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This research was performed within the framework of the Eindhoven MedTech Innovation Center (e/MTIC). e/MTIC had no role in the study design, collection, analysis and interpretation of data, nor in writing the manuscript or the decision to submit the manuscript for publication. This research was funded by a Horizon 2020 grant and supported by Nemo Healthcare BV (grant number 719500). Nemo Healthcare BV is a spin-off company from the Eindhoven University of Technology (TUe). The Maxima Medical Center has a research collaboration with Nemo Healthcare.
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Cuerva, Marcos JavierAuthorIntrapartum non-invasive electrophysiological monitoring: A prospective observational study
Publicated to:ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. 99 (10): 1387-1395 - 2020-10-01 99(10), DOI: 10.1111/aogs.13873
Authors: Lempersz, Carlijn; Noben, Lore; van Osta, Gonnie; Wassen, Martine L. H.; Meershoek, Bert P. J.; Bakker, Petra; Jacquemyn, Yves; Cuerva, Marcos Javier; Vullings, Rik; Westerhuis, Michelle E. M. H.; Oei, S. Guid;
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Abstract
Introduction Doppler ultrasound cardiotocography is a non-invasive alternative that, despite its poor specificity, is often first choice for intrapartum monitoring. Doppler ultrasound suffers from signal loss due to fetal movements and is negatively correlated with maternal body mass index (BMI). Reported accuracy of fetal heart rate monitoring by Doppler ultrasound varies between 10.6 and 14.3 bpm and reliability between 62.4% and 73%. The fetal scalp electrode (FSE) is considered the reference standard for fetal monitoring but can only be applied after membranes have ruptured with sufficient cervical dilatation and is sometimes contra-indicated. A non-invasive alternative that overcomes the shortcomings of Doppler ultrasound, providing reliable information on fetal heart rate, could be the answer. Non-invasive fetal electrocardiography (NI-fECG) uses a wireless electrode patch on the maternal abdomen to obtain both fetal and maternal heart rate signals as well as an electrohysterogram. We aimed to validate a wireless NI-fECG device for intrapartum monitoring in term singleton pregnancies, by comparison with the FSE.Material and methods We performed a multicenter cross-sectional observational study at labor wards of 6 hospitals located in the Netherlands, Belgium, and Spain. Laboring women with a healthy singleton fetus in cephalic presentation and gestational age between 36 and 42 weeks were included. Participants received an abdominal electrode patch and FSE after written informed consent. Accuracy, reliability, and success rate of fetal heart rate readings were determined, using FSE as reference standard. Analysis was performed for the total population and measurement period as well as separated by labor stage and BMI class (<= 30 and >30 kg/m(2)).Results We included a total of 125 women. Simultaneous registrations with NI-fECG and FSE were available in 103 women. Overall accuracy is -1.46 bpm and overall reliability 86.84%. Overall success rate of the NI-fECG is around 90% for the total population as well as for both BMI subgroups. Success rate dropped to 63% during second stage of labor, similar results are found when looking at the separate BMI groups.Conclusions Performance measures of the NI-fECG device are good in the overall group and the separate BMI groups. Compared with Doppler ultrasound performance measures from the literature, NI-fECG is a more accurate alternative. Especially, when women have a higher BMI, NI-fECG performs well, resembling FSE performance measures.
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Bibliometric impact. Analysis of the contribution and dissemination channel
The work has been published in the journal ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 19/83, thus managing to position itself as a Q1 (Primer Cuartil), in the category Obstetrics & Gynecology.
From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.02. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)
This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:
- Weighted Average of Normalized Impact by the Scopus agency: 1.01 (source consulted: FECYT Feb 2024)
- Field Citation Ratio (FCR) from Dimensions: 7.29 (source consulted: Dimensions Jul 2025)
Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-31, the following number of citations:
- WoS: 9
- Scopus: 14
Impact and social visibility
Leadership analysis of institutional authors
This work has been carried out with international collaboration, specifically with researchers from: Belgium; Netherlands.