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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Volume 37, Issue 4 (Jul 2009)


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

Young-Sun Park
  • Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, Korea
/ Jeong-Kyu Hoh
  • Department of Obstetrics and Gynecology, College of Medicine, University of California, Irvine, CA, USA
/ Seung-Kwon Koh
  • Department of Obstetrics and Gynecology, Hanyang University Hospital, Seoul, Korea
/ Nam-Su Kim
  • Department of Pediatric Cardiology, Hanyang University Hospital, Seoul, Korea
/ Moon-II Park
  • Department of Obstetrics and Gynecology, Hanyang University Hospital, Seoul, Korea
Published Online: 2009-03-17 | DOI: https://doi.org/10.1515/JPM.2009.072


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

About the article

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

Received: 2008-08-08

Revised: 2008-09-24

Accepted: 2009-01-26

Published Online: 2009-03-17

Published Online: 2009-03-17

Published in Print: 2009-07-01

Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2009.072. Export Citation

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