Open AccessAssociations between fetal heart rate variability and umbilical cord occlusions‐induced neural injury: An experimental study in a fetal sheep model
Author(s) -
Ghesquière Louise,
Perbet Romain,
Lacan Laure,
Hamoud Yasmine,
Stichelbout Morgane,
Sharma Dyuti,
Nguyen Sylvie,
Storme Laurent,
HoufflinDebarge Véronique,
De Jonckheere Julien,
Garabedian Charles
Publication year - 2022
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.14352
Subject(s) - medicine , fetus , brainstem , encephalopathy , anesthesia , umbilical cord , heart rate variability , hypoxia (environmental) , cardiology , heart rate , anatomy , pregnancy , blood pressure , biology , genetics , chemistry , organic chemistry , oxygen
This study evaluated the association between fetal heart rate variability (HRV) and the occurrence of hypoxic–ischemic encephalopathy in a fetal sheep model. Material and methods The experimental protocol created a hypoxic condition with repeated cord occlusions in three phases (A, B, C) to achieve acidosis to pH <7.00. Hemodynamic, gasometric and HRV parameters were analyzed during the protocol, and the fetal brain, brainstem and spinal cord were assessed histopathologically 48 h later. Associations between the various parameters and neural injury were compared between phases A, B and C using Spearman's rho test. Results Acute anoxic–ischemic brain lesions in all regions was present in 7/9 fetuses, and specific neural injury was observed in 3/9 fetuses. The number of brainstem lesions correlated significantly and inversely with the HRV fetal stress index ( r = −0.784; p = 0.021) in phase C and with HRV long‐term variability ( r = −0.677; p = 0.045) and short‐term variability ( r = −0.837; p = 0.005) in phase B. The number of neurological lesions did not correlate significantly with other markers of HRV. Conclusions Neural injury caused by severe hypoxia was associated with HRV changes; in particular, brainstem damage was associated with changes in fetal‐specific HRV markers.