Development and evaluation of an algoritm for computer analysis of maternal heart rate during labor

• Autor(a) principal: Pinto, Paula
• Data de Publicação: 2014
• Outros Autores: Bernardes, João, Costa-Santos, Cristina, Amorim-Costa, Célia
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.26/29325
• topic: fetal rate rate; maternal rate rate; cardiotocography; computer analysis; agreement; reliability; Madeira Island; Portugal

Background 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 2 h 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). Therover, 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.