Document Detail


Maternal heart rate patterns in the first and second stages of labor.
MedLine Citation:
PMID:  22313165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Objective. To analyze typical maternal heart rate (MHR) patterns in the first and second stages of labor. Design. Observational study. Setting. Tertiary care community hospital. Population. Normal term parturients with epidural anesthesia. Methods. Confirmed MHR and uterine activity were simultaneously recorded. The average MHR was analyzed 10 seconds before, as well as at the peak of, each contraction and/or pushing effort. Each woman contributed one datapoint at each time point to the analysis. Main outcome measure. Change in MHR during contractions. Results. First stage: 7.6±2.1 contractions per woman (n=18) were analyzed. Average MHR decreased during contractions: from 83±13 to 74±10bpm; p<0.001). In 56% (10/18) of the women, 'early' type decelerations were seen in at least 50% of contractions. Second stage: 3.5±1.5 contractions per woman. All women (n=15) showed MHR accelerations during every pushing effort (ΔMHR: +35±13bpm; 88±14 to 123±17bpm; p<0.001). MHR was persistently >100bpm in three women (17%) in the first stage, and in four women (27%) in the second stage. Peak MHR >140bpm occurred during pushing in 20%. Conclusion. Decreases in MHR during contractions in the first stage of labor can mimic fetal heart rate (FHR) accelerations as well as early type decelerations. Thus, first stage tracings with a low baseline and early type decelerations may be maternal in origin and FHR should be independently confirmed in such tracings. Because second stage MHR accelerations generally show greater amplitude than FHR accelerations, tracings with repetitive accelerations during contractions (especially when Δ >20bpm) should be considered MHR until proven otherwise.
Authors:
Teelkien R VAN Veen; Michael A Belfort; Shalece Kofford
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-03-29
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  91     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-20     Completed Date:  2012-06-14     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  598-604     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Electrocardiography
Female
Heart Rate / physiology*
Heart Rate, Fetal / physiology
Humans
Labor Stage, First / physiology*
Labor Stage, Second / physiology*
Pregnancy
Uterine Contraction / physiology
Grant Support
ID/Acronym/Agency:
U01 HD040636/HD/NICHD NIH HHS; U01 HD040657/HD/NICHD NIH HHS; U01 HD043464/HD/NICHD NIH HHS
Comments/Corrections
Comment In:
Acta Obstet Gynecol Scand. 2012 Dec;91(12):1474   [PMID:  22582924 ]

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


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