Changes with time in fetal heart rate variation, movement incidences and haemodynamics in intrauterine growth retarded fetuses: a longitudinal approach to the assessment of fetal well being

Ribbert, L. S. M.; Visser, Gerard H.A.; Mulder, E.J.H.; Zonneveld, M.F.; Morssink, L. P.

doi:10.1016/0378-3782(93)90195-z

Cited by 74 publications

(30 citation statements)

References 22 publications

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“…Although computerized analysis precludes subjectivity, it must be taken into account that despite a 'reactive' pattern correlating with fetal well-being, a non-reactive recording has a low positive predictive value 26 . FHR variability reduction and decelerations have been related to hypoxia 2 but when recordings turn into abnormal ones, more than 77% of fetuses present with hypoxia and acidemia 3,4 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A temporal model of deterioration in Doppler velocimetric parameters in fetal growth restriction related to cardiotocographic monitoring

LT¹,

Carrasco²,

JC³

2004

The Ultrasound Review of Obstetrics & Gynecology

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The present study aimed to describe the time sequence of abnormal changes in Doppler velocimetric parameters and its relationship with fetal heart rate recorded in growth-restricted fetuses. Fifteen singleton pregnancies with an ultrasound diagnosis of fetal growth restriction (abdominal circumference 5 2SD) were evaluated prospectively and longitudinally. Fetal outcome included four perinatal deaths, seven emergency Cesarean sections due to abnormal cardiotocogram (CTG) and four admissions to the neonatal intensive-care unit. We observed 'early' Doppler changes (15 to 10 days prior to delivery) in the umbilical artery (UA), middle cerebral artery (MCA) and cerebroplacental ratio. 'Late' Doppler changes included absent or reverse end-diastolic flow in the UA, high resistance in the ductus venosus (DV) and decrease of umbilical venous blood flow. These changes appeared in 10% of cases 4-7 days prior to delivery and in up to 40% of cases on the day of delivery. Although occurring less frequently, umbilical vein pulsations, reverse 'a' wave at the DV and increased flow resistance in the MCA were also observed closer to delivery. 'Late' Doppler changes appeared in two-thirds of cases with 'early' Doppler changes and in 40% of cases with an abnormal CTG. These changes preceded the abnormal CTG patterns by 1-10 days. All perinatal deaths were of patients who showed 'late' Doppler changes (4/10), whereas an abnormal CTG without 'late' Doppler changes led to emergency Cesarean delivery because of the risk of loss of fetal well-being (7/10). From the time sequence observed we describe a standard model of Doppler changes in fetal growth restriction. It is obviously not a rule for fetal deterioration to take place the same way in every individual affected fetus. Nevertheless, it is apparent that 'late' Doppler changes usually precede an abnormal CTG and are associated with greater perinatal mortality.

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Section: Discussionmentioning

confidence: 99%

“…Fetal heart rate (FHR) monitoring can detect hypoxemia 2,3 , but the latter can occur too late to be a useful sign of fetal compromise 3,4 . Biophysical profile score 5 can also be applied to detect fetal compromise.…”

Section: Introductionmentioning

confidence: 99%

A temporal model of deterioration in Doppler velocimetric parameters in fetal growth restriction related to cardiotocographic monitoring

LT¹,

Carrasco²,

JC³

2004

The Ultrasound Review of Obstetrics & Gynecology

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“…However, in pregnancies with placental dysfunction before labour, the onset of hypoxia and acidosis is more gradual and results of these tests are often normal until a preterminal stage11 where urgent delivery is required to prevent an intrauterine death.…”

Section: Diagnosis Of Acidosismentioning

confidence: 99%

Causes and consequences of fetal acidosis

Bobrow

Soothill

1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…It was concluded that with progressive deterioration of the fetal condition abnormal velocity wave form patterns occur first; FHR variation is reduced subsequently while GMs and FBM are the last to become abnormal. 24 In another study fetal heart rate (FHR) variation and movements (FA) was investigated in 27 normally grown fetuses and in 18 fetuses with intrauterine growth restriction (IUGR). 25 The results confirmed previously shown decrease of fetal movements in IUGR fetuses as compared to normally grown fetuses at all gestation times.…”

Section: Fetal Behavior In Pregnancies Complicated By Intrauterine Grmentioning

confidence: 99%

“…23 On the other hand Ribbert and coworkers showed that the assessment of fetal activity may be of help in fetuses with a marginally reduced FHR variation, in which prolongation of pregnancy is considered desirable to allow further maturation in utero. 24 In order to determine changes occurring with time they longitudinally studied fetal heart rate variation, general movements, breathing movements and hemodynamics in 19 intrauterine growth restricted fetuses, who eventually were delivered by caesarean section (CS) because of fetal distress. In 14 of 19 fetuses abnormal velocity wave forms were present from the beginning of the study onwards.…”

Section: Fetal Behavior In Pregnancies Complicated By Intrauterine Grmentioning

confidence: 99%

Fetal Behavior in High-risk Pregnancies Assessed by Two-Dimensional (2D) and Three-Dimensional/Four-Dimensional (3D)/(4D) Ultrasound: A Review

Kurjak¹,

Tikvica²,

Mišković³

et al. 2008

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Direct assessment of functional development of the fetal central nervous system is not possible, but the assessment of fetal behavior may provide the possibility to distinct between normal and abnormal brain development. Since the ultrasonographic technique allowed the investigation of spontaneous fetal motor activity in utero first studies of spontaneous prenatal movements and fetal behavior were performed and published. 2D ultrasound was considered somewhat subjective method because information needs observer interpretation. The latest development of three-dimensional (3D) and four dimensional (4D) sonography that overcame some of the limitations of 2D methods enable precise study of fetal and even embryonic activity and behavior. In the following text we reviewed the literature on the behavior in the high-risk pregnancies for cerebral palsy assessed by the ultrasonographic techniques.

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Changes with time in fetal heart rate variation, movement incidences and haemodynamics in intrauterine growth retarded fetuses: a longitudinal approach to the assessment of fetal well being

Cited by 74 publications

References 22 publications

A temporal model of deterioration in Doppler velocimetric parameters in fetal growth restriction related to cardiotocographic monitoring

A temporal model of deterioration in Doppler velocimetric parameters in fetal growth restriction related to cardiotocographic monitoring

Causes and consequences of fetal acidosis

Fetal Behavior in High-risk Pregnancies Assessed by Two-Dimensional (2D) and Three-Dimensional/Four-Dimensional (3D)/(4D) Ultrasound: A Review

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