Development of integrative autonomic nervous system function: an investigation based on time correlation in fetal heart rate patterns

Wallwitz, Ulrike; Schneider, Uwe; Nowack, Samuel; Feuker, Janine; Bauer, Stephan; Rudolph, Anja; Hoyer, Dirk

doi:10.1515/jpm-2012-0074

Cited by 17 publications

(9 citation statements)

References 29 publications

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“…Approximate entropy, a mathematical approach to quantify the complexity of a system, consists in the clinical application of chaos theory. Previous studies [ 55 , 56 ] had analyzed the relationship of ApEn with maturity of autonomous nervous system (ANS), thus emphasizing the relationship of a low value of ApEn with a lower Apgar score and metabolic acidosis. In our study, we found that ApEn progressively and significantly decreases in the <34th week group.…”

Section: Discussionmentioning

confidence: 99%

IUGR Management: New Perspectives

Giuliano

Annunziata

Tagliaferri

et al. 2014

Journal of Pregnancy

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Aim of the Study. Analyzing velocimetric (umbilical artery, UA; ductus venosus, DV; middle cerebral artery, MCA) and computerized cardiotocographic (cCTG) (fetal heart rate, FHR; short term variability, STV; approximate entropy, ApEn) parameters in intrauterine growth restriction, IUGR, in order to detect early signs of fetal compromise. Population Study. 375 pregnant women assisted from the 28th week of amenorrhea to delivery and monitored through cCTG and Doppler ultrasound investigation. The patients were divided into three groups according to the age of gestation at the time of delivery, before the 34th week, from 34th to 37th week, and after the 37th week. Data were analyzed in relation to the days before delivery and according to the physiology or pathology of velocimetry. Statistical analysis was performed through the t-test, chi-square test, and Pearson correlation test ( < 0.05). Our results evidenced an earlier alteration of UA, DV, and MCA. The analysis between cCTG and velocimetric parameters (the last distinguished into physiological and pathological values) suggests a possible relation between cCTG alterations and Doppler ones. The present study emphasizes the need for an antenatal testing in IUGR fetuses using multiple surveillance modalities to enhance prediction of neonatal outcome.

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Section: Discussionmentioning

confidence: 99%

IUGR Management: New Perspectives

Giuliano

Annunziata

Tagliaferri

et al. 2014

Journal of Pregnancy

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“…While ultrasound-based techniques are generally based on the physical development and influenced by genetic variations, FHR provides a marker for neuro-physiological development of the fetus, since it reflects the Autonomic Nervous System (ANS) control of the cardiovascular system, which matures through the progress in pregnancy. Various linear, nonlinear and complexity-based FHR variability (FHRV) parameters have been found to be closely related to the fetal development (Van Leeuwen et al, 2003; Hoyer et al, 2009; Wallwitz et al, 2012; Hoyer et al, 2013; Tetschke et al, 2016). Vagal and sympathetic activity rhythms and their interactions has been traditionally attributed to different frequencies of FHR fluctuations and their ratios (European Society of Cardiology, 1996) which can be evaluated during fetal development.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Fetal Development Using Cardiac Valve Intervals

et al. 2017

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An automated method to assess the fetal physiological development is introduced which uses the component intervals between fetal cardiac valve timings and the Q-wave of fetal electrocardiogram (fECG). These intervals were estimated automatically from one-dimensional Doppler Ultrasound and noninvasive fECG. We hypothesize that the fetal growth can be estimated by the cardiac valve intervals. This hypothesis was evaluated by modeling the fetal development using the cardiac intervals and validating against the gold standard gestational age identified by Crown-Rump Length (CRL). Among the intervals, electromechanical delay time, isovolumic contraction time, ventricular filling time and their interactions were selected in a stepwise regression process that used gestational age as the target in a cohort of 57 fetuses. Compared with the gold standard age, the newly proposed regression model resulted in a mean absolute error of 3.8 weeks for all recordings and 2.7 weeks after excluding the low quality recordings. Since Fetal Heart Rate Variability (FHRV) has been proposed in the literature for assessing the fetal development, we compared the performance of gestational age estimation by our new valve-interval based method, vs. FHRV, while assuming the CRL as the gold standard. The valve interval-based method outperformed both the model based on FHRV. Results of evaluation for 30 abnormal cases showed that the new method is less affected by arrhythmias such as tachycardia and bradycardia compared to FHRV, however certain types of heart anomalies cause large errors (more than 10 weeks) with respect to the CRL-based gold standard age. Therefore, discrepancies between the regression based estimation and CRL age estimation could indicate the abnormalities. The cardiac valve intervals have been known to reflect the autonomic function. Therefore the new method potentially provides a novel approach for assessing the development of fetal autonomic nervous system, which may be growth curve independent.

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“…Autocorrelation and adjustment of the fetal heart rate (FHR) to fetal behavior develop over the second half of pregnancy along with the development of the fetal autonomic nervous system . FHR fluctuates somewhat in accordance with the maternal heart rate (MHR), with a circadian rhythm (i.e.…”

Section: Introductionmentioning

confidence: 99%