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Fetal heart rate and umbilical artery flow velocity variability in intrauterine growth restriction: a matched controlled study
Author(s) -
Vinkesteijn A. S. M.,
Struijk P. C.,
Ursem N. T. C.,
Hop W. C. J.,
Wladimiroff J. W.
Publication year - 2004
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.1032
Subject(s) - umbilical artery , medicine , heart rate variability , intrauterine growth restriction , heart rate , blood flow , fetus , cardiology , artery , hemodynamics , flow velocity , laser doppler velocimetry , blood pressure , pregnancy , biology , genetics , relaxation (psychology)
Abstract Objectives To study heart rate and umbilical artery blood flow velocity variability in growth‐restricted fetuses and investigate the influence of the autonomic nervous system on these parameters. Methods Doppler velocity waveforms were collected from long‐lasting umbilical artery recordings in 15 fetuses with growth restriction and 15 normal age‐matched controls at 23–35 weeks of gestation. Absolute heart rate and umbilical artery blood flow velocity as well as the coefficient of variation were determined. Using power spectral analysis the low‐ and high‐frequency bands of heart rate variability and blood flow velocity variability were calculated. The low‐to‐high (LH) ratio of heart rate variability and blood flow velocity variability were examined as a measure of sympathovagal balance. Results In growth‐restricted fetuses umbilical artery velocities were significantly reduced. Heart rate variability was significantly reduced in the presence of growth restriction, but no significant difference was demonstrated for blood flow velocity variability. The LH ratio for heart rate variability was significantly decreased in growth restriction, but no difference in LH ratio was demonstrated for blood flow velocity variability. Conclusion Flow velocity variability in growth restriction seems not to be predominantly influenced by the autonomic nervous system, whereas the decreased heart rate variability seems to be influenced by altered sympathetic–parasympathetic balance. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.