Document Detail

Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation.
MedLine Citation:
PMID:  18605969     Owner:  NLM     Status:  MEDLINE    
AIM: To describe developmental aspects of the sympatho-vagal heart rate regulation in the human fetus by applying numerics to visual descriptions of fetal heart rate patterns throughout the third trimester of pregnancy. The focus is to determine potential benefits of this alternative means of assessing the maturation of the fetal autonomic nervous system by analysis of fetal heart rate variability (fHRV). SUBJECTS AND METHODS: The magnetocardiograms of 103 normal fetuses between 24+1 and 41+6 weeks of gestation were studied. Fetal heart beat intervals were determined with a temporal precision of 1 ms. The levels of fetal activity were estimated according to characteristic heart rate patterns (I-III) prior to 32, between 32-35 and beyond 35 (groups 1-3) completed weeks. Mean heart rate (mHR), standard deviation of normal-to-normal beat intervals (SDNN) and root mean square of successive differences of normal beats (RMSSD) served as fHRV indices, mean permutation entropy (PE_Mean) as complexity measure. SDNN/RMSSD was introduced as a potential marker for sympatho-vagal balance. RESULTS: Low activity fHRP (I) were characterized by significantly lower level fHRV indices and higher PE_Mean when compared to fHRP II. We found that SDNN/RMSSD decreases with gestation in fHRP I, which suggests increasing vagal influence. In fHRP III (assigned to active awake fetuses only after 32 weeks), highest level SDNN and mHR are associated with a dramatically reduced complexity. fHRV indices cluster characteristically with the activity levels. CONCLUSIONS: We conclude that a combined analysis of fHRV, based on SDNN/RMSSD and PE_Mean, and fHRP is advantageous in the assessment of maturation of the fetal autonomic nervous system.
Uwe Schneider; Birgit Frank; Anja Fiedler; Christiane Kaehler; Dirk Hoyer; Mario Liehr; Jens Haueisen; Ekkehard Schleussner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  36     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  2008  
Date Detail:
Created Date:  2008-09-05     Completed Date:  2009-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  433-41     Citation Subset:  IM    
University Hospital, Department of Obstetrics, Friedrich Schiller University of Jena, Germany.
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MeSH Terms
Autonomic Nervous System / embryology,  physiology*
Fetal Movement / physiology
Fetus / physiology*
Gestational Age
Heart Rate, Fetal / physiology*
Pregnancy Trimester, Third

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