Fetal electrocardiographic measurements in the assessment of fetal heart rate variability in the antepartum period
Fetal electrocardiographic measurements in the assessment of fetal heart rate variability in the antepartum period
复制标题
胎儿心电图测量评估产前胎儿心率变异性
DOI：
10.1088/0967-3334/35/3/441
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发表时间：
2014
影响因子：
3.2
通讯作者：
D. Grönemeyer
中科院分区：
文献类型：
--
作者：
P. van Leeuwen;Lisa Werner;Z. Hilal;S. Schiermeier;W. Hatzmann;D. Grönemeyer
本研究探讨信号的可用性，在胎儿心电图（FECG）心跳到心跳采集和准确性的胎儿心率变异性（HRV）分析在临床环境中使用市售的FECG监护仪。在非受控条件下，在63个胎儿（妊娠第25 - 42周）中收集的130个持续时间为0.3-17.5 h的FECG记录中检查信号可用性。R峰的识别表明信号损失为30% ± 24%，每分钟有3.6 ± 1.7个信号间隙。记录内间隙的中位持续时间为1.8 ± 0.2 s。每小时记录1.8 ± 2.1次5分钟的不间断数据，信号可用性随胎龄增加而提高，高体重指数的妇女信号可用性较差。在55例FECG和46例高质量胎儿心磁图的基础上，在控制安静条件下获得的5 min RR间期发作的基础上，检查了36-42周之间的胎儿HRV。RR间期、标准差和低频功率无差异。然而，短期HRV的各种测量值在FECG数据中显著较高：逐次差分的均方根（10.0 ± 1.8 vs 6.6 ± 3.0 ms，p < 0.001），高频频谱功率（24 ± 12 vs 13 ± 13 ms 2，p < 0.001）和近似熵（0.86 ± 0.16对比0.73 ± 0.24，p = 0.007）。我们的结论是，尽管相当大的信号损失，胎儿心电图记录可以准确地估计心率和其整体方差。然而，量化短期心跳间HRV的测量将由于可能反复出现的单个R峰的不适当检测而受到损害。
This study examines signal availability in fetal electrocardiogram (FECG) beat-to-beat acquisition and the accuracy of fetal heart rate variability (HRV) analysis in the clinical setting using a commercially available FECG monitor. Signal availability was examined in 130 FECG recordings of 0.3–17.5 h duration collected in 63 fetuses (25th–42nd week of gestation) under uncontrolled conditions. Identification of R-peaks demonstrated a signal loss of 30% ± 24% with 3.6 ± 1.7 signal gaps per minute. Median duration of the gaps within a recording was 1.8 ± 0.2 s. Per hour of recording, 1.8 ± 2.1 episodes of 5 min of uninterrupted data were found. Signal availability improved with gestational age and was poorer in women with high body-mass index. Fetal HRV between weeks 36–42 was examined on the basis of 5 min RR-interval episodes obtained under controlled quiet conditions in 55 FECG compared to 46 high quality fetal magnetocardiograms. There were no differences in RR-interval duration, its standard deviation and low frequency power. However, various measures of short-term HRV were significantly higher in the FECG data: root mean square of successive differences (10.0 ± 1.8 versus 6.6 ± 3.0 ms, p < 0.001, high frequency spectral power (24 ± 12 versus 13 ± 13 ms2, p < 0.001) and approximate entropy (0.86 ± 0.16 versus 0.73 ± 0.24, p = 0.007). We conclude that, in spite of considerable signal loss, FECG recordings can accurately estimate heart rate and its overall variance. However, measures that quantify short-term beat-to-beat HRV will be compromised due to possible recurring inappropriate detection of single R-peaks.
影响因子：
9.8
作者：
Clifford G;Sameni R;Ward J;Robinson J;Wolfberg AJ
通讯作者：
Wolfberg AJ