The development and implementation of an expert system for the analysis of umbilical cord blood

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 the technique. Samples frequently contain errors in one or more of the important parameters, preventing accurate interpretation and many clinical staff lack the expert knowledge required to interpret error-free results. In this paper the development and implementation of an expert system to overcome these difficulties is described. The expert system validates results, provides a textual interpretation and archives all results to database for audit, research and medico-legal purposes. The system has now been in routine clinical use for over 3 years in Plymouth, and has also been installed in several other hospitals in the UK. Results are presented in which the types and frequency of errors are established and the user acceptance of the system is determined.