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ARTICLES:
Volkan Tuzcu, Selman Nas, Umit Ulusar, Ahmet Ugur, and Jeffrey R. Kaiser
Altered Heart Rhythm Dynamics in Very Low Birth Weight Infants With Impending Intraventricular Hemorrhage
Pediatrics 2009; 123: 810-815 [Abstract] [Full text] [PDF]
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[Read eLetters] Fetal heart monitoring
Thomas Downs   (24 July 2009)

Fetal heart monitoring 24 July 2009
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Thomas Downs,
Maternal-Fetal Medicine
Kaiser Perm

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Re: Fetal heart monitoring

Thomas.Downs{at}kp.org Thomas Downs

Dear Sirs,

As you are probably aware, continuous electronic fetal heart rate monitoring (EFM) has been used for decades to assess fetal well being during labor. There are no large prospective trials demonstrating EFM significantly reduces major morbidity or mortality. In addition, there is good evidence which suggest it increases the cesarean section rate by two to three fold. Despite this, because of medicolegal and hospital economic pressures, EFM has become standard of care in this country. To my knowledge, no one has looked at the possibilities of using fractal analysis to interpret the fetal heart rate. Much of the problems associated with EFM stem from the highly subjective manner in which the fetal heart rate tracing (during labor) is interpreted in clinical practice. Could fractal analysis make EFM intrepretation less subjective? Are you aware of anyone who is studying fractal analysis of the fetal heart rate?

Sincerely,

Thomas Downs, MD Maternal-Fetal Medicine Kaiser Vallejo Med Center

Conflict of Interest:

None declared