MODERN APPROACHES TO THE EVALUATION OF FETAL HEART RATE
Main Article Content
Abstract
Presented in the historical aspect of analytical review methods for studying fetal heart rate to assess his condition. The most widely used in recent years is the method of cardiotocography. However, when using this method have problems: subjectivity decryption cardiotocographic curves for visual evaluation, the complexity and the complexity of the mathematical methods of processing, the high frequency of false-positive and false-negative results. Modern computer programs are also not solve all the problems: the continuous monitoring of the increased frequency of caesarean section, but did not improve perinatal outcomes. The authors suggest that the lack of informative study of heart rate as an indicator of the state of the fetus due to the fact that the evaluation is carried out without taking into account the state of the whole system of mother - placenta - fetus.
Presented in the historical aspect of analytical review methods for studying fetal heart rate to assess his condition. The most widely used in recent years is the method of cardiotocography. However, when using this method have problems: subjectivity decryption cardiotocographic curves for visual evaluation, the complexity and the complexity of the mathematical methods of processing, the high frequency of false-positive and false-negative results. Modern computer programs are also not solve all the problems: the continuous monitoring of the increased frequency of caesarean section, but did not improve perinatal outcomes. The authors suggest that the lack of informative study of heart rate as an indicator of the state of the fetus due to the fact that the evaluation is carried out without taking into account the state of the whole system of mother - placenta - fetus.
Keywords
Author Biographies
Галина Александровна Ушакова,
Ushakova Galina Aleksandrovna
MD, PhD, professor
She is the Honoured Doctor of the Russian Federation, the Head of the Department of Obstetrics and Gynaecology, an academician of the Russian Academy of Natural Sciences, the founder of the Scientific School of the Preservation of Medical and Biological Reserves of Fertility.
After graduating from high school she entered Tomsk State Medical Institute and graduated in 1960. She had been working as an obstetrics and gynecology doctor in maternity hospitals of Kemerovo and Novosibirsk region for 3 years. From 1963 to 1966 she studied at post-graduate school at the Department of Obstetrics and Gynaecology of Kemerovo Medical Institute. After her post-graduate studies and the defense of candidate thesis about “Metrohemostat in the prevention and treatment of early postpartum haemorrhage”, she started to work as an assistant at the Department. In 1985 she defended her doctoral thesis “The establishment of the reproductive function of females and the basis for the primary prevention of its abnormalities”, took a degree of a Professor and became the Head of the Department of Obstetrics and Gynaecology of Kemerovo Medical Institute.
The priorities for her and her co-workers were the social and demographic problems in the region, so their work was aimed at preservation of medical and biological reserves of fertility.
She developed the scientific basis and organizational forms of reproductive health care of females on the stages of childhood, puberty, fertile period.
Another one priority is the study of the regulatory, energetic and metabolic processes in the mother-placenta-fetus system, in the case of physiological and complicated pregnancy.
Under her supervision 24 dissertations were defended, including a doctoral one. She published 250 works, 6 monographs and had 1 invention patent.
She is also a member of the Presidium of the Union of Kuzbass Women. She was awarded the medal “For the Special Contribution to the Development of Kuzbass” of III degree, the “Medal of Honor of Kuzbass”. She is a freeman of Kuzbass.Любовь Никитична Петрич,
candidate of medical sciences, assistante, the chair of obstetrics and gynecology N 1Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Абуладзе, Г.В. Спектральные свойства вариабельности частоты сердечного ритма плода. Норма и клиническое применение /Абуладзе Г.В., Папиташвили А.М. //Ультразвуковая и функциональная диагностика. – 2003. – № 2. – С. 128-137
Акушерство, гинекология и здоровье женщины /Ф. Карр, Х. Рициотти, К. Фройнд, С. Кахан; Пер. с англ. под общ. ред. проф. В.Н. Прилепской. – М.: МЕДпресс-информ, 2005. – 176 с.
Вариабельность сердечного ритма: Стандарты измерения, физиологической интерпретации и клинического использования //Подготовлены рабочей группой Европейского Кардиологического Общества и Северо-Американского общества стимуляции и электрофизиологии. – СПб., 2000. – 63 с.
Возможности антенатальной компьютерной кардиотокографии в оценке состояния плода в III триместре беременности /Кулаков В.И., Демидов В.Н., Сигизбаева И.Н. и соавт. //Акушерство и гинекология. – 2001. – № 5. – С. 12-16
Гребнева, И.С. Регуляторные процессы в системе мать-плацента-плод при восходящем инфицировании плодного яйца //Автроф. дис. … канд. мед. наук. – Томск, 2011. – 23 с.
Диагностическая значимость кардио-мониторинга у женщин с угрозой развития дистресса плода /Кулаков В.И., Зарубина Е.Н., Кузин В.Ф., Ильина Н.Д. //Акушерство и гинекология. – 1994. – № 6. – С. 24-27
Карась, И.Ю. Материнско-плодовые взаимоотношения регуляции кардиоритма при угрозе преждевременных родов, возможности их коррекции в профилактике акушерских и перинатальных осложнений //Автроф. дис. … канд. мед. наук. – Томск, 2004. – 22 с.
Карсаева, В.В. Прогностическое значение нарушений регуляции кардиоритма матери и плода при фетоплацентарной недостаточности, возможности их коррекции в профилактике акушерских и перинатальных осложнений: автореф. дис. … канд. мед. наук /В.В. Карсаева. – Барнаул, 2005. – 22 с.
Коган, И.Ю. Оценка функционального состояния плода при беременности и в родах /Коган И.Ю., Полянин А.А., Павлова Н.Г. //Журнал акушерства и женских болезней. – 2003. – Т. LII, Вып. 2. – С. 110-115
Кубасова, Л.А. Прогностическое значение нарушений регуляции кардиоритма матери и плода при тяжелой форме гестоза, возможности их коррекции в снижении акушерских и перинатальных осложнений: автореф. дис. … канд. мед. наук /Л.А. Кубасова. – Томск, 2006. – 22 с.
Новикова, О.Н. Внутриутробные инфекции: клинические, морфологические аспекты, прогнозирование перинатальных осложнений: автореф. дис. … докт. мед. наук /О.Н. Новикова. – Томск, 2013. – 43 с.
Породонова, О.Ю. Нейровегетативная регуляция кардиоритма матери и плода, их прогностическое значение в исходе родов при физиологической беременности: автореф. дис. … канд. мед. наук /О.Ю. Породонова. – Тюмень, 2006. – 22 с.
Рец, Ю.В. Материнско-плодовые корреляции гемодинамики при гестозе, возможности их коррекции в профилактике акушерских и перинатальных осложнений: автореф. дис. … канд. мед. наук /Рец Ю.В. – Томск, 2004. – 19 с.
Рудаева, Е.В. Регуляторные процессы в системе мать-плацента-плод при дефиците массы тела у беременных: автореф. дис. ... канд. мед. наук /Е.В. Рудаева. – Кемерово, 2004. – 21 с.
Стрижаков, А.И. Антенатальная кардиология (для акушеров-гинекологов) /Стрижаков А.И. – М., 1991. – 239 с.
Ушакова, Г.А., Регуляторные и адаптационные процессы в системе мать-плацента-плод при физиологической и осложненной беременности /Г.А. Ушакова [и др.]; под ред. Г.А. Ушаковой. – Кемерово: Кузбассвузиздат, 2015. – 284 с.
A comparative study of a new cardiotocography analysis program /Chen C.Y., Chen J.C., Yu C., Lin C.W. //Conf. Proc. IEEE Eng. Med. Biol. Soc. – 2009. – P. 2567-2570
A comparative study of fetal heart rate variability analysis techniques /Hopkins P., Outram N., Löfgren N. et al. //Conf. Proc. IEEE Eng. Med. Biol. Soc.– 2006. – N 1. – P. 1784-1787
Abdominal fetal ECG enhancement by event synchronous canceller /Taralunga D.D., Wolf W., Strungaru R., Ungureanu G. //Conf. Proc. IEEE. Eng. Med. Biol. Soc. – 2008. – P. 5402-5405
Acker D. Clinical pearls in application of electronic fetal heart rate monitoring. – Accessed November 17, 2008
Alfirevic, Z. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour /Alfirevic Z., Devane D., Gyte G.M. //Cochrane Database Syst. Rev. – 2006. – 3:CD006066
Approximate entropy of fetal heart rate variability as a predictor of fetal distress in women at term pregnancy /Li X., Zheng D., Zhou S. et al. //Acta Obstet. Gynecol. Scand. – 2005. – V. 84, N 9. – P. 837-843
Ayres-de-Campos, D. SisPorto Multicentre Validation Study Group. Prediction of neonatal state by computer analysis of fetal heart rate tracings: the antepartum arm of the SisPorto multicentre validation study /Ayres-de-Campos D., Costa-Santos C., Bernardes J. //Eur. J. Obstet. Gynecol. Reprod. Biol. – 2005. – V. 118, N 1. – P. 52-60
Biophysical profile with amniotic fluid volume assessments /Magann E.F., Doherty D.A., Field K. et al. //Obstet. Gynecol. – 2004. – V. 104, N 1. – P. 5-10
Births: final data for 2002 /Martin J.A., Hamilton B.E., Sutton P.D. et al. //Natl. Vital. Stat. Rep. – 2003. – V. 10, N 52. – P. 111-113
Blind adaptive filtering for non-invasive extraction of the fetal electrocardiogram and its non-stationarities /Graupe D., Graupe M.H., Zhong Y., Jackson R.K. //Proc. Inst. Mech. Eng. H. – 2008. – V. 222, N 8. – P. 1221-1234
Cesarean section for suspected fetal distress, continuous fetal heart monitoring and decision to delivery time /Roy K.K., Baruah J., Kumar S. et al. //Indian. J. Pediatr. – 2008. – Epub ahead of print
Cesarelli, M. Comparison of short term variability indexes in cardiotocographic foetal monitoring /Cesarelli M., Romano M., Bifulco P. //Comput. Biol. Med.. – 2009. – V. 39, N 2. – P. 106-118
Changes in the ST-interval segment of the fetal electrocardiogram in relation to acid-base status at birth /Melin M., Bonnevier A., Cardell M. et al. //BJOG. – 2008. – V. 115, N 13. – P. 1669-1675
Comparison of normal and abnormal cardiotoco-graphy with pregnancy outcomes and early neonatal outcomes /Sultana J., Chowdhury T.A., Begum K., Khan M.H. //Mymensingh. Med. J. – 2009. – N 18, 1 Suppl. – P. 103-107
Computerized analysis of fetal heart rate in pregnancies complicated by gestational diabetes mellitus /Buscicchio G., Gentilucci L., Giannubilo S.R., Tranquilli A.L. //Gynecol. Endocrinol. – 2009. – N 15. – P. 1-5
Detecting the temporal extent of the impulse response function from intra-partum cardiotocography for normal and hypoxic fetuses /Warrick P.A., Hamilton E.F., Precup D., Kearney R.E. //Conf. Proc. IEEE Eng.Med. Biol. Soc. – 2008. – P. 2797-2800
Fetal acidemia and electronic fetal heart rate patterns: is there evidence of an association? /Parer J.T., King T., Flanders S. et al. //J. Matern. Fetal. Neonatal. Med. – 2006. – N 19. – P. 289-294
Fetal distress evaluation using and analyzing the variables of antepartum computerized cardiotocography /Galazios G., Tripsianis G., Tsikouras P. et al. //Arch. Gynecol. Obstet. – 2009. – Epub ahead of print
Fetal heart rate patterns in neonatal hypoxic-ischemic encephalopathy: relationship with early cerebral activity and neurodevelopmental outcome /Murray D.M., O'Riordan M.N., Horgan R. et al. //Am. J. Perinatol. – 2009. – V. 26, N 8. – P. 605-612
Fetal short time variation during labor: a non-invasive alternative to fetal scalp pH measurements? /Schiermeier S., Reinhard J., Hatzmann H. et al. //J. Perinat. Med. – 2009. – V. 37, N 5. – P. 529-533
Fischer, W.M. A suggestion for evaluation of the antepartal cardiotocogram /Fischer W.M., Stude I., Brandt H. //Zeitschrift. Geburt.. Perinatol. – 1976. – Bd. 180. – P. 117-123
Goodlin, R.C. History of fetal monitoring /Goodlin R.C. //Am. J. Obstet. Gynecol. – 1979. – V. 3, N 133. – P. 323-352
Haws, R.A. Reducing stillbirths: screening and monitoring during pregnancy and labour /Haws R.A., Yakoob M.Y., Soomro T. //BMC Pregnancy and Childbirth. – 2009. – V. 9, Suppl. 1. – P. 1471-2393
Human fetuses have nonlinear cardiac dynamics /Groome L.J., Mooney D.M., Holland S.B. et al. //J. Appl. Physiol. – 1999. – V. 87, N 2. – P. 530-537
Ingemarsson, I. Fetal monitoring during labor /Ingemarsson I. //Neonatology. – 2009. – V. 95, N 4. – P. 342-346
Inter-observer agreement in clinical decision-making for abnormal cardiotocogram (CTG) during labour: a comparison between CTG and CTG plus STAN /Vayssière C., Tsatsaris V., Pirrello O., Cristini C., Arnaud C., Goffinet F. //BJOG. – 2009. – V. 116, N 8. – P. 1081-1087
Intrapartum fetal heart rate monitoring in cases of congenital heart disease /Ueda K., Ikeda T., Iwanaga N. et al. //Am. J. Obstet. Gynecol. – 2009. – V. 201, N 1. – P. 1-6
National Certification Corporation, authors. Applying NICHD Terminology and Other Factors to Electronic Fetal Monitoring Interpretation. Chicago: National Certification Corporation; 2006
Rising trend and indications of caesarean section at the university of Maiduguri teaching hospital, Nigeria /Geidam A.D., Audu B.M., Kawuwa B.M., Obed J.Y. //Ann. Afr. Med. – 2009. – V. 8, N 2. – P. 127-132
Robinson, B. A Review of the Proceedings from the 2008 NICHD Workshop on Standardized Nomenclature for Cardiotocography: Update on Definitions, Interpretative Systems With Management Strategies, and Research Priorities in Relation to Intrapartum Electronic Fetal Monitoring /Robinson B., Nelson L. //Rev. Obstet. Gynecol. – 2008. – V. 1, N 4. – P. 186-192
Sahin, I. A least square DFT method for sub-sample fetal heart rate estimation under noisy conditions /Sahin I., Yilmazer N. //Conf. Proc. IEEE. Eng. Med. Biol. Soc. – 2008. – P. 4399-4402
The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring: update on definitions, interpretation, and research guidelines /Macones G.A., Hankins G.D., Spong C.Y. et al. //Obstet. Gynecol. – 2008. – V. 112. – P. 661-666
The American College of Obstetricians and Gynecologists, authors. Intrapartum Fetal Heart Rate Monitoring. Washington, DC: The American College of Obstetricians and Gynecologists; 2005. pp. 1-9. (ACOG Practice Bulletin No. 70)
Towers, C.V. The fetal heart monitor tracing in pregnancies complicated by a spontaneous umbilical cord hematoma /Towers C.V., Juratsch C.E., Garite T.J. //J. Perinatol. – 2009. – V. 29, N 7. – P. 517-520