Cardiotocography in Obstetrics: New Solutions for “Routine” Technology

Abstract

This work is devoted to the problems of one of the most common screening examinations used in medical practice: fetal cardiotocography (CTG). The technology of ultrasonic monitoring of fetal heart rate (HR) variations has been used for more than 70 years. During this time, it has undergone many upgrades and has been characterized several times as a hopelessly outdated routine technology. Over the past 5–7 years, many in-depth studies and review papers on cardiotocography have appeared, which revealed both the problems and prospects of the technology. Basically, hopes are associated with artificial intelligence, which should increase the accuracy of the analysis of initially inaccurate measurements obtained using ultrasonic testing. At the same time, after the introduction of pulsed operating modes and the appearance of multi-chip sensors, the quality of the original signal remains practically unchanged. This circumstance makes the prospects of the technology very problematic. However, until now, there has not been a reliable replacement for this screening, which is equally safe, non-invasive, and accessible to a wide range of specialists, medical institutions, and patients. The paper discusses and substantiates proposals for improving the technology based on original (different from traditional CTG) methods of processing information received from ultrasonic sensors, which, in the author’s opinion, allow for solving the main problems of CTG: identifying the correct direction of radiation to the fetal heart and to reliably evaluate beat-to-beat heart rate.