Central Computerized Automatic Fetal Heart Rate Diagnosis with a Rapidand Direct Alarm System

摘要

Aims: This study aimed to simplify fetal monitoring, reduce inter-observer differences and false-positive diagnosisand monitor a large number of births simultaneously. Methods: Fetal signals from several births were transmitted toa central computer via local area network (LAN) or telemetry and analyzed using a multichannel timesharing system. Fetalheart rate (FHR) abnormalities were detected by using three programs: the experts' knowledge system, power spectralanalysis and artificial neural network. Abnormal results were automatically communicated directly to the attending doctor.Instead of an FHR chart recorder, the original fetal signals were stored on the computer and re-processed on demand.Results: a maximal FHR score in the first stage of labor indicated a low Apgar score, and correlated with umbilical bloodpH. The fetal distress index derived from the FHR score was three or more in cases of fetal acidosis. The neural networkyielded probabilities of fetal outcome that coincided with the FHR score, and the neural index derived from these probabilitiespredicted fetal outcome. Pathological sinusoidal FHR and severe loss of FHR variability were automaticallydiagnosed by power spectral analysis. Perinatal mortality was 1.1 in 1.000 births, which was significantly lower using thiscentral computerized system than the previous system, and no cases of cerebral palsy were reported 2 months afterdelivery. Conclusion: The central computerized automated fetal monitoring system improved fetal outcomes even in institutionsdealing with a large number of births.