The Efficacy of Individual Computer Heart Rate Indices in Detecting Acidemia at Birth in Growth-Restricted Fetuses

Guzman, Edwin R.; Vintzileos, Anthony M.; Martins, Maria Carolina de Campos; Benito, Carlos; Houlihan, Christopher; Hanley, Maryellen L.

doi:10.1016/0029-7844(96)00020-8

Cited by 90 publications

(41 citation statements)

References 13 publications

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“…Our results agree with some previous studies (Dalton et al 1983;Druzin et al 1986;Serra et al 2009), confirming that there is a significant change in foetal condition throughout gestation by the synergic action elicited by the Autonomic Nervous System (ANS) activity, through its sympathetic and parasympathetic branches (Pillai and James 1990;Guzman et al 1996). The most evident modification consists of a significant decrease of baseline FHR during gestational age, which reflects the normal foetal neural maturity, because the progressive increase in the parasympathetic influence on foetal heart rate results in a gradual lowering of baseline rate.…”

Section: Discussionsupporting

confidence: 92%

Computerised analysis of antepartum foetal heart parameters: New reference ranges

Giuliano

Annunziata

Esposito

et al. 2016

Journal of Obstetrics and Gynaecology

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We selected 4012 cCTG records (one trace for each patient) performed in healthy pregnancies from 30th to 42nd gestational week using foetal heart rate (FHR), short-term variability (STV), long-term irregularity (LTI), Delta, approximate entropy (ApEn), spectral components as low frequency (LF), median frequency (MF), high frequency (HF) and LF/(HF þ MF) ratio were analysed. Reference nomograms were created and sensitivity and specificity for the prediction of foetal compromise were calculated which were 90% and 89%, respectively. Changes of cCTG parameters according to gestational week were evaluated: FHR (r ¼ À.65) and LF (r ¼ À.87) showed a statistically significant reduction (p < .05) with gestational age. STV (r ¼ .59), LTI (r ¼ .69), Delta (r ¼ .67), and MF (r ¼ .88) showed a statistically significant increase (p < .05) with gestational age. In contrast, for ApEn (r ¼ À.098), HF (r ¼ .14) and LF/(HF þ MF) ratio (r ¼ À.47) a non-statistically significant change was found (p > .05). The identification of reference ranges for cCTG indexes in according to gestational age could provide a more objective examination of cCTG trace.

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Section: Discussionsupporting

confidence: 92%

Computerised analysis of antepartum foetal heart parameters: New reference ranges

Giuliano

Annunziata

Esposito

et al. 2016

Journal of Obstetrics and Gynaecology

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“…Many studies have revealed that heart rate reduction in the fetus and the presence of repeated late decelerations in CTG traces performed intrapartum are related to fetal hypoxia. Moreover, STV below 3 ms regarded as worsening of fetal well-being is highly correlated with the grade of hypoxia, acidosis, and the risk of intrauterine death [14][15][16]. Anseschi et al in their study proved that a value of STV below 4.5 ms along with other risk factors may be regarded as a threshold below which timing of delivery should be considered in order to improve perinatal outcomes in pregnancies complicated by IUGR [17].…”

Section: Discussionmentioning

confidence: 99%

Fetal Heart Rate Monitoring Using Maternal Abdominal Surface Electrodes in Third Trimester: Can We Obtain Additional Information Other than CTG Trace?

et al. 2016

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Cardiotocography (CTG) is the most widely used method of monitoring fetal heart rate despite its low specificity for fetal acidosis and poor perinatal outcome [1]. It is derived from simple auscultation of the fetal heart, but currently Doppler ultrasound CTG is used for monitoring. Fetal electrocardiography has a greater potential for detecting impairment of fetal circulation; however, it is technically more difficult to perform than CTG.Methods of monitoring fetal well-being, both in the antepartum period and during labor, are constantly developed as they assist in identifying fetal hypoxia and reducing perinatal mortality and morbidity. From the first attempts of monitoring fetal heart rate and registering electrical activity of the fetal heart, researchers sought out a precise description of intrauterine fetal condition and an accurate assessment of the risk of fetal hypoxia. AbstractBackground. Cardiotocography (CTG) is the most widely used procedure despite its low specificity for fetal acidosis and poor perinatal outcome. Fetal electrocardiography (fECG) with transabdominal electrodes is a new, non--invasive and promising method with greater potential for detecting impairment of fetal circulation. This study is the first that attempts to assess the usefulness of fECG in comparison to CTG during antepartum period. Objectives. To determine if a single fECG examination along with CTG tracing and Doppler flow measurement in the fetal vessels has any additional clinical value in normal and intrauterine growth restricted (IUGR) fetuses. Material and Methods. The study included 93 pregnancies with IUGR, 37 pregnancies with IUGR and brain sparing effect, and 324 healthy pregnant women. The T/QRS ratio, cerebro-placental ratio (CRP), and CTG tracings were analyzed. One-way analysis of variance and Spearman's rank correlation coefficient were applied. The relationship between results of the T/QRS ratio and CTG examination among the study groups was analyzed. Results. The highest average mean value of the T/QRS ratio was recorded in the IUGR group with a normal CPR and a pathologic CTG (0.235 ± 0.014). The highest average maximum values were observed in the groups of IUGR pregnancies with a reduced CPR with normal (0.309 ± 0.100), suspicious (0.330 ± 0.102) and pathologic (0.319 ± 0.056) CTGs. Analysis of variance revealed differences between study groups regarding maximum values and the difference between maximum and minimal values of T/QRS. Correlations between groups were insignificant. Conclusions. Higher values of T/QRS ratio in IUGR pregnancies with normal and reduced CPR than in control group regardless of the result of CTG examination may indicate minimal worsening of intrauterine fetal well-being in growth retarded fetuses. No relationship between fECG examination and CTG tracings suggests that a single fECG does not provide any additional clinically significant information determining the condition of the fetus; however, further studies are required (Adv Clin Exp Med 2016, 25, 2, 309-316).

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“…Five studies were performed on high risk pregnancies 10,11,23,25,26 , one on low-risk 24 and one included both high and low risk populations 22 . Amongst high-risk pregnancies, 4 studies observed a predictive relationship of STV for neonatal acidaemia in intrauterine growth restricted (IUGR) fetuses 10,11,23,26 . However, all studies excluded fetuses with chromosomal and structural anomalies.…”

Section: Resultsmentioning

confidence: 99%

“…An initial search of 398 citations, identified 7 primary articles 10,11,[22][23][24][25][26] 24 where no such record was found. Five studies were performed on high risk pregnancies 10,11,23,25,26 , one on low-risk 24 and one included both high and low risk populations 22 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

“Does short-term variation in fetal heart rate predict fetal acidaemia?” A systematic review and meta-analysis

Kapaya¹,

Jacques

Rahaim³

et al. 2016

The Journal of Maternal-Fetal & Neonatal Medicine

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The Efficacy of Individual Computer Heart Rate Indices in Detecting Acidemia at Birth in Growth-Restricted Fetuses

Abstract: In this population of growth-restricted fetuses delivered by elective cesarean, the computer indices of duration of episodes of low variation and short-term and long-term variation were significantly associated with umbilical artery pH and predicted umbilical artery acidemia at birth.

Cited by 90 publications

References 13 publications

Computerised analysis of antepartum foetal heart parameters: New reference ranges

Computerised analysis of antepartum foetal heart parameters: New reference ranges

Fetal Heart Rate Monitoring Using Maternal Abdominal Surface Electrodes in Third Trimester: Can We Obtain Additional Information Other than CTG Trace?

“Does short-term variation in fetal heart rate predict fetal acidaemia?” A systematic review and meta-analysis

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