Skip to main content
SpringerLink
Log in

Linear and nonlinear fetal heart rate analysis of normal and acidemic fetuses in the minutes preceding delivery

  • Original Article
  • Published:
Medical and Biological Engineering and Computing Aims and scope Submit manuscript

Abstract

Linear and nonlinear fetal heart rate (FHR) indices, namely mean FHR, interval index (II), very low, low and high frequencies, approximate (ApEn) and sample entropy (SampEn), were computed, immediately before delivery, in the initial and final FHR tracing segments, from 48 normal, 10 mildly acidemic and 10 moderate-to-severely acidemic fetuses. Progression of labor was associated with a significant increase in linear frequency domain indices whereas nonlinear indices were significantly decreased. Moderate-to-severe fetal acidemia was associated with a significant decrease in nonlinear indices. The best discrimination between moderate-to-severe acidemic fetuses and the remaining cases was obtained combining II and ApEn(2,0.15), with a specificity of 71% and a sensitivity of 80%. These findings support the hypothesis of increased autonomic nervous system activity in the final minutes of labor and of decreased central nervous system activity, both in the final minutes of labor and in moderate-to-severe acidemic fetuses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. ACOG (1995) ACOG technical bulletin. fetal heart rate patterns: monitoring, interpretation, and management. Int J Gynecol Obstet 51:65–74

    Article  Google Scholar 

  2. Ayres-de-Campos D, Bernardes J, Costa-Pereira A, Pereira-Leite L (1999) Inconsistencies in expert’s classification of cardiotocograms and subsequent clinical decision. Br J Obstet Gynecol 106:1307–1310

    Google Scholar 

  3. Ayres-de-Campos D, Bernardes J, Garrido A, de Sá JM, Pereira-Leite L (2000) Sisporto 2.0: a program for automated analysis of cardiotocograms. J Mat Fet Med 9:311–318

    Article  Google Scholar 

  4. Bernardes J, de Campos DA, Costa-Pereira A, Pereira-Leite L, Garrido A (1998) Objective computerized fetal heart rate analysis. Int J Gynecol Obstet 62:141–147

    Article  Google Scholar 

  5. Bernardes J, Costa-Pereira A, de Campos DA, van Geijn HP, Pereira-Leite L (1997) Evaluation of interobserver agreement of cardiotocograms. Int J Gynecol Obstet 57(1):33–37

    Article  Google Scholar 

  6. Bernardes J, Moura C, de Sá JPM, Pereira-Leite L (1991) The porto system for automated cardiotocographic signal analysis. J Perinat Med 19:61–65

    Google Scholar 

  7. Boog G (2004) Analyse informatisTe du rythme cardiaque foetal au cours de la grossesse et de l’accouchement. EncyclopTdie MTdico-Chirurgicale 148(5-049-D-23), pp 1–10

    Google Scholar 

  8. Carter MC (1993) Signal processing and display—cardiotocographs. Br J Obstet Gynaecol 100(9):21–23

    Google Scholar 

  9. Chaffin DG, Barnard JM, Phernetton T, Reed KL (1998) Decreased approximate entropy of heart rate variability in the hypoxic ovine fetus. J Matern Fetal Invest 8:23–26

    Google Scholar 

  10. Chung DY, Sim YB, Park KT, Yi SH, Shin JC, Kim SP (2001) Spectral analysis of fetal heart rate variability as a predictor of intrapartum fetal distress. Int J Gynecol Obstet 73:109–116

    Article  Google Scholar 

  11. Colenbrander GJ, van Geijn HP, Goovaerts HG (1994) Acquisition of fetal heart rate signals. In: Geijn HPV, Copray FJA (eds) A critical appraisal of fetal surveillance. Elsevier Science, Amsterdam, pp 203–210

    Google Scholar 

  12. Dawes GS, Moulden M, Sheil O, Redman CWG (1992) Approximate entropy, a statistic of regularity, applied to fetal heart rate data before and during labour. Obstet Gynecol 80(5):763–768

    Google Scholar 

  13. Dudewicz E, Mishra S (1988) Modern mathematical statistics. Wiley, New York

    MATH  Google Scholar 

  14. Echeverrfa JC, Hayes-Gill BR, Crowe JA, Woolfson MS, Croaker GDH (1990) Detrended fluctuation analysis: a suitable method for studying fetal heart rate variability? Int J Biomed Comput 25:287–294

    Article  Google Scholar 

  15. Felgueiras C, de Sá JPM, Bernardes J, Gama S (1998) Fractal characterisation of fetal heart rate sequences. Biomed Eng 36(2):197–201

    Google Scholar 

  16. Fusheng Y, Bo H, Qingyu T (1998) Approximate entropy and its application in biosignal analysis. In: Akay M (ed) Nonlinear biomedical signal processing. Dynamical analysis and modelling, vol II. IEEE Press, New York, pp 72–91

  17. Gonçalves H, Rocha AP, de Campos DA, Bernardes J (2006) Internal versus external intrapartum foetal heart rate monitoring: the effect on linear and nonlinear parameters. Physiol Meas 27:307–319

    Article  Google Scholar 

  18. Gough NA (1993) Fractal analysis of foetal heart rate variability. Physiol Meas 14(3):309–315

    Article  Google Scholar 

  19. Hayes M (1996) Statistical digital signal processing and modelling. Wiley, New York

    Google Scholar 

  20. Hewlett-Packard (1993) Hewlett-Packard Series 50 Service Manual, M1351A and 1353A. Germany

  21. King T, Parer J (2000) The physiology of fetal heart rate patterns and perinatal asphyxia. J Perinat Neonat Nurs 14(3):19–39

    Google Scholar 

  22. Li X, Tang D, Zhou S, Zhou G, Wang C, Zhuang Y, Wu G, Shen L (2004) Redistribution of power spectrum of heart rate variability during acute umbilical artery embolism and hypoxemia in late-gestation fetal sheep. Eur J Obstet Gynecol Reprod Biol 114:137–143

    Article  Google Scholar 

  23. Magenes G, Signorini MG, Arduini D (2000) Classification of cardiotocographic records by neural networks. In: IJCNN 2000, Proceedings of the IEEE-INNS-ENNS international joint conference on neural networks, vol 3, pp 637–641

  24. Martin JCB (1998) Electronic fetal monitoring: a brief summary of its development, problems and prospects. Eur J Obstet Gynecol Reprod Biol 78:133–140

    Article  Google Scholar 

  25. Martinez WL, Martinez AR (2002) Computational statistics handbook with MATLAB. CRC Press, Boca Raton

    MATH  Google Scholar 

  26. Oppenheimer LW, Lewinsky RM (1994) Power spectral analysis of fetal heart rate. Baillieres Clin Obstet Gynaecol 8(3):643–661

    Article  Google Scholar 

  27. Pincus S (1991) Approximate entropy as a measure of system complexity. Proc Natl Acad Sci USA 88:2297–2301

    Article  MATH  MathSciNet  Google Scholar 

  28. Pincus S (1995) Approximate entropy (apen) as a complexity measure. Chaos 5(1):110–117

    Article  MathSciNet  Google Scholar 

  29. Pincus S, Viscarello R (1992) Approximate entropy: a regularity measure for fetal heart rate analysis. Obstet Gynecol 79(2):249–255

    Google Scholar 

  30. di Renzo GC, Montani M, Fioriti V, Clerici G, Branconi F, Pardini A, Indraccolo R, Cosmi EV (1996) Fractal analysis: a new method for evaluating fetal heart rate variability. J Perinat Med 24(3):261–269

    Article  Google Scholar 

  31. Richman JS, Moorman JR (2000) Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol 278:H2039–H2049

    Google Scholar 

  32. Ripley BD (1996) Pattern recognition and neural networks. Cambridge University Press, London

    MATH  Google Scholar 

  33. Rooth G, Huch A, Huch R (1987) FIGO news. guidelines for the use of fetal monitoring. Int J Gynecol Obstet 25:159

    Article  Google Scholar 

  34. Royal College of Obstetricians and Gynaecologists (2001) Evidence-Based Clinical Guideline Number 8. The use of electronic fetal monitoring. Royal College of Obstetricians and Gynaecologists, London

    Google Scholar 

  35. Salamalekis E, Thomopoulos P, Giannaris D, Salloum I, Vasios G, Prentza A, Koutsouris D (2002) Computerised intrapartum diagnosis of fetal hypoxia based on fetal heart rate monitoring and fetal pulse oximetry recordings utilising wavelet analysis and neural networks. BJOG 109(10):1137–1142

    Google Scholar 

  36. Signorini MG, Cerutti S (1999) Nonlinear properties of cardiovascular time series. In: Di Rienzo M, Mancia G, Parati G, Pedotti A, Zanchetti A (eds) Methodology and clinical applications of blood pressure and heart rate analysis, IOS Press, Amsterdam, pp 73–89

  37. Signorini MG, Magenes G, Cerrutti S, Arduini D (2003) Linear and nonlinear parameters for the analysis of fetal heart rate signal from cardiotacographic recordings. IEEE Trans Biomed Eng 50(3):365–373

    Article  Google Scholar 

  38. Siira SM, Ojala TH, Vahlberg TJ, Jalonen JO, Valimaki IA, Rosen KG, Ekholm EM (2005) Marked fetal acidosis and specific changes in power spectrum analysis of fetal heart rate variability recorded during the last hour of labour. Br J Obstet Gynaecol 112:418–423

    Google Scholar 

  39. Suzuki T, Okamura K, Kimura Y, Watanabe T, Murotsuki NYJ, Uehara S, Yajima A (2000) Power spectral analysis of R-R interval variability before and during the sinusoidal heart rate pattern in fetal lambs. Am J Obstet Gynecol 182:1227–1232

    Article  Google Scholar 

  40. Task-Force (1996) Heart rate variability. standards of measurement, physiological interpretation, and clinical use. task force of the european society of cardiology and the north american society of pacing and electrophysiology. Eur Heart J 17:354–381

    Google Scholar 

  41. Teich MC, Lowen SB, Jost BM, Vibe-Rheymer K, Heneghan C (1998) Heart rate variability: measures and models. In: Akay M (ed) Nonlinear biomedical signal processing. Dynamic analysis and modeling, vol II. IEEE Press, New York, pp. 159–213

  42. Yum MK, Kim K, Kim JH, Park EY (2004) A consistent abnormality in the average local smoothness of fetal heart rate in growth-restricted fetuses affected by severe pre-eclampsia. Hypertens Res 27(12):911–918

    Article  Google Scholar 

Download references

Acknowledgment

The authors acknowledge project POSI/CPS/40153 /2001 funded by FCT (Fundação para a Ciência e Tecnologia, Portugal).

Author information

Authors and Affiliations

  1. Departamento de Matemática Aplicada, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre—687, 4169-007, Porto, Portugal

    Hernâni Gonçalves & Ana Paula Rocha

  2. Centro de Matemática da Universidade do Porto, Porto, Portugal

    Ana Paula Rocha

  3. Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

    Diogo Ayres-de-Campos & João Bernardes

  4. Instituto de Engenharia Biomédica (INEB), Porto, Portugal

    João Bernardes

Authors
  1. Hernâni Gonçalves
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ana Paula Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Diogo Ayres-de-Campos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. João Bernardes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hernâni Gonçalves.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gonçalves, H., Rocha, A.P., Ayres-de-Campos, D. et al. Linear and nonlinear fetal heart rate analysis of normal and acidemic fetuses in the minutes preceding delivery. Med Bio Eng Comput 44, 847–855 (2006). https://doi.org/10.1007/s11517-006-0105-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-006-0105-6

Keywords

Search

Navigation