THE PREDICTION OF FETAL ACIDOSIS AT BIRTH BY COMPUTERIZED ANALYSIS OFINTRAPARTUM CARDIOTOCOGRAPHY

Objective To assess the capability of a computer software interpretati on program, using intrapartum fetal heart rate and intrauterine pressu re as recorded in a cardiotocogram to predict fetal acidosis at birth. Design and subjects A retrospective analysis of digitised fetal heart rate and uterine activity values obtained from 73 high risk women in labour. Setting Two university teaching hospitals. Methods A computer software program was constructed to analyse the digitised data and pre dict acidosis. The results of the analysis were compared with actual u mbilical arterial blood pH and base excess at delivery. Results The so ftware cardiotocogram interpreter was able to predict a pH of less tha n 7.15 with an accuracy of 77%, a sensitivity of 88% and specificity o f 75% in this set of data. It was able to predict a base excess of les s than -8 mmol/l with an accuracy of 81%, a sensitivity of 76% and spe cificity of 82%. Conclusions A computerised method of analysing fetal heart rate and uterine activity using a simple algorithm has demonstra ted a capability to predict fetal acidosis at the time of delivery. Fu rther research in this area is warranted.