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- W2912409892 abstract "Visual interpretation of FHR is prone to human error. We sought to evaluate the association between neonatal adverse outcome and intrapartum FHR characteristics using computerized pattern recognition. Secondary analysis of a multi-center trial of intrapartum fetal ECG monitoring in women with singletons >36 weeks. The last 60 mins of stored digital FHR (scalp electrode) were analyzed by PeriCALM Patterns. Files missing >30 mins before delivery were excluded. The neonatal adverse outcome was a composite of any of: intrapartum fetal death, neonatal death, Apgar score ≤ 3 at 5 minutes, neonatal seizure, cord artery pH ≤ 7.05 plus base deficit ≥ 12 mmol/L, intubation for ventilation at delivery, or neonatal encephalopathy. Valid cord artery pH required both artery and vein values confirmed based on a pre-specified algorithm and outcomes were reviewed centrally. The association between various FHR patterns (as defined by NICHD criteria) and the primary outcome was evaluated by univariate analysis, and by logistic regression after adding FHR variability. 9,848 patients were included and the neonatal outcome occurred in 1.2%. Several FHR characteristics were associated with the outcome (Table). Very few cases had FHR variability <5 bpm and variability overall was not associated with the outcome regardless of the cutoff used or the duration. Accelerations were associated with better outcomes, while prolonged decelerations were associated with worse outcomes. Variable decelerations were common and were less frequent in neonates with the outcome, regardless of nadir or duration. Number and percent of the FHR tracing with late decelerations were both higher in the group with the primary outcome. Except for prolonged decelerations, adding variability to decelerations in the model did not improve the association. In this well-characterized intrapartum cohort with rigorous cord gases and outcome ascertainment, FHR pattern-recognition software identifies patterns that are associated with neonatal outcome. Decelerations are common and not discriminatory, unless recurrent lates or prolonged. Assessment of variability is not useful. Presence and frequency of accelerations are reassuring and the most likely to be useful for guiding management." @default.
- W2912409892 created "2019-02-21" @default.
- W2912409892 creator A5060166195 @default.
- W2912409892 date "2016-01-01" @default.
- W2912409892 modified "2023-09-25" @default.
- W2912409892 title "666: Using pattern-recognition software to evaluate intrapartum fetal heart rate (FHR) tracings" @default.
- W2912409892 doi "https://doi.org/10.1016/j.ajog.2015.10.713" @default.
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