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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

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Determination of fetal heart rate reactivity from a single 20-min window of non-stress testing in compromised fetuses

Young-Sun Park1 / Jeong-Kyu Hoh2 / Seung-Kwon Koh3 / Nam-Su Kim4 / Moon-II Park3

1Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, Korea

2Department of Obstetrics and Gynecology, College of Medicine, University of California, Irvine, CA, USA

3Department of Obstetrics and Gynecology, Hanyang University Hospital, Seoul, Korea

4Department of Pediatric Cardiology, Hanyang University Hospital, Seoul, Korea

Corresponding author: Moon-II Park, MD, PhD Department of Obstetrics and Gynecology College of Medicine Hanyang University 17 Haengdang-dong Sungdong-gu Seoul Korea (133-792) Tel.: +82-2-2290-8409 Fax: +82-2-2297-8409

Citation Information: Journal of Perinatal Medicine. Volume 37, Issue 4, Pages 386–391, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2009.072, March 2009

Publication History

Received:
2008-08-08
Revised:
2008-09-24
Accepted:
2009-01-26
Published Online:
2009-03-17

Abstract

Aims: To shorten the analysis time needed for non-stress testing (NST) without decreasing efficacy in compromised fetuses.

Methods: We selected 80 cases with a 5-min Apgar score <7 as a study group and 259 cases with a 5-min Apgar score ≥9 as a control group. We applied four different criteria (A, B, C, and D) to each study and control group for the first 20-min window of NST data to evaluate reactivity. Criteria A, B, and C consisted of conventional reactivity criteria according to amplitude (15 or 10 beats per minute), duration (15 or 10 s) and weeks of gestation (≤31, ≥32), and criteria D combined criteria C with approximate entropy (ApEn).

Results: The sensitivity of criteria D (91.25%) was greater than the other three criteria (P<0.0001). The specificities of criteria C (96.14%) and D (99.23%) were also higher than criteria A and B (P<0.0001). The positive and negative predictive value of criteria D were better than that of criteria C (97.33 vs. 83.87, P=0.0066) and (97.35 vs. 89.89, P=0.0004), respectively.

Conclusion: Adding ApEn to the conventional criteria for reactivity shortened NST analysis time without decreasing efficacy, facilitating a decision of reactivity within a single 20-min NST window.

Keywords: Approximate entropy; non-stress testing; reactivity

Citing Articles

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[1]
Jeong-Kyu Hoh, Moon-Il Park, Young-Sun Park, and Seung-Kwon Koh
Taiwanese Journal of Obstetrics and Gynecology, 2012, Volume 51, Number 3, Page 397
[2]
Jeong-Kyu Hoh, Young-Mo Sung, and Moon-Il Park
Journal of Obstetrics and Gynaecology Research, 2012, Volume 38, Number 2, Page 358
[3]
F. Sahhaf, F. Abbas`Aliz, H. Kokcheli, and M. Ghojazadeh
Pakistan Journal of Biological Sciences, 2010, Volume 13, Number 1, Page 34

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