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Validation of a computerized algorithm to quantify fetal heart rate deceleration area
Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Ostersund Hosp, Dept Obstet & Gynecol, S-83183 Region Jamtland Harjedal, Ostersund, Sweden..
KTH, School of Technology and Health (STH).ORCID iD: 0000-0002-3256-9029
KTH, School of Technology and Health (STH). Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..ORCID iD: 0000-0003-4853-7731
Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.;Karolinska Univ Hosp, Pregnancy & Delivery Care, Stockholm, Sweden..ORCID iD: 0000-0002-1652-8235
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2018 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 9, p. 1137-1147Article in journal (Refereed) Published
Abstract [en]

IntroductionReliability in visual cardiotocography interpretation is unsatisfying, which has led to the development of computerized cardiotocography. Computerized analysis is well established for antenatal fetal surveillance but has yet not performed sufficiently during labor. We aimed to investigate the capacity of a new computerized algorithm compared with visual assessment in identifying intrapartum fetal heart rate baseline and decelerations. Material and methodsIn all, 312 intrapartum cardiotocography tracings with variable decelerations were analyzed by the computerized algorithm and visually examined by two observers, blinded to each other and the computer analysis. The width, depth and area of each deceleration was measured. Four cases (>100 variable decelerations) were subjected to in-depth detailed analysis. The outcome measures were bias in seconds (width), beats per minute (depth), and beats (area) between computer and observers using Bland-Altman analysis. Interobserver reliability was determined by calculating intraclass correlation and Spearman rank analysis. ResultsThe analysis (312 cases) showed excellent intraclass correlation (0.89-0.95) and very strong Spearman correlation (0.82-0.91). The detailed analysis of >100 decelerations in four cases revealed low bias between the computer and the two observers; width 1.4 and 1.4 seconds, depth 5.1 and 0.7 beats per minute, and area 0.1 and -1.7 beats. This was comparable to the bias between the two observers: 0.3 seconds (width), 4.4 beats per minute (depth) and 1.7 beats (area). The intraclass correlation was excellent (0.90-.98). ConclusionA novel computerized algorithm for intrapartum cardiotocography analysis is as accurate as gold standard visual assessment, with high correlation and low bias.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018. Vol. 97, no 9, p. 1137-1147
Keywords [en]
Cardiotocography, computer-assisted signal processing, deceleration, fetal monitoring, interobserver variation
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:kth:diva-233267DOI: 10.1111/aogs.13370ISI: 000440679900010PubMedID: 29768660Scopus ID: 2-s2.0-85051058017OAI: oai:DiVA.org:kth-233267DiVA, id: diva2:1239447
Note

QC 20180816

Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2018-08-16Bibliographically approved

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Lu, KeLindecrantz, KajLindqvist, Pelle G.Holzmann, MalinAbtahi, Farhad
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