Respiratory sinus arrhythmia in growth restricted fetuses with normal Doppler hemodynamic indices

Arias-Ortega, R.; Guzmán-Huerta, Mario; Camargo-Marín, Lisbeth; Gaitán-González, Mercedes J.; Borboa-Olivares, Héctor; Portilla-Islas, E.; Camal-Ugarte, Sergio; Vargas-García, Carlos; Ortiz, Mario R; González-Camarena, R.

doi:10.1016/j.earlhumdev.2015.11.008

Cited by 15 publications

(31 citation statements)

References 46 publications

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“…RSA was determined as a crucial regulatory mechanism of the synchronization (Ivanov 2009). Fetal RSA plays an important role in the adaptive response to chronic placental insufficiency (Arias-Ortega et al 2015). The umbilical vein could be approached as a ‘mirror’ of the oscillatory processes in the ‘mother-placenta-fetus’ system since the cord is not an innervated tissue.…”

Section: Reduced Materno-fetal Correlations Of Heart Rate Pattern In mentioning

confidence: 99%

Monitoring fetal maturation—objectives, techniques and indices of autonomic function

et al. 2017

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Objective Monitoring the fetal behavior does not only have implications for acute care but also for identifying developmental disturbances that burden the entire later life. The concept, of ‘fetal programming’, also known as ‘developmental origins of adult disease hypothesis’, e.g. applies for cardiovascular, metabolic, hyperkinetic, cognitive disorders. Since the autonomic nervous system is involved in all of those systems, cardiac autonomic control may provide relevant functional diagnostic and prognostic information. Approach The fetal heart rate patterns (HRP) are one of the few functional signals in the prenatal period that relate to autonomic control and, therefore, is key to fetal autonomic assessment. The development of sensitive markers of fetal maturation and its disturbances requires the consideration of physiological fundamentals, recording technology and HRP parameters of autonomic control. Main Results Based on the ESGCO2016 special session on monitoring the fetal maturation we herein report the most recent results on: (i) functional fetal autonomic brain age score (fABAS), Recurrence Quantitative Analysis and Binary Symbolic Dynamics of complex HRP resolve specific maturation periods, (ii) magnetocardiography (MCG) based fABAS was validated for cardiotocography (CTG), (iii) 30 min recordings are sufficient for obtaining episodes of high variability, important for intrauterine growth restriction (IUGR) detection in handheld Doppler, (iv) novel parameters from PRSA to identify Intra IUGR fetuses, (v) evaluation of fetal electrocardiographic (ECG) recordings, (vi) correlation between maternal and fetal HRV is disturbed in pre-eclampsia. Significance The reported novel developments significantly extend the possibilities for the established CTG methodology. Novel HRP indices improve the accuracy of assessment due to their more appropriate consideration of complex autonomic processes across the recording technologies (CTG, handheld Doppler, MCG, ECG). The ultimate objective is their dissemination into routine practice and studies of fetal developmental disturbances with implications for programming of adult diseases.

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Section: Reduced Materno-fetal Correlations Of Heart Rate Pattern In mentioning

confidence: 99%

Monitoring fetal maturation—objectives, techniques and indices of autonomic function

et al. 2017

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“…In addition to the sympathetic hyperactivity, a decreased parasympathetic tone was also found in PE. The RSA is known to have a strong relationship with the parasympathetic division of autonomic nervous regulation (14,20). Therefore, the suppression of parasympathetic regulation reduced the role of RSA in the total level of maternal HRV in PE.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of fetal parasympathetic regulation till the last weeks of healthy pregnancy was found (12). But fetal respiratory activity is strongly associated with an increased vagal domain region of HRV (6,14).…”

Section: Introductionmentioning

confidence: 99%

“…The umbilical vein could be approached as a "mirror" of the oscillatory processes in the mother-placenta-fetus system since the cord is not an innervated tissue. Fetal RSA is involved in its adaptive response to chronic placental insufficiency (14). The investigation of the relationship between maternal and fetal HRV parameters could contribute to a better understanding of their role in PE.…”

Section: Introductionmentioning

confidence: 99%

“…The investigation of the relationship between maternal and fetal HRV parameters could contribute to a better understanding of their role in PE. The root mean square of successive heartbeat interval differences (RMSSD) was considered as a RSA-related parameter (14). The investigation's aim was to determine the role of maternal RSA in regulating the fetal circulatory system in case of healthy pregnancy and in pre-eclamptic patients.…”

Section: Introductionmentioning

confidence: 99%

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The Autonomic Repercussions of Fetal and Maternal Interaction in Pre-eclampsia

Лахно

2017

Serbian Journal of Experimental and Clinical Research

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Severe smallness as predictor of adverse perinatal outcome in suspected late small‐for‐gestational‐age fetuses: systematic review and meta‐analysis

Meler

Martínez-Portilla

Caradeux

et al. 2022

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?Although suspected severe small-for-gestational age (SGA), defined as estimated fetal weight or abdominal circumference < 3 rd percentile or < 2 SD, is associated with a higher risk of perinatal complications, it performs poorly as a standalone parameter in predicting adverse perinatal outcome. The predictive performance of suspected severe SGA is similar to the individual performance of fetal cerebral Doppler and uterine artery Doppler parameters, as reported in the literature. The combination of these parameters may improve the overall prediction of abnormal perinatal outcome. What are the clinical implications of this work?Suspected severe SGA is not an accurate standalone predictor of adverse perinatal outcome. Given that severe SGA and abnormal Doppler parameters may reflect different pathological pathways, their combination could improve the overall prediction of abnormal perinatal outcome. A complete fetal examination incorporating fetal biometry and uterine artery and fetal Doppler evaluation should be performed when assessing for SGA.

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Respiratory sinus arrhythmia in growth restricted fetuses with normal Doppler hemodynamic indices

Cited by 15 publications

References 46 publications

Monitoring fetal maturation—objectives, techniques and indices of autonomic function

Monitoring fetal maturation—objectives, techniques and indices of autonomic function

The Autonomic Repercussions of Fetal and Maternal Interaction in Pre-eclampsia

Severe smallness as predictor of adverse perinatal outcome in suspected late small‐for‐gestational‐age fetuses: systematic review and meta‐analysis

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