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Systematic review of intrapartum fetal heart rate spectral analysis and an application in the detection of fetal acidemia

2021-08-02Journal article Open access
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dc.contributor.authorCastro, Luísa
dc.contributor.authorLoureiro, Maria
dc.contributor.authorHenriques, Teresa S.
dc.contributor.authorNunes, Inês
dc.date.accessioned2021-09-22T15:29:54Z
dc.date.available2021-09-22T15:29:54Z
dc.date.issued2021-08-02
dc.description.abstractIt is fundamental to diagnose fetal acidemia as early as possible, allowing adequate obstetrical interventions to prevent brain damage or perinatal death. The visual analysis of cardiotocography traces has been complemented by computerized methods in order to overcome some of its limitations in the screening of fetal hypoxia/acidemia. Spectral analysis has been proposed by several studies exploring fetal heart rate recordings while referring to a great variety of frequency bands for integrating the power spectrum. In this paper, the main goal was to systematically review the spectral bands reported in intrapartum fetal heart rate studies and to evaluate their performance in detecting fetal acidemia/hypoxia. A total of 176 articles were reviewed, from MEDLINE, and 26 were included for the extraction of frequency bands and other relevant methodological information. An open-access fetal heart rate database was used, with recordings of the last half an hour of labor of 246 fetuses. Four different umbilical artery pH cutoffs were considered for fetuses' classification into acidemic or non-acidemic: 7.05, 7.10, 7.15, and 7.20. The area under the receiver operating characteristic curve (AUROC) was used to quantify the frequency bands' ability to distinguish acidemic fetuses. Bands referring to low frequencies, mainly associated with neural sympathetic activity, were the best at detecting acidemic fetuses, with the more severe definition (pH ≤ 7.05) attaining the highest values for the AUROC. This study shows that the power spectrum analysis of the fetal heart rate is a simple and powerful tool that may become an adjunctive method to CTG, helping healthcare professionals to accurately identify fetuses at risk of intrapartum hypoxia and to implement timely obstetrical interventions to reduce the incidence of related adverse perinatal outcomes.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCastro L, Loureiro M, Henriques TS and Nunes I (2021) Systematic Review of Intrapartum Fetal Heart Rate Spectral Analysis and an Application in the Detection of Fetal Acidemia. Front. Pediatr. 9:661400. doi: 10.3389/fped.2021.661400pt_PT
dc.identifier.doi10.3389/fped.2021.661400pt_PT
dc.identifier.issn2296-2360
dc.identifier.urihttp://hdl.handle.net/10400.22/18491
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontierspt_PT
dc.relation.publisherversionhttps://www.frontiersin.org/articles/10.3389/fped.2021.661400/fullpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectFetal acidemiapt_PT
dc.subjectFetal heart ratept_PT
dc.subjectSpectral anlysispt_PT
dc.subjectFrequency bandspt_PT
dc.subjectIntrapartumpt_PT
dc.titleSystematic review of intrapartum fetal heart rate spectral analysis and an application in the detection of fetal acidemiapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage12pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleFrontiers in pediatricspt_PT
oaire.citation.volume9pt_PT
person.familyNameCastro Guedes
person.givenNameMaria Luísa
person.identifier.ciencia-id7D19-EABE-CF3B
person.identifier.orcid0000-0002-1312-0154
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication59f421de-a393-47e4-83b1-fb436c35b797
relation.isAuthorOfPublication.latestForDiscovery59f421de-a393-47e4-83b1-fb436c35b797

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