Document Detail


Fetal autonomic response to severe acidaemia during labour.
MedLine Citation:
PMID:  20025619     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Spectral analysis of heart-rate variability is used to monitor autonomic nervous system fluctuations. The low-frequency component is associated with sympathetic and parasympathetic modulation and the high-frequency component is associated with parasympathetic modulation. The objective was to study whether changes in low-frequency or high-frequency power of heart-rate variability occur in case of fetal distress. DESIGN: Case-control study. SETTING: Obstetric unit of a tertiary-care teaching hospital. POPULATION: Twenty healthy human fetuses during labour at term of which ten had an umbilical artery pH < 7.05 (cases), and ten had an arterial pH > 7.20 (controls) after birth. METHODS: Spectral information about fetal beat-to-beat heart rate, calculated from direct fetal electrocardiogram registrations, was obtained by using a short-time Fourier transform. MAIN OUTCOME MEASURES: Absolute power and normalised power in the low-frequency and high-frequency bands. RESULTS: No differences were found between fetuses with and without acidaemia in absolute low or high frequency power (P = 0.2 and P = 0.3, respectively). During the last 30 minutes of labour, acidaemic fetuses had significantly increased normalised low-frequency power (P = 0.01) and decreased normalised high-frequency power (P = 0.03) compared with non-acidaemic fetuses. These differences were not observed from 3 to 2 hours before birth (P = 0.7 and P = 0.9, respectively). CONCLUSION: The autonomic nervous system of human fetuses at term responds adequately to severe stress during labour. Normalised low and high frequency power of heart-rate variability might be able to discriminate between normal and abnormal fetal condition.
Authors:
J O E H van Laar; C H L Peters; R Vullings; S Houterman; J W M Bergmans; S G Oei
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-12-17
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  429-37     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, M?xima Medical Centre, Veldhoven. joehvanlaar@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acidosis / physiopathology*
Autonomic Nervous System / embryology*
Case-Control Studies
Delivery, Obstetric
Fetal Distress / diagnosis*,  physiopathology
Fetal Monitoring / methods,  standards
Gestational Age
Heart Rate, Fetal / physiology*
Humans
Hydrogen-Ion Concentration
Stress, Physiological / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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