Journal of Medical Ultrasonics

, Volume 46, Issue 1, pp 105–111 | Cite as

Reproducibility of automated fetal heart rate measurement using a novel technique with two-dimensional tracking

  • Ryuhei Nagai
  • Susumu Miyashita
  • Susumu Murata
  • Yuichiro Takahashi
  • Atsushi Tajima
  • Sumito Nagasaki
  • Mayumi Takano
  • Masahiko NakataEmail author
Original Article



To assess the accuracy of automated fetal heart rate measurement using two-dimensional tracking (AutoFHR) by comparison with the conventional free-angle M-mode (M-mode) and pulsed-waved Doppler (PWD) methods.


A multicenter prospective comparative study was conducted. AutoFHR is a novel technique for the automatic calculation of fetal heart rate using a two-dimensional speckle-tracking method. The fetal heart rate (FHR) obtained by AutoFHR was compared with that obtained by the conventional M-mode and PWD. Statistical analysis was performed on the correlation between the FHR measured by AutoFHR and that determined by M-mode and PWD.


Data from 326 singleton pregnancies were analyzed, and all the data and the data from 178 cases were compared with M-mode and PWD, respectively. The intraobserver ICC was 0.96 (95% CI: 0.93–0.98), whereas the interobserver ICC was 0.97 (95% CI: 0.95–0.99). Systematic bias was not observed between M-mode and PWD, based on the Bland–Altman plots. Analyses of the relationships among the FHRs yielded by each method revealed that AutoFHR was strongly associated with M-mode (rs = 0.99, p < 0.001) and PWD (rs = 0.86, p < 0.001).


Evaluation of FHR by AutoFHR was proved to be equivalent to evaluation by the conventional M-mode and PWD. AutoFHR can be employed with only B-mode data, making FHR measurement easier and safer.


Automated fetal heart rate measurement Two-dimensional tracking method 



This work was partially supported by JSPS KAKENHI (Grant Number: JP16K11114).

Compliance with ethical standards

Conflict of interest

Ryuhei Nagai, Susumu Miyashita, Susumu Murata, Yuichiro Takahashi, Atsushi Tajima, Sumito Nagasaki, and Mayumi Takano declare that they have no conflicts of interest. Masahiko Nakata reports grants from JSPS KAKENHI during the conduct of the study. In addition, Nakata has a patent from the Japan Patent Office licensed to 5386001.

Ethical statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1946 and later versions.

Informed consent

Informed consent was obtained from all patients whose identifying information is included in this article.


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Copyright information

© The Japan Society of Ultrasonics in Medicine 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyKochi Health Sciences CenterKochiJapan
  2. 2.Department of Obstetrics and GynecologyDokkyo Medical UniversityTochigiJapan
  3. 3.Department of Obstetrics and Gynecology 1Kawasaki Medical SchoolOkayamaJapan
  4. 4.Department of ObstetricsNagara Medical CenterGifuJapan
  5. 5.Department of Obstetrics and GynecologyJuntendo University Urayasu HospitalChibaJapan
  6. 6.Department of Obstetrics and GynecologyToho University Graduate School of MedicineTokyoJapan

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