Linear and nonlinear fetal heart rate analysis of normal and acidemic fetuses in the minutes preceding delivery
Linear and nonlinear fetal heart rate analysis of normal and acidemic fetuses in the minutes preceding delivery
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DOI：
10.1007/s11517-006-0105-6
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发表时间：
2006-10-01
影响因子：
3.2
通讯作者：
Bernardes, Joao
中科院分区：
文献类型：
--
作者：
Goncalves, Hernani;Rocha, Ana Paula;Bernardes, Joao
本文对48例正常、10例轻度酸血症和10例中重度酸血症胎儿在临产前的FHR描记起始段和终止段分别计算了线性和非线性FHR指数，即平均FHR、间期指数（II）、极低频、低频和高频近似值（ApEn）和样本熵（SampEn）。产程进展与线性频域指数显著增加相关，而非线性指数显著降低。中重度胎儿酸血症与非线性指数显著降低相关。结合II和ApEn（2，0.15）可获得中重度酸血症胎儿和其余病例之间的最佳区分，特异性为71%，灵敏度为80%。这些发现支持了这一假设，即在分娩的最后几分钟，自主神经系统活动增加，中枢神经系统活动减少，无论是在分娩的最后几分钟，还是在中度至重度酸血症胎儿中。
Linear and nonlinear fetal heart rate (FHR) indices, namely mean FHR, interval index (II), very low, low and high frequencies, approximate (ApEn) and sample entropy (SampEn), were computed, immediately before delivery, in the initial and final FHR tracing segments, from 48 normal, 10 mildly acidemic and 10 moderate-to-severely acidemic fetuses. Progression of labor was associated with a significant increase in linear frequency domain indices whereas nonlinear indices were significantly decreased. Moderate-to-severe fetal acidemia was associated with a significant decrease in nonlinear indices. The best discrimination between moderate-to-severe acidemic fetuses and the remaining cases was obtained combining II and ApEn(2,0.15), with a specificity of 71% and a sensitivity of 80%. These findings support the hypothesis of increased autonomic nervous system activity in the final minutes of labor and of decreased central nervous system activity, both in the final minutes of labor and in moderate-to-severe acidemic fetuses.