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Theoretical Value of Deceleration Capacity Points to Deceleration Reserve of Fetal Heart Rate
IEEE Transactions on Biomedical Engineering ( IF 4.6 ) Pub Date : 2020-04-01 , DOI: 10.1109/tbme.2019.2932808
Massimo Walter Rivolta , Tamara Stampalija , Martin G. Frasch , Roberto Sassi

Objective: The interpretation of Average Acceleration and Deceleration Capacities (AC/DC), computed through Phase-Rectified Signal Averaging (PRSA), in intrapartum fetal heart rate (FHR) monitoring is still matter of investigation. We aimed to elucidate some behaviors of AC/DC. Methods: We derived the theoretical value of PRSA for stationary stochastic Gaussian processes and proved that for these time series AC and DC are necessarily identical in absolute value. The difference between DC and AC, termed Deceleration Reserve (DR), was introduced to detect signal's asymmetric trends. DR was tested on FHR signals from: near-term pregnant sheep model of labor consisting of chronically hypoxic and normoxic fetuses with both groups developing acidemia due to umbilical cord occlusions (UCO); and the CTU-UHB dataset containing fetal CTG recordings collected during labor of newborns that resulted acidotic and non-acidotic, respectively. DR was compared with AC and DC in terms of discriminatory power (AUC), between the groups, after correcting for signal power or deceleration area, respectively. Results: DR displayed higher discriminatory power on the animal model during severe acidemia, with respect to AC/DC ($p< 0.05$) but also distinguished correctly all chronically hypoxic from normoxic fetuses at baseline prior to UCO. DR also outperformed AC/DC on the CTU-UHB dataset in distinguishing acidemic fetuses at birth (AUC: 0.65). Conclusion: Theoretical results motivated the introduction of DR, that proved to be superior than AC/DC for risk stratification during labor. Significance: DR, measured during labor, might permit to distinguish acidemic fetuses due to their different autonomic regulation, paving the way for new monitoring strategies.

中文翻译:

减速能力的理论值指向胎心率的减速储备

目标:在产时胎儿心率 (FHR) 监测中,通过相位整流信号平均 (PRSA) 计算的平均加速和减速能力 (AC/DC) 的解释仍然是研究问题。我们旨在阐明 AC/DC 的一些行为。方法:我们推导出了平稳随机高斯过程的 PRSA 理论值,并证明对于这些时间序列 AC 和 DC 的绝对值必然相同。直流和交流之间的差异称为减速储备 (DR),用于检测信号的不对称趋势。DR 测试了来自以下 FHR 信号的近期妊娠绵羊分娩模型,该模型由长期缺氧和常氧的胎儿组成,两组均因脐带闭塞 (UCO) 而出现酸血症;以及包含分别导致酸中毒和非酸中毒的新生儿分娩期间收集的胎儿 CTG 记录的 CTU-UHB 数据集。在分别校正信号功率或减速区域后,DR 与 AC 和 DC 在组间的判别力 (AUC) 方面进行了比较。结果:DR 在严重酸血症期间对动物模型显示出更高的辨别力,就 AC/DC 而言($p<0.05$),但在 UCO 之前的基线时也正确区分了所有慢性缺氧胎儿和正常氧胎儿。在区分出生时的酸性胎儿方面,DR 在 CTU-UHB 数据集上的表现也优于 AC/DC(AUC:0.65)。结论:理论结果推动了 DR 的引入,事实证明 DR 在分娩期间的风险分层方面优于 AC/DC。意义:DR,在分娩期间测量,
更新日期:2020-04-01
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