Temporal Evolution of Intrapartum Fetal Heart Rate Features.
Temporal Evolution of Intrapartum Fetal Heart Rate Features.
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产时胎儿心率特征的时间演变。
DOI：
10.23919/cinc53138.2021.9662865
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发表时间：
2021-09
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我们的研究目的是提高产时对出生时严重酸中毒及随后的缺氧缺血性脑病的鉴别，以便及时干预以避免此类并发症，而不会对正常结局的出生造成过多不必要的干预。本研究探讨了胎儿心率（FHR）特征在分娩过程中的演变。我们分析了来自北加州凯泽医疗机构15家医院的21853例正常新生儿和163例发生缺氧缺血性脑病（HIE）的新生儿在分娩前6小时采集的FHR信号。我们把这六个小时分成18个互不重叠的20分钟的时间段。每个历元的功率谱密度分为三个频段：低频（LF, 30-150 mHz）、运动频率（MF, 150-500 mHz）和高频（HF, 500-1000 mHz）。我们还估计了LF/(MF+HF)比、FHR信号的均值和标准差、近似熵（ApEn）和减速能力（DC）。在我们的研究结果中，ApEn、标准差和DC显示出早在出生前120分钟就能检测出HIE风险的良好能力，这为及时干预提供了足够的领先时间。
Our research goal is to improve the intrapartum identification of tracings associated with severe acidosis at birth and subsequent hypoxic-ischemic encephalopathy so that timely interventions could avoid such complications without causing excessive unnecessary interventions in births with normal outcomes. The present study examines the evolution of fetal heart rate (FHR) features over the course of labor. We analyzed FHR signals collected in the last 6 hours before delivery in 21,853 births with normal neonatal outcomes and in 163 that developed hypoxic-ischemic encephalopathy (HIE) from 15 hospitals of Kaiser Permanente Northern California. We divided these six hours into 18 nonoverlapping 20-minute epochs. The power spectral density of each epoch was divided into three bands: low frequency (LF, 30–150 mHz), movement frequency (MF, 150–500 mHz), and high frequency (HF, 500–1000 mHz). We also estimated the LF/(MF+HF) ratio, the mean and standard deviation of the FHR signal, the approximate entropy (ApEn), and the deceleration capacity (DC). In our results, ApEn, the standard deviation, and DC showed a promising ability to detect risk of HIE as early as 120 minutes before birth, which gives enough leading time for timely interventions.