Publications – THE SISPORTO PROJECT

2020-today

Gonçalves H, Ferro B, Pinto P, Bernardes J. An exploratory study on maternal-fetal heart rate variability during normal and operative vaginal delivery: physiopathological, behavioral and clinical perspectives. Physiol Meas. 2025 Jun 13;46(6). doi: 10.1088/1361-6579/ade113.

Reis-de-Carvalho C, Carvalho-Afonso M, Marinho-Soares C, David I, Ayres-de- Campos D. Acceptability of intrapartum cardiotocography using wireless transabdominal fetal ECG and electrohysterography: A prospective cohort. Eur J Obstet Gynecol Reprod Biol. 2025 Jun;310:113955. doi: 10.1016/j.ejogrb.2025.113955.

Ramos MS, Brás S, Pinto P, Castro L. Extraction of compression indices from maternal-fetal heart rate simultaneous signals. PLoS One. 2025 Jan 2;20(1):e0313709. doi: 10.1371/journal.pone.0313709.

Campos I, Gonçalves H, Bernardes J, Castro L. Fetal Heart Rate Preprocessing Techniques: A Scoping Review. Bioengineering (Basel). 2024 Apr 11;11(4):368. doi: 10.3390/bioengineering11040368.

Ribeiro M, Nunes I, Castro L, Costa-Santos C, S Henriques T. Machine learning models based on clinical indices and cardiotocographic features for discriminating asphyxia fetuses-Porto retrospective intrapartum study. Front Public Health. 2023 Mar 20;11:1099263. doi: 10.3389/fpubh.2023.1099263.

Reis-de-Carvalho C, Nogueira P, Ayres-de-Campos D. Quality of fetal heart rate monitoring with transabdominal fetal ECG during maternal movement in labor: A prospective study. Acta Obstet Gynecol Scand. 2022 Nov;101(11):1269-1275. doi: 10.1111/aogs.14434.

Georgieva A, Abry P, Nunes I, Frasch MG. Editorial: Fetal-maternal monitoring in the age of artificial intelligence and computer-aided decision support: A multidisciplinary perspective. Front Pediatr. 2022 Sep 5;10:1007799. doi: 10.3389/fped.2022.1007799.

Bernardes J. Computerized analysis of cardiotocograms in clinical practice and the SisPorto^® system thirty-two years after: technological, physiopathological and clinical studies. J Perinat Med. 2022 Sep 5;51(1):145-160. doi: 10.1515/jpm-2022-0406.

Ribeiro M, Castro L, Carrault G, Pladys P, Costa-Santos C, Henriques T. Evolution of Heart Rate Complexity Indices in the Early Detection of Neonatal Sepsis. Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:367-372. doi: 10.1109/EMBC48229.2022.9871274.

Ribeiro M, Monteiro-Santos J, Castro L, Antunes L, Costa-Santos C, Teixeira A, Henriques TS. Non-linear Methods Predominant in Fetal Heart Rate Analysis: A Systematic Review. Front Med (Lausanne). 2021 Nov 30;8:661226. doi: 10.3389/fmed.2021.661226.

Costa M, Xavier M, Nunes I, Henriques TS. Fetal Heart Rate Fragmentation. Front Pediatr. 2021 Sep 1;9:662101. doi: 10.3389/fped.2021.662101.

Castro L, Loureiro M, Henriques TS, Nunes I. Systematic Review of Intrapartum Fetal Heart Rate Spectral Analysis and an Application in the Detection of Fetal Acidemia. Front Pediatr. 2021 Aug 2;9:661400. doi: 10.3389/fped.2021.661400.

Bernardes J. Low sensitivity of the new FIGO classification system for electronic fetal monitoring to identify fetal acidosis in the second stage of labor? Eur J Obstet Gynecol Reprod Biol. 2021 Mar;258:464-465. doi: 10.1016/j.ejogrb.2021.01.042.

Hoyer D, Schmidt A, Pytlik A, Viehöfer L, Gonçalves H, Amorim-Costa C, Bernardes J, Ayres-de-Campos D, Lobmaier SM, Schneider U. Can fetal heart rate variability obtained from cardiotocography provide the same diagnostic value like from electrophysiological interbeat intervals? Physiol Meas. 2021 Feb 11;42(1):015006. doi: 10.1088/1361-6579/abc791.

Henriques T, Ribeiro M, Teixeira A, Castro L, Antunes L, Costa-Santos C. Nonlinear Methods Most Applied to Heart-Rate Time Series: A Review. Entropy (Basel). 2020 Mar 9;22(3):309. doi: 10.3390/e22030309.

Monteiro-Santos J, Henriques T, Nunes I, Amorim-Costa C, Bernardes J, Costa- Santos C. Complexity of Cardiotocographic Signals as A Predictor of Labor. Entropy (Basel). 2020 Jan 16;22(1):104. doi: 10.3390/e22010104.

2010-2019

Lopes-Pereira, J, Costa, A, Ayres-De-Campos, D, Costa-Santos, C, Amaral, J, Bernardes, J. Computerized analysis of cardiotocograms and ST signals is associated with significant reductions in hypoxic-ischemic encephalopathy and cesarean delivery: an observational study in 38, 466 deliveries. Am J Obstet Gynecol 2019;220:269.e1–8

Nunes, I, Ayres-de-Campos, D, Ugwumadu, A, Amin, P, Banfield, P, Nicoll, A, et al.. Fetal Monitoring and Alert (FM-ALERT) Study Group. Central fetal monitoring with and without computer analysis: a randomized controlled trial. Obstet Gynecol 2017;129:83–90.

Ayres-de-Campos, D, Rei, M, Nunes, I, Sousa, P, Bernardes, J. SisPorto® 4.0 – computer analysis following the 2015 FIGO Guidelines for intrapartum fetal monitoring. J Matern Fetal Neonatal Med 2017;30:62–7

Gonçalves, H, Morais, M, Pinto, P, Ayres-de-Campos, D, Bernardes, J. Linear and non-linear analysis of uterine contraction signals obtained with tocodynamometry in prediction of operative vaginal delivery. J Perinat Med 2017;45:327–32

Gonçalves, H, Amorim-Costa, C, Ayres-de-Campos, D, Bernardes, J. Gender-specific evolution of fetal heart rate variability throughout gestation: a study of 8823 cases. Early Hum Dev 2017;115:38–45

Amorim-Costa, C, Gaio, AR, Ayres-de-Campos, D, Bernardes, J. Longitudinal changes of cardiotocographic parameters throughout pregnancy: a prospective cohort study comparing small-for-gestational-age and normal fetuses from 24 to 40 weeks. J Perinat Med 2017;45:493–501

Amorim-Costa, C, Costa-Santos, C, Ayres-de-Campos, D, Bernardes, J. Longitudinal evaluation of computerized cardiotocographic parameters throughout pregnancy in normal fetuses: a prospective cohort study. Acta Obstet Gynecol Scand 2016;95:1143–52.

Amorim-Costa, C, Cruz, J, Ayres-de-Campos, D, Bernardes, J. Gender-specific reference charts for cardiotocographic parameters throughout normal pregnancy: a retrospective cross-sectional study of 9701 fetuses. Eur J Obstet Gynecol Reprod Biol 2016;199:102–7.

Gonçalves, H, Pinto, P, Silva, M, Ayres-de-Campos, D, Bernardes, J. Electrocardiography versus photoplethysmography in assessment of maternal heart rate variability during labor. SpringerPlus 2016;5:1079

Gonçalves, H, Pinto, P, Silva, M, Ayres-de-Campos, D, Bernardes, J. Toward the improvement in fetal monitoring during labor with the inclusion of maternal heart rate analysis. Med Biol Eng Comput 2016;54:691–9

Pinto, P, Costa-Santos, C, Ayres-de-Campos, D, Bernardes, J. Computer analysis of maternal-fetal heart rate recordings during labor in relation with maternal-fetal attachment and prediction of newborn acidemia. J Matern Fetal Neonatal Med 2016;29:1440–4.

Ayres-de-Campos, D, Spong, CY, Chandraharan, E. FIGO intrapartum fetal monitoring expert consensus panel. FIGO consensus guidelines on intrapartum fetal monitoring: cardiotocography. Int J Gynaecol Obstet 2015;131:13–24.

Tendais, I, Figueiredo, B, Gonçalves, H, Bernardes, J, Ayres-de-Campos, D, Montenegro, N. Sex differences in the fetal heart rate variability indices of twins. J Perinat Med 2015;43:221–5

Pinto, P, Costa-Santos, C, Gonçalves, H, Ayres-De-Campos, D, Bernardes, J. Improvements in fetal heart rate analysis by the removal of maternal-fetal heart rate ambiguities. BMC Pregnancy Childbirth 2015;15:301

Nunes, I, Ayres-de-Campos, D, Costa-Santos, C, Bernardes, J. Differences between external and internal fetal heart rate monitoring during the second stage of labor: a prospective observational study. J Perinat Med 2014;42:493–8.

Pinto, P, Bernardes, J, Costa-Santos, C, Amorim-Costa, C, Silva, M, Ayres-de-Campos, D. Development and evaluation of an algorithm for computer analysis of maternal heart rate during labor. Comput Biol Med 2014;49:30–5.

Gonçalves, H, Costa, A, Ayres-de-Campos, D, Costa-Santos, C, Rocha, AP, Bernardes, J. Comparison of real beat-to-beat signals with commercially available 4 Hz sampling on the evaluation of foetal heart rate variability. Med Biol Eng Comput 2013;51:665–76.

Nunes, I, Ayres-de-Campos, D, Figueiredo, C, Bernardes, J. An overview of central fetal monitoring systems in labour. J Perinat Med 2013;41:93–9.

Gonçalves, H, Bernardes, J, Ayres-de-Campos, D. Gender-specific heart rate dynamics in severe intrauterine growth restricted fetuses. Early Hum Dev 2013;89:431–7.

Amorim-Costa, C, Ayres-De-Campos, D, Sousa, P, Bernardes, J. Audit of a fetal central monitoring station in a clinical setting. J Matern Fetal Neonatal Med 2011;24:1249–53.

Costa, A, Santos, C, Ayres-de-Campos, D, Costa, C, Bernardes, J. Access to computerised analysis of intrapartum cardiotocographs improves clinicians’ prediction of newborn umbilical artery blood pH. Br J Obstet Gynaecol 2010;117:1288–93

Costa, MA, Ayres-de-Campos, D, Machado, AP, Santos, CC, Bernardes, J. Comparison of a computer system evaluation of intrapartum cardiotocographic events and a consensus of clinicians. J Perinat Med 2010;38:191–5.

2000-2009

Costa A, Ayres-de-Campos D, Costa F, Santos C, Bernardes J. Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals. Am J Obstet Gynecol. 2009 Nov;201(5):464.e1-6.

Bernardes J, Gonçalves H, Ayres-de-Campos D, Rocha AP. Sex differences in linear and complex fetal heart rate dynamics of normal and acidemic fetuses in the minutes preceding delivery. J Perinat Med. 2009;37(2):168-76.

Bernardes J, Gonçalves H, Ayres-de-Campos D, Rocha AP. Linear and complex heart rate dynamics vary with sex in relation to fetal behavioural states. Early Hum Dev. 2008 Jul;84(7):433-9.

Ayres-de-Campos D, Sousa P, Costa A, Bernardes J. Omniview-SisPorto 3.5 – a central fetal monitoring station with online alerts based on computerized cardiotocogram+ST event analysis. J Perinat Med. 2008;36(3):260-4.

Gonçalves, H, Bernardes, J, Rocha, AP, Ayres-de-Campos, D. Linear and nonlinear analysis of heart rate patterns associated with fetal behavioral states in the antepartum period. Early Hum Dev 2007;83:585–91

Gonçalves, H, Rocha, AP, Ayres-de-Campos, D, Bernardes, J. Linear and nonlinear fetal heart rate analysis of normal and acidemic fetuses in the minutes preceding delivery. Med Biol Eng Comput 2006;44:847–55

Gonçalves, H, Rocha, AP, Ayres-de-Campos, D, Bernardes, J. Internal versus external intrapartum foetal heart rate monitoring: the effect on linear and nonlinear parameters. Physiol Meas 2006;27:307–19

Ayres-de-Campos, D, Costa-Santos, C, Bernardes, J. SisPorto® Multicentre Validation Study Group. Prediction of neonatal state by computer analysis of fetal heart rate tracings: the antepartum arm of the SisPorto® multicentre validation study. Eur J Obstet Gynecol Reprod Biol 2005;118:52–60

Costa Santos C, Costa Pereira A, Bernardes J. Agreement studies in obstetrics and gynaecology: inappropriateness, controversies and consequences. BJOG. 2005 May;112(5):667-9.

Ayres-de-Campos, D, Bernardes, J. Comparison of fetal heart rate baseline estimation by SisPorto® 2.01 and a consensus of clinicians. Eur J Obstet Gynecol Reprod Biol 2004;117:174–8.

Ayres-de-Campos D, Bernardes J, Marsal K, Nickelsen C, Makarainen L, Banfield P, Xavier P, Campos I. Can the reproducibility of fetal heart rate baseline estimation be improved? Eur J Obstet Gynecol Reprod Biol. 2004 Jan 15;112(1):49-54.

Ayres-de Campos D, Bernardes J, Garrido A, Marques-de-Sá J, Pereira-Leite L. SisPorto 2.0: a program for automated analysis of cardiotocograms. J Matern Fetal Med. 2000 Sep-Oct;9(5):311-8.

1990-1999

Ayres-de-Campos D, Bernardes J, Costa-Pereira A, Pereira-Leite L. Inconsistencies in classification by experts of cardiotocograms and subsequent clinical decision. Br J Obstet Gynaecol. 1999 Dec;106(12):1307-10.

Ayres-de-Campos D, Bernardes J. Early, variable and late decelerations: can a consensus be reached in their identification? Int J Gynaecol Obstet. 1999 Jun;65(3):305-6.

Pereira Leite, L, Bernardes, J, Xavier, P. Computerized cardiotocogram analysis in twins. Experience with SisPorto®. In: Cosmi, EV, editor. Proceedings of the congress of women’s health in the 2000 from reproduction to menopause. Monduzzi Editore, Bologna; 1999:99–101 pp.

Bernardes J, Ayres-de-Campos D, Costa-Pereira A, Pereira-Leite L, Garrido A. Objective computerized fetal heart rate analysis. Int J Gynaecol Obstet. 1998 Aug;62(2):141-7.

Felgueiras, C, Marques-de-Sá, JP, Bernardes, J, Gama, S. Fractal characterisation of fetal heart rate sequences. Biomed Eng 1998;36:197–201.

Felgueiras CS, de Sá JP, Bernardes J, Gama S. Classification of foetal heart rate sequences based on fractal features. Med Biol Eng Comput. 1998 Mar;36(2):197-201.

Matias A, Xavier P, Bernardes J, Patrício B. Fetal heart-rate monitoring during maternal hypoglycaemic coma: a case report. Eur J Obstet Gynecol Reprod Biol. 1998 Aug;79(2):223-5.

Bernardes J, Costa-Pereira A, Ayres-de-Campos D, van Geijn HP, Pereira-Leite L. Evaluation of interobserver agreement of cardiotocograms. Int J Gynaecol Obstet. 1997 Apr;57(1):33-7.

Montenegro N, Bernardes J, Ayres-de-Campos D, Matias A, Areias JC. Monitoring of cardiac-extracardiac haemodynamics and automated fetal heart rate preceding intrauterine death. Eur J Obstet Gynecol Reprod Biol. 1996 Jan;64(1):3-6.

Bernardes J, Costa-Pereira A, van Geijn H, Pereira-Leite L. A more objective fetal heart rate baseline estimation. Br J Obstet Gynaecol. 1996 Jul;103(7):714-5.

Bernardes, J, Moura, C, Marques-de-Sá, JP, van Geijn, HP, Pereira-Leite, L. The Porto system. In: van Geijn, HP, Copray, FJA, editors. A critical appraisal of fetal surveillance. Amsterdam: Elsevier Science; 1994:315–24 pp.

Van Geijn, HP, Dekker, GA, Vries, JIP, van Vugt, JMG. Fetal heart rate patterns during labour. In: van Geijn, HP, Copray, FJA, editors. A critical appraisal of fetal surveillance. Amsterdam: Elsevier Science; 1994:238–70 pp.

Montenegro, N, Bernardes, J, Pereira-Leite. Non-invasive assessment of the hypoxic fetus with color Doppler and automated heart rate analysis. In: Kurjak, A, Chervenak, F, editors. The fetus as a patient – advances in diagnosis and therapy. London: The Parthenon Publishing Group; 1994:399–411 pp.

Marques de Sá, JP, Reis, LP, Lau, N, Bernardes, J. Estimation and classification of fetal heart rate baselines using artificial neural networks. In: Proceedings computer’s in cardiology’ 94. IEEE Computer Society Press; 1994:541–44 pp.

Bernardes, J, Ayres-de-Campos, D, Marques-de-Sá, JP, Moura, C, Pereira Leite, L. Computer recognition of FHR patterns by the porto system. In: Cosmi, EV, Di Renzo, GC, editors. 2nd world congress of perinatal medicine – proceedings of communications and posters. Monduzzi Editore, Bologna; 1993:559–64 pp.

Bernardes J, Moura C, de Sa JP, Leite LP. The Porto system for automated cardiotocographic signal analysis. J Perinat Med. 1991;19(1-2):61-5.