JT, Ikeda T, King TL. The 2008 National Institute of Child Health and Human Development report on fetal heart rate monitoring[J]. Obstet Gynecol, 2009, 114(1):136-138.
[13]	Beksac MS, Karakas U, Yalcin S，et al. Computerized analysis of antepartum fetal heart rate tracings in normal pregnancies[J]. Eur J Obstet Gynecol Reprod Biol, 1990, 37(2):121-132
[14]	Dawes GS, Redman CW. Computerised and visual assessment of the ardiotocograph[J]．Br J Obstet and Gynaecol, 1993, 100(7):701-702.
[15]	Ayres-de-Campos D, Sousa P, Costa A, et al. Omniview-SisPorto 3.5-a central fetal monitoring station with online alerts based on computerized cardiotocogram＋ST event analysis[J]. J Perinat Med, 2008, 36(3): 260-264.
[16]	Serra V, Bellver J, Moulden M, et al.Computerized analysis of normal fetal heart rate pattern throughout gestation[J]. Ultrasound Obstet Gynecol, 2009, 34(1): 74-79.
[17]	Freeman RK. Problems with intrapartum fetal heart rate monitoring interpretation and patient management[J]. Obstet Gynecol, 2002, 100(4): 813-826.
[18]	Lauletta AL, Nomura RM, Miyadahira S, et al. Transient accelerations of fetal heart rate analyzed by computerized cardiotocography in the third trimester of pregnancy[J]. Rev Assoc Med Bras, 2014, 60(3):270-275.
[19]	Johnson N, Johnson VA, Fisher J，et al. Fetal monitoring with pulse oximetry[J]. Br J Obstet Gynaecol, 1991, 98(1): 36-41.
[20]	Neilson JP. Fetal electrocardiogram (ECG) for fetal monitoring during labour[J]. Cochrane Database Syst Rev, 2006, 19(3): CD000116.
[21]	East CE, Begg L, Colditz PB, et al.Fetal pulse oximetry for fetal assessment in labour[J]．Cochrane Database Syst Rev，2014, 10: CD004075.
[22]	Graatsma EM, Jacod BC, van Egmond LA, et al. Fetal electrocardiography：feasibility of long-term fetal heart rate recordings[J]. BJOG, 2009, 116(2): 334-337.
[23]	Amer-Wåhlin I, Kjellmer I, Maršál K, et al.Swedish randomized controlled trial of cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram revisited: analysis of data according to standard versus modified intention-to-treat principle[J]. Acta Obstet Gynecol Scand, 2011, 90(9): 990-996.
[24]	Alfirevic Z, Devane D, Gyte GM. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour[J]. Cochrane Database Syst Rev, 2013, 5: CD006066.
[25]	Chen CY, Yu C, Chang CC, et al. Comparison of a Novel Computerized Analysis Program and Visual Interpretation of Cardiotocography[J]. PLoS One, 2014, 9(12):e112296.

项目		例数^a	百分率(%)	灵敏度(%)^b	特异度(%)^b	Kappa值^c	P值^d
1.胎心率基线		1 760	93.36	?	?	0.529 6	0.001 5
?	胎心正常	1 762	93.47	96.99(1 707/1 760例)	61.79(55/89例)	0.533 8	<0.000 1
?	胎心过缓	1 787	94.80	34.78(36/46例)	98.23(1 771/1 803例)	0.323 2	<0.000 1
?	胎心过速	1 820	96.55	86.05(37/43例)	98.83(1 783/1 806例)	0.710 6	<0.000 1
2.基线变异		1 742	92.36	?	?	0.261	<0.000 1
?	微小变异	1 773	94.06	100.00(1/1例)	95.89(1 771/1 848例)	0.024 6	0.041 6
?	中度变异	1 742	92.41	95.08(1 740/1 830例)	10.52(2/19例)	0.019 3	0.243 3
?	显著变异	1 818	96.45	0.58(1/18例)	99.24(1 817/1 831例)	0.052	0.137 0
3.加速		1 483	78.67	80.26(1 383/1 723)	79.36(100/126例)	0.275	0.000
4.减速		1 328	70.45	66.74(929/1 392例)	87.31(399/457例)	0.416 5	<0.000 1
?	早期减速	1 413	74.96	54.17(78/144例)	78.29(1 335/1 705例)	0.165 1	<0.000 1
?	晚期减速	1 408	74.69	22.98(88/383例)	90.04(1 320/1 466例)	0.152 0	<0.000 1
?	变异减速	1 033	54.80	41.47(535/1 290例)	89.09(498/559例)	0.226 1	<0.000 1
?	延长减速	1 671	88.65	20.42(39/191例)	98.43(1 632/1 658例)	0.266 2	<0.000 1
5.胎监评估结果		1 269	67.32	86.50(391/452例)	58.48(817/1 397例)	0.324 0	0.324 0

项目		例数^a	百分率(%)	灵敏度(%)^b	特异度(%)^b	Kappa值^c	P值^d
1.胎心率基线		1 760	93.36	?	?	0.529 6	0.001 5
?	胎心正常	1 762	93.47	96.99(1 707/1 760例)	61.79(55/89例)	0.533 8	<0.000 1
?	胎心过缓	1 787	94.80	34.78(36/46例)	98.23(1 771/1 803例)	0.323 2	<0.000 1
?	胎心过速	1 820	96.55	86.05(37/43例)	98.83(1 783/1 806例)	0.710 6	<0.000 1
2.基线变异		1 742	92.36	?	?	0.261	<0.000 1
?	微小变异	1 773	94.06	100.00(1/1例)	95.89(1 771/1 848例)	0.024 6	0.041 6
?	中度变异	1 742	92.41	95.08(1 740/1 830例)	10.52(2/19例)	0.019 3	0.243 3
?	显著变异	1 818	96.45	0.58(1/18例)	99.24(1 817/1 831例)	0.052	0.137 0
3.加速		1 483	78.67	80.26(1 383/1 723)	79.36(100/126例)	0.275	0.000
4.减速		1 328	70.45	66.74(929/1 392例)	87.31(399/457例)	0.416 5	<0.000 1
?	早期减速	1 413	74.96	54.17(78/144例)	78.29(1 335/1 705例)	0.165 1	<0.000 1
?	晚期减速	1 408	74.69	22.98(88/383例)	90.04(1 320/1 466例)	0.152 0	<0.000 1
?	变异减速	1 033	54.80	41.47(535/1 290例)	89.09(498/559例)	0.226 1	<0.000 1
?	延长减速	1 671	88.65	20.42(39/191例)	98.43(1 632/1 658例)	0.266 2	<0.000 1
5.胎监评估结果		1 269	67.32	86.50(391/452例)	58.48(817/1 397例)	0.324 0	0.324 0

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