Birth asphyxia - diagnosing fetal distress during labour

Background
During birth, the stress of contractions and descent through the birth canal can reduce a baby’s oxygen supply. Most babies have the resilience to cope but two per cent suffer birth asphyxia (suffocation), of which, 250 babies in the UK die each year. Those who survive asphyxia may suffer convulsions and permanent brain damage. Therefore, babies at risk of birth asphyxia must be rescued by urgent delivery. To diagnose fetal distress and prevent birth asphyxia, the baby’s heart beat is electronically recorded during labour on a paper strip called a Cardiotocogram or CTG. It is difficult to assess the complicated patterns by eye and even experts disagree when reviewing the same trace at different times. Such uncertainty causes ‘fail-safe’ decisions and many unneeded Caesarean sections.

The research project
This team will design a new diagnostic system, using objective computer analysis to assist interpretation of the labour CTGs. The researchers have saved the electronic CTGs of nearly 30,000 babies with relevant clinical details. They can now use this important database to perform statistical analysis. This analysis is complex, because CTGs change as labour advances or with events such as epidural use, but the unique size of their database makes the analysis very powerful. The labour experiences of nearly 30,000 women will be distilled into the memory of this computerised system. The aim is to identify the CTG patterns that matter most for the baby and develop a new system to aid recognition of impending asphyxia, at the bedside.