Project: Development of synergetic functionalities between computerized CTG and ST wave analyses for intrapartum decision support

“Time is short. We must seize this historic moment to act responsibly and decisively for the common good.” - Ban Ki-moon, UN Secretary-General, preparing the high-level meeting in September 2010 to review progress towards the Millennium Development Goals._x000D_The proportion of child deaths that occurs in the neonatal period (38% in 2000) is increasing, and the Millennium Development Goal for child survival cannot be met without substantial reductions in neonatal mortality. Every year an estimated 4 million babies die in the first 4 weeks of life (the neonatal period). Globally, the CO direct causes of neonatal death are estimated to be preterm birth (28%), severe infections (26%), and asphyxia (23%). Fetal oxygenation deficiency during birth can cause permanent neurologic injuries or even death of the child._x000D__x000D_Continuous monitoring of fetal heart rate by cardiotocography (CTG) is a common practice in European countries for monitoring the status of the fetus during labor. Nevertheless, hypoxia reCOs an important cause of suffering for parents and families that can be avoided using a recognition system of abnormal FHR patterns and on-time alterts (says an UK report). _x000D_Analysis o fetal heart rate (FHR) tracings is almost universally performed visually by health professionals, and it has been shown to be subject to wide intra- and interobserver variation, both in what concerns overall interpretation and identification of individual tracing events._x000D_More recently monitoring of fetal electrocardiographic ST waveform signals by Neoventa has arisen as an adjunct to intrapartum FHR monitoring. A systematic review of the first 3 conducted trials comparing joint FHR plus ST monitoring with isolated FHR monitoring showed that the former significantly decreases the rates of fetal blood sampling, neonatal encephalopathy, operative delivery, and the incidence of umbilical artery metabolic acidosis. The technique is gaining expansion globally. However, adverse neonatal outcomes continue to occur with routine use of the STAN technology, COly because of human errors, such as poor FHR tracing interpretation, delay in taking appropriate action and failure to follow clinical guidelines._x000D_Computer analysis of the CTG has emerged as a way to overcome this problem and is perceived by many renowned international institutions the most rational way to improve the value of technology._x000D__x000D_Aware of this problem, during the last years Speculum and INEB have been working together in a computerized algorithm to improve the predictive results of CTG + ST analysis. They have been creating a global system to support clinical decisions, based on alerts proceeding from the computerized analysis of the cardiotocography and electrocardiography - the Omniview-SisPorto. According to previous research published in the AJOG the potential to detect accurately the fetuses at risk is very high._x000D_The goals of this project are to:_x000D_• Confirm the potential of the combination of the Omniview-Sisporto computer analysis with the STAN ST analysis to detect fetal hypoxia_x000D_• Use additional data to further increase the accuracy of the alerts_x000D_• Create a new interface in both systems that will address the issue of non-recognition of abnormal FHR patterns and delay in taking appropriate action._x000D__x000D_We expect to contribut towards the Millennium Development goals and Uultimately the goal is to contribute for a better health of babies and mothers. _x000D_

Acronym	OMNIANALYSIS (Reference Number: 5649)
Duration	01/03/2011 - 28/02/2015
Project Topic	The objective is to develop and add new synergetic functionalities to the Omniview-SisPorto central monitoring and to the STAN fetal monitors, which allow the reduction of neonatal neurological damage and mortality due to hypoxia, trough a unique decision support system with computerized analysis.
Project Results (after finalisation)	The conclusion of a clinical study, a level I evidence randomised clinical trial, confirming the safety and a trend towards the reduction of fetal hypoxia with the use of computer analysis of cardiotocograms (CTGs)._x000D_Refinement of existing algorithms for computer analysis of CTGs._x000D_A validated interface for the sending information of clinical alerts.
Network	Eurostars
Call	Eurostars Cut-Off 4

Project partner

Number	Name	Role	Country
3	Instituto Nacional de Engenharia Biomédica	Partner	Portugal
3	Neoventa Holding AB	Partner	Sweden
3	Speculum, Artigos Médicos S.A.	Coordinator	Portugal