Key result
Computerized cardiotocography parameters based on new gestational age reference ranges accurately predicted fetal compromise with a sensitivity of 90%, specificity of 89%, and an AUC of 0.874.
Why the study?
Does computerized cardiotocography parameter analysis according to gestational age predict fetal compromise in pregnancies?
Observational (n=4,012)
No
Does computerized cardiotocography parameter analysis according to gestational age predict fetal compromise in pregnancies?
Effect estimate: AUC 0.874 (95% CI 0.834-0.941)
p-value: p=<0.0001
Establishing new gestational age-specific reference ranges for computerized cardiotocography parameters can provide a more objective and accurate prediction of fetal compromise.
Gestational age-specific cCTG parameters may aid fetal compromise prediction; hypothesis-generating and requires prospective validation before practice change.
We selected 4012 cCTG records (one trace for each patient) performed in healthy pregnancies from 30th to 42nd gestational week using foetal heart rate (FHR), short-term variability (STV), long-term irregularity (LTI), Delta, approximate entropy (ApEn), spectral components as low frequency (LF), median frequency (MF), high frequency (HF) and LF/(HF + MF) ratio were analysed. Reference nomograms were created and sensitivity and specificity for the prediction of foetal compromise were calculated which were 90% and 89%, respectively. Changes of cCTG parameters according to gestational week were evaluated: FHR (r = -.65) and LF (r = -.87) showed a statistically significant reduction (p < .05) with gestational age. STV (r = .59), LTI (r = .69), Delta (r = .67), and MF (r = .88) showed a statistically significant increase (p < .05) with gestational age. In contrast, for ApEn (r = -.098), HF (r = .14) and LF/(HF + MF) ratio (r = -.47) a non-statistically significant change was found (p > .05). The identification of reference ranges for cCTG indexes in according to gestational age could provide a more objective examination of cCTG trace.
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Giuliano et al. (2016) conducted an observational in Healthy pregnancies (n=4,012). Gestational age and computerized cardiotocography parameters was evaluated on Prediction of fetal compromise (Area under the ROC curve) (AUC 0.874, 95% CI 0.834-0.941, p=<0.0001). Computerized cardiotocography parameters based on new gestational age reference ranges accurately predicted fetal compromise with a sensitivity of 90%, specificity of 89%, and an AUC of 0.874.
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