Heart Rate Variability Analysis Allows Early Asphyxia Detection in Ovine Fetus

被引：25
作者：
Frasch, Martin G. [1 ,4 ]
Mueller, Thomas [2 ]
Weiss, Christian [1 ]
Schwab, Karin [3 ]
Schubert, Harald [2 ]
Schwab, Matthias [1 ]
机构：
[1] Univ Jena, Dept Neurol, D-07740 Jena, Germany
[2] Univ Jena, Inst Lab Anim Sci, D-07740 Jena, Germany
[3] Univ Jena, Inst Med Stat Comp Sci & Documentat, D-07740 Jena, Germany
[4] Univ Western Ontario, Children Hlth Res Inst, Dept Obstet & Gynaecol, London, ON N6A 4V2, Canada
来源：
REPRODUCTIVE SCIENCES | 2009年 / 16卷 / 05期
关键词：
Fetal asphyxia; heart rate variability; RMSSD; autonomic nervous system; vagus; monitoring; UMBILICAL-CORD OCCLUSION; FETAL AUTONOMIC STATE; SPECTRAL-ANALYSIS; CARDIOVASCULAR-RESPONSES; HYPOXEMIA; HYPOXIA; PRETERM; INJURY; DAMAGE; RISK;
D O I：
10.1177/1933719108327597
中图分类号：
R71 [妇产科学];
学科分类号：
100211 ;
摘要：
Fetal heart rate (FHR) monitoring is commonly used to predict asphyxia but clinical and experimental studies have questioned its diagnostic value. We examined the usefulness of fetal heart rate variability (fHRV) measures in detecting early asphyxia using, chronically), instrumented fetal sheep under normoxic (n = 6) mid asphyxic conditions (3 umbilical cord occlusions, n = 6), The occlusions consistently led to pH decreases from 7.35 +/- 0.01 to 7.09 +/- 0.03 (P < .05). FHR showed biphasic deceleration during each occlusion, associated with increasing arterial blood pressure (P <. 05). RMSSD, an index of vagal modulation of fHRV increased consistently during repeated occlusion induced FHR deceleration (P < .05). Under normoxic conditions, RMSSD did not change during FHR decelerations and decreased during FHR accelerations (P < .05). Our results suggest that an increase of RMSSD in association with FHR decelerations reflects initial vagal activation during fetal ashyxia. RMSSd may accurately identify asphyxic fetuses early. Clinical validation is needed.
引用
收藏
页码：509 / 517
页数：9
相关论文
共 38 条
[1]   CAROTID, NOT AORTIC, CHEMORECEPTORS MEDIATE THE FETAL CARDIOVASCULAR-RESPONSE TO ACUTE HYPOXEMIA IN LAMBS [J].
BARTELDS, B ;
VANBEL, F ;
TEITEL, DF ;
RUDOLPH, AM .
PEDIATRIC RESEARCH, 1993, 34 (01) :51-55
[2]   ECG and heart rate variability changes in preterm and near-term fetal lamb following LPS exposure [J].
Blad, Sofia ;
Welin, Anna-Karin ;
Kjellmer, Ingemar ;
Rosen, K. G. ;
Mallard, Carina .
REPRODUCTIVE SCIENCES, 2008, 15 (06) :572-583
[3]   FETAL RESPIRATORY MOVEMENTS, ELECTROCORTICAL AND CARDIOVASCULAR-RESPONSES TO HYPOXEMIA AND HYPERCAPNIA IN SHEEP [J].
BODDY, K ;
DAWES, GS ;
FISHER, R ;
PINTER, S ;
ROBINSON, JS .
JOURNAL OF PHYSIOLOGY-LONDON, 1974, 243 (03) :599-618
[4]  
Camm AJ, 1996, CIRCULATION, V93, P1043
[5]   An estimate of fetal autonomic state by time-frequency analysis of fetal heart rate variability [J].
David, Maya ;
Hirsch, Michael ;
Karin, Jacob ;
Toledo, Eran ;
Akselrod, Solange .
JOURNAL OF APPLIED PHYSIOLOGY, 2007, 102 (03) :1057-1064
[6]  
DAWES G, 1994, J PERINAT MED, V22, P491
[7]   Fetal heart rate changes do not reflect cardiovascular deterioration during brief repeated umbilical cord occlusions in near-term fetal lambs [J].
deHaan, HH ;
Gunn, AJ ;
Gluckman, PD .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1997, 176 (01) :8-17
[8]   Fetal body weight and the development of the control of the cardiovascular system in fetal sheep [J].
Frasch, M. G. ;
Mueller, T. ;
Wicher, C. ;
Weiss, C. ;
Loehle, M. ;
Schwab, K. ;
Schubert, H. ;
Nathanielsz, P. W. ;
Witte, O. W. ;
Schwab, M. .
JOURNAL OF PHYSIOLOGY-LONDON, 2007, 579 (03) :893-907
[9]   Problems with intrapartum fetal heart rate monitoring interpretation and patient management [J].
Freeman, RK .
OBSTETRICS AND GYNECOLOGY, 2002, 100 (04) :813-826
[10]   Fetal heart rate variability and brain stem injury after asphyxia in preterm fetal sheep [J].
George, S ;
Gunn, AJ ;
Westgate, JA ;
Brabyn, C ;
Guan, J ;
Bennet, L .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 2004, 287 (04) :R925-R933
1234