Keith R. Greene

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OBJECTIVES To investigate 1. whether an intelligent computer system could obtain a performance in labour management comparable with experts when using cardiotocograms (CTGs), patient information, and fetal blood sampling and 2. whether experts could be consistent and agree in their management of labour. SUBJECTS An intelligent computer system and 17(More)
OBJECTIVE The physiology of changes in the ST waveform of the fetal electrocardiogram has been elucidated in extensive animal and human observational studies. A combination of heart rate and ST waveform analysis might improve the predictive value of intrapartum monitoring. Our purpose was to compare operative intervention and neonatal outcome in labors(More)
OBJECTIVES To address the practical problems of routine umbilical cord blood sampling, to determine the ranges for pH, PCO2 and base deficit and to examine the relationships of these parameters between cord vessels. DESIGN An observational study of umbilical cord artery and vein blood gas results. SETTING A large district general hospital in the UK. (More)
An assessment of neonatal outcome may be obtained from analysis of blood in the umbilical cord of the infant immediately after delivery. This can provide information on the health of the newborn infant, guide requirements for neonatal care, and is recommended practice of the Royal College of Obstetricians and Gynaecologists. However, there are problems with(More)
It is possible to record the fetal electrocardiographic waveform (ECG) from the scalp electrode used in labour for detection of fetal heart rate. Animal and observational studies of changes in the ST waveform of the ECG during hypoxia suggest that a combination of heart rate and ST waveform analysis might improve the predictive value of intrapartum(More)
The ST waveform of the fetal electrocardiogram (ECG) was examined in 10 chronically instrumented fetal lambs from 115 days to term. Averaged ST waveforms were plotted at 5-minute intervals in six fetuses for 2 to 22 days. No diurnal or other rhythms were seen. To correct for changes in signal gain the amplitude of the T wave was measured relative to the(More)
The experimental evaluation of the fetal ECG waveform as a method of fetal surveillance has been based largely on experimentally induced hypoxia. The present data, obtained from chronically instrumented fetal lambs, includes three fetuses monitored throughout spontaneous labour, six fetuses with spontaneously developed long-term ST waveform changes and(More)
Waveform changes in the fetal electrocardiogram (ECG) are under reassessment as a means of fetal surveillance. The purpose of the study was to identify ST waveform changes from the fetal scalp lead during labour and to compare any change with conventional signs of fetal distress. Two scalp electrodes provided a sufficiently stable signal from which ST(More)
Over the past 4 years our group has developed a prototype intelligent system which applies captured expert knowledge to support clinical decision-making during labour. This chapter presents a review of the system and the progress made to date. The system classifies the same features from the CTG as experienced clinicians using numerical algorithms and a(More)