



@article {3312,
	title = {Development and evaluation of an algorithm for computer analysis of maternal heart rate during labor},
	journal = {Computers in Biology and Medicine},
	volume = {49},
	year = {2014},
	note = {Export Date: 21 November 2014},
	month = {2014},
	pages = {30 - 35},
	abstract = {Background: Maternal heart rate (MHR) recordings are morphologically similar and sometimes coincident with fetal heart rate (FHR) recordings and may be useful for maternal-fetal monitoring if appropriately interpreted. However, similarly to FHR, visual interpretation of MHR features may be poorly reproducible. Methods: A computer algorithm for on-line MHR analysis was developed based on a previously existing version for FHR analysis. Inter-observer and computer-observer agreement and reliability were assessed in 40 one-hour recordings obtained from 20 women during the last 2. h of labor. Agreement and reliability were evaluated for the detection of basal MHR, long-term variability (LTV), accelerations and decelerations, using proportions of agreement (PA) and Kappa statistic (K), with 95\% confidence intervals (95\% CI). Changes in MHR characteristics between the first and the second hour of the tracings were also evaluated. Results: There was a statistically significant inter-observer and computer-observer agreement and reliability in estimation of basal MHR, accelerations, decelerations and LTV, with PA values ranging from 0.72 (95\% CI: 0.62-0.79) to 1.00 (95\% CI: 0.99-1.00), and K values ranging from 0.44 (95\% CI: 0.28-0.60) to 0.89 (95\% CI: 0.82-0.96). Moreover, basal MHR, number of accelerations and LTV were significantly higher in the last hour of labor, when compared to the initial hour. Discussion: The developed algorithm for on-line computer analysis of MHR recordings provided good to excellent computer-observer agreement and reliability. Moreover, it allowed an objective detection of MHR changes associated with labor progression, providing more information about the interpretation of maternal-fetal monitoring during labor. {\textcopyright} 2014 Elsevier Ltd.},
	keywords = {Agreement, Cardiotocography, computer analysis, Fetal heart rate, Maternal heart rate, reliability},
	url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84897934596\&partnerID=40\&md5=95b314c6374a68fedb313594f59fdcce},
	author = {Pinto, P. and Bernardes, J. and Costa-Santos, C. and Amorim-Costa, C. and Silva, M. and Ayres-de-Campos, D.}
}
