Obstetrics and Gynaecology - Research Publications

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    The Effect of Fetal Heart Rate Segment Selection on Deep Learning Models for Fetal Compromise Detection
    Mendis, L ; Palaniswami, M ; Brownfoot, F ; Keenan, E (IEEE, 2023)
    Monitoring the fetal heart rate (FHR) is common practice in obstetric care to assess the risk of fetal compromise. Unfortunately, human interpretation of FHR recordings is subject to inter-observer variability with high false positive rates. To improve the performance of fetal compromise detection, deep learning methods have been proposed to automatically interpret FHR recordings. However, existing deep learning methods typically analyse a fixed-length segment of the FHR recording after removing signal gaps, where the influence of this segment selection process has not been comprehensively assessed. In this work, we develop a novel input length invariant deep learning model to determine the effect of FHR segment selection for detecting fetal compromise. Using this model, we perform five times repeated five-fold cross-validation on an open-access database of 552 FHR recordings and assess model performance for FHR segment lengths between 15 and 60 minutes. We show that the performance after removing signal gaps improves with increasing segment length from 15 minutes (AUC = 0.50) to 60 minutes (AUC = 0.74). Additionally, we demonstrate that using FHR segments without removing signal gaps achieves superior performance across signal lengths from 15 minutes (AUC = 0.68) to 60 minutes (AUC = 0.76). These results show that future works should carefully consider FHR segment selection and that removing signal gaps might contribute to the loss of valuable information.
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    Breastfeeding Duration and Bone Mineral Density in Childhood: A Prospective Study within GUSTO Cohort
    Gridneva, Z ; Pang, WW ; Vlaskovsky, P ; McEachran, JL ; Perrella, SL ; Yap, F ; Wlodek, ME ; Chong, Y-S ; Eriksson, JG ; Geddes, DT ; Tint, MT (MDPI, )
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    Sampling Procedures for Estimating the Infant Intake of Human Milk Hormones, Glucose and Total Lipids
    Suwaydi, MA ; Lai, CT ; Gridneva, Z ; Perrella, SL ; Wlodek, ME ; Geddes, DT (MDPI, )
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    Combination methotrexate and gefitinib: A potential medical treatment for inoperable nontubal ectopic pregnancy
    Italiano, S ; Tong, S ; Readman, E ; Tassone, M ; Hastie, R ; Pritchard, N (WILEY, 2020-03)
    Nontubal ectopic pregnancies present as a therapeutic challenge. A 35-year-old primigravida at 7 weeks gestation had a live interstitial ectopic pregnancy and contraindications to surgery. The patient was treated with a multidose methotrexate regimen combined with oral gefitinib (250 mg daily for 7 days). The peak human chorionic gonadotropin (hCG) of the patient was recorded at 19 510 IU/L and began declining from day 4 of combination therapy (day 6 of initial treatment). Successful resolution of the ectopic was demonstrated by cessation of the fetal heart by day 15 and hCG falling to 23 IU/L by day 42. A 10-year review of all nontubal ectopic pregnancies treated with methotrexate identified 46 cases, which had a comparable time to resolution to combination therapy. However, for cases where cardiac activity was present, the median time to resolution following methotrexate treatment was 64 days (47-87 days), 22 days longer than combination therapy. Combination therapy may provide a safe medical treatment for inoperable nontubal ectopic pregnancy.
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    Sex variation in perinatal outcomes by infertility treatment modality in a population cohort
    Davies, M ; Rumbold, A ; Marino, J ; Willson, K ; Moore, V ; Giles, L (OXFORD UNIV PRESS, 2013-06)