Heart Rate Variability Analysis Allows Early Asphyxia Detection in Ovine Fetus

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 n...

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Published inReproductive sciences (Thousand Oaks, Calif.) Vol. 16; no. 5; pp. 509 - 517
Main Authors Frasch, Martin G., Müller, Thomas, Weiss, Christian, Schwab, Karin, Schubert, Harald, Schwab, Matthias
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.05.2009
Springer International Publishing
Sage Publications
Subjects
Animals
Asphyxia - diagnosis
Asphyxia - physiopathology
Biological and medical sciences
Early Diagnosis
Embryology
Female
Gynecology. Andrology. Obstetrics
Heart Rate - physiology
Heart Rate, Fetal - physiology
Medical sciences
Medicine & Public Health
Obstetrics/Perinatology/Midwifery
Pregnancy
Prenatal Diagnosis - methods
Reproductive Medicine
Sheep, Domestic
autonomic nervous system
monitoring
heart rate variability
vagus
fetal asphyxia
RMSSD
Respiratory disease
Gynecology
Variability
Early stage
Asphyxia
Obstetrics
Pregnancy
Heart rate
Surveillance
Autonomic nervous system
Fetus
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Summary: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) and 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 decelerations ( 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 asphyxia. RMSSD may accurately identify asphyxic fetuses early. Clinical validation is needed.
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ISSN:1933-7191
1933-7205
DOI:10.1177/1933719108327597