Baseline fetal heart rate analysis: eleven automatic methods versus expert consensus

Visual analysis of fetal heart rate (FHR) during labor is subject to inter- and intra-observer variability that is particularly troublesome for anomalous recordings. Automatic FHR analysis has been proposed as a promising way to reduce this variability. The major difficulty with automatic analysis is to determine the baseline from which accelerations and decelerations will be detected. Eleven methods for automatic FHR analysis were reprogrammed using description from the literature and applied to 66 FHR recordings collected during the first stage of delivery. The FHR baselines produced by the automatic methods were compared with the baseline defined by agreement among a panel of three experts. The better performance of the automatic methods described by Mongelli, Lu, Wrobel and Pardey was noted despite their different approaches on signal processing. Nevertheless, for several recordings, none of the automatic studied methods produced a baseline similar to that defined by the experts.