OP06.02: Heart sounds at home: preliminary results of an ambulatory fetal heart rhythm surveillance program for anti‐<scp>SSA</scp> positive pregnancies
Bibliographic record
Abstract
Standard fetal echo surveillance infrequently detects emergent SSA-mediated complete atrioventricular block (E-CAVB). This is important because 30/1000 pregnant women are at risk for fetal E-CAVB and anti-inflammatory treatment can arrest progression of E-CAVB to irreversible CAVB. The purpose of our study was to test the feasibility of a new surveillance method for E-CAVB using 2 x/day home Doppler monitoring of fetal heart rhythm (FHR). We recruited anti-SSA positive mothers at 16–18 wks gestation (baseline) from 9 centres and instructed them to monitor FHR 2x/day at home until 25 wks using a commercially available Doppler device. Mothers described the FHR as irregular or regular. If FHR was irregular, mothers contacted their provider and underwent immediate diagnostic fetal echo. FHR was also surveilled weekly or every other week by fetal echo. After the monitoring period (∼7-9 weeks), mothers completed a satisfaction questionnaire. Postnatally, each infant underwent a 12-lead ECG. Amongst 131 mothers recruited, 117 (89%) enrolled and 114 (97%) completed the study. Reason for withdrawal from the study were termination of pregnancy or monitoring too stressful or time consuming (n = 3). During home monitoring, 6 mothers detected irregular FHR (5%) diagnosed by fetal echo as normal (false positive, n = 2), benign arrhythmia (n = 4) or E-CAVB (n = 2). No E-CAVB was detected by surveillance echoes. No CAVB was missed or developed between the end of monitoring to birth. All mothers felt comforted and empowered by the experience and would monitor again in subsequent pregnancies. These data suggest ambulatory FHR surveillance is feasible, detects E-CAVB with an acceptable false positive rate, and is empowering and comforting to mothers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".