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Computational and Mathematical Methods in Medicine
Volume 2015, Article ID 236896, 9 pages
http://dx.doi.org/10.1155/2015/236896
Research Article

Evaluation of the Acceleration and Deceleration Phase-Rectified Slope to Detect and Improve IUGR Clinical Management

1Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, Federico II University, 5 Pansini Street, 80131 Naples, Italy
2Computational Physiology and Clinical Inference Group, Research Laboratory of Electronics, Massachusetts Institute of Technology, 25 Carleton Street, Cambridge, MA 02139, USA
3Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 5 Ferrata Street, 27100 Pavia, Italy
4Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy

Received 6 September 2015; Revised 16 November 2015; Accepted 17 November 2015

Academic Editor: Joao Cardoso

Copyright © 2015 Salvatore Tagliaferri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. This study used a new method called Acceleration (or Deceleration) Phase-Rectified Slope, APRS (or DPRS) to analyze computerized Cardiotocographic (cCTG) traces in intrauterine growth restriction (IUGR), in order to calculate acceleration- and deceleration-related fluctuations of the fetal heart rate, and to enhance the prediction of neonatal outcome. Method. Cardiotocograms from a population of 59 healthy and 61 IUGR fetuses from the 30th gestation week matched for gestational age were included. APRS and DPRS analysis was compared to the standard linear and nonlinear cCTG parameters. Statistical analysis was performed through the -test, ANOVA test, Pearson correlation test and receiver operator characteristic (ROC) curves (). Results. APRS and DPRS showed high performance to discriminate between Healthy and IUGR fetuses, according to gestational week. A linear correlation with the fetal pH at birth was found in IUGR. The area under the ROC curve was 0.865 for APRS and 0.900 for DPRS before the 34th gestation week. Conclusions. APRS and DPRS could be useful in the identification and management of IUGR fetuses and in the prediction of the neonatal outcome, especially before the 34th week of gestation.