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In this investigation the Pre-ejection-period (PEP) has been monitored as the most important systolic time interval.PEP is defined as the interval from the beginning of ventricular depolarization and onset of ventricular ejection. The PEP of the cardiac cycle, fetal heart rate (FHR), intrauterine pressure (IUP) and acid-base Status were monitored.in a saries of more than .150.cases.of unselected human fetuses in perinatal .period. A new online technique using the fetal.EGG and Poppler-ultrasound permits. a cantinous registration of PEP patterns simultaneously with the fetal CTG sub partu. In addition relative PEP time was calculated from absolute PEP and duration of heart period. Results; Successful registrations of PEP were possible in about 95 % of all cases. By evaluation of the relative PEP it is possible to differentiate changes in PEP due to fetal heart rate' alterations from those being hemodynamically effective. The normal rage of PEP under delivery is 65 to 8O msec. with a mean value of about 73 msec. Within this normal range and under steady state conditions the basic PEP is heart-frequency dependand in the majori^ty of cases.^ that. means, increases of the. basic heart rate lead to the decline of actual basic PEP and worthwise, whereas the relative PEP remains constant. (Fig. t) . Actual basic PEP values below and beyond this normal range were registered in fetal acidosis and hypoxia as well as in states of severe placental insufficiency. Within the normal range of PEP, that means from 65 to 80 msec pnly pH values better than 7,3 and BE values better than 3 have been registered. A decrease of myocardial contractility leading to a Prolongation of the PEP during chronic acidosis possibly due to a derectely damage of the fetal myocardium. An abnormal shortening of the basic PEP due to an increase of myocardial contractility in acute hypoxia. This phenomenon can be explained by an increase of the catecholamine output in acute fetal distress Situation. Fig. 2: During accelerations and decelerations of the fetal heart rate caused by fetal head compression and reflexly

Monitoring of fetal systolic time intervals as a parameter of hemodynamic changes in the fetal cardiovascular system sub partu.