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Computer-based intrapartum fetal monitoring and beyond: A review of the 2nd Workshop on Signal Processing and Monitoring in Labor (October 2017, Oxford, UK)

A. Georgieva, P. Abry, V. Chudáček, PM. Djurić, MG. Frasch, R. Kok, CA. Lear, SN. Lemmens, I. Nunes, AT. Papageorghiou, GJ. Quirk, CWG. Redman, B. Schifrin, J. Spilka, A. Ugwumadu, R. Vullings,

. 2019 ; 98 (9) : 1207-1217. [pub] 20190618

Language English Country United States

Document type Congress, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc20006370

Grant support
17/601 Health Research Council of New Zealand - International
Canadian Institutes of Health Research (CIHR) - International
R01 HD097188 NICHD NIH HHS - United States
R21 HD080025 NICHD NIH HHS - United States
CDF-2016-09-004 Department of Health - United Kingdom
CDF-2016-09-004 National Institute of Health Research (NIHR) - International
719500 European Union Horizon - International
Institute of Human Development, Child and Youth Health - International

The second Signal Processing and Monitoring in Labor workshop gathered researchers who utilize promising new research strategies and initiatives to tackle the challenges of intrapartum fetal monitoring. The workshop included a series of lectures and discussions focusing on: new algorithms and techniques for cardiotocogoraphy (CTG) and electrocardiogram acquisition and analyses; the results of a CTG evaluation challenge comparing state-of-the-art computerized methods and visual interpretation for the detection of arterial cord pH <7.05 at birth; the lack of consensus about the role of intrapartum acidemia in the etiology of fetal brain injury; the differences between methods for CTG analysis "mimicking" expert clinicians and those derived from "data-driven" analyses; a critical review of the results from two randomized controlled trials testing the former in clinical practice; and relevant insights from modern physiology-based studies. We concluded that the automated algorithms performed comparably to each other and to clinical assessment of the CTG. However, the sensitivity and specificity urgently need to be improved (both computerized and visual assessment). Data-driven CTG evaluation requires further work with large multicenter datasets based on well-defined labor outcomes. And before first tests in the clinic, there are important lessons to be learnt from clinical trials that tested automated algorithms mimicking expert CTG interpretation. In addition, transabdominal fetal electrocardiogram monitoring provides reliable CTG traces and variability estimates; and fetal electrocardiogram waveform analysis is subject to promising new research. There is a clear need for close collaboration between computing and clinical experts. We believe that progress will be possible with multidisciplinary collaborative research.

References provided by Crossref.org

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$a The second Signal Processing and Monitoring in Labor workshop gathered researchers who utilize promising new research strategies and initiatives to tackle the challenges of intrapartum fetal monitoring. The workshop included a series of lectures and discussions focusing on: new algorithms and techniques for cardiotocogoraphy (CTG) and electrocardiogram acquisition and analyses; the results of a CTG evaluation challenge comparing state-of-the-art computerized methods and visual interpretation for the detection of arterial cord pH <7.05 at birth; the lack of consensus about the role of intrapartum acidemia in the etiology of fetal brain injury; the differences between methods for CTG analysis "mimicking" expert clinicians and those derived from "data-driven" analyses; a critical review of the results from two randomized controlled trials testing the former in clinical practice; and relevant insights from modern physiology-based studies. We concluded that the automated algorithms performed comparably to each other and to clinical assessment of the CTG. However, the sensitivity and specificity urgently need to be improved (both computerized and visual assessment). Data-driven CTG evaluation requires further work with large multicenter datasets based on well-defined labor outcomes. And before first tests in the clinic, there are important lessons to be learnt from clinical trials that tested automated algorithms mimicking expert CTG interpretation. In addition, transabdominal fetal electrocardiogram monitoring provides reliable CTG traces and variability estimates; and fetal electrocardiogram waveform analysis is subject to promising new research. There is a clear need for close collaboration between computing and clinical experts. We believe that progress will be possible with multidisciplinary collaborative research.
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$a Abry, Patrice $u University of Lyon, Ens de Lyon, University Claude Bernard, CNRS, Laboratoire de Physique, Lyon, France.
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$a Chudáček, Václav $u CIIRC, Czech Technical University in Prague, Prague, Czech Republic.
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$a Djurić, Petar M $u Electrical and Computer Engineering, Stony Brook University, Stony Brook, NY, USA.
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$a Frasch, Martin G $u Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
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