胎儿生长受限与正常妊娠胎儿窘迫的模糊检测在产前监测中的应用

Igor Victorovich. Lakhno, Bertha Patricia Guzmán-Velázquez, J. A. Díaz-Méndez
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引用次数: 1

摘要

监测胎儿心脏活动是一种众所周知的方法来评估胎儿健康。胎儿心率可以用常规心脏造影(CTG)测量。然而,由于自相关函数的平均性质,该方法不能提供胎儿心率的每拍变异性,该自相关函数用于从自相关函数窗口中包含的一组心跳估计心率。因此,CTG对胎儿心律失常的诊断有重要的局限性。CTG的假阳性率高,观察者之间和观察者内部的可靠性差,因此不能可靠地预测胎儿状态和围产期结局。无创胎儿心电图(NI-FECG)是一种有前途的低成本、无创胎儿连续监测替代方案。然而,迄今为止,关于NI-FECG的临床可用性的报道很少。本章将包括基于心率变异性(HRV)准确诊断胎儿窘迫的数据。为了提高检测的灵敏度和特异性,从HRV应答中选择胎儿描述符作为胎儿健康状况的明显描述符,设计了一套模糊逻辑推理系统。这种方法被发现是相当前瞻性的后续临床实施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fuzzy Detection of Fetal Distress for Antenatal Monitoring in Pregnancy with Fetal Growth Restriction and Normal
Monitoring of fetal cardiac activity is a well-known approach to the assessment of fetal health. The fetal heart rate can be measured using conventional cardiotocography (CTG). However, this method does not provide the beat-to-beat variability of the fetal heart rate because of the averaging nature of the autocorrelation function that is used to estimate the heart rate from a set of heart beats enclosed in the autocorrelation function window. Therefore, CTG presents important limitations for fetal arrhythmia diagnosis. CTG has a high rate of false positives and poor interand intra-observer reliability, such that fetal status and the perinatal outcome cannot be predicted reliably. Non-invasive fetal electrocardiography (NI-FECG) is a promising low-cost and non-invasive continuous fetal monitoring alternative. However, there is little that has been published to date on the clinical usability of NI-FECG. The chapter will include data on the accurate diagnosing of fetal distress based on heart rate variability (HRV). A fuzzy logic inference system was designed based on a set of fetal descriptors selected from the HRV responses, as evident descriptors of fetal well-being, to increase the sensitivity and specificity of detection. This approach is found to be rather prospective for the subsequent clinical implementation.
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