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Fetal autonomic response to severe acidaemia during labour
Author(s) -
van Laar JOEH,
Peters CHL,
Vullings R,
Houterman S,
Bergmans JWM,
Oei SG
Publication year - 2010
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2009.02456.x
Subject(s) - fetal distress , fetus , medicine , heart rate , heart rate variability , autonomic nervous system , umbilical artery , fetal heart rate , cardiology , population , anesthesia , obstetrics , pregnancy , blood pressure , biology , genetics , environmental health
Please cite this paper as: van Laar J, Peters C, Vullings R, Houterman S, Bergmans J, Oei S. Fetal autonomic response to severe acidaemia during labour. BJOG 2010;117:429–437. Objective Spectral analysis of heart‐rate variability is used to monitor autonomic nervous system fluctuations. The low‐frequency component is associated with sympathetic and parasympathetic modulation and the high‐frequency component is associated with parasympathetic modulation. The objective was to study whether changes in low‐frequency or high‐frequency power of heart‐rate variability occur in case of fetal distress. Design Case–control study. Setting Obstetric unit of a tertiary‐care teaching hospital. Population Twenty healthy human fetuses during labour at term of which ten had an umbilical artery pH < 7.05 (cases), and ten had an arterial pH > 7.20 (controls) after birth. Methods Spectral information about fetal beat‐to‐beat heart rate, calculated from direct fetal electrocardiogram registrations, was obtained by using a short‐time Fourier transform. Main outcome measures Absolute power and normalised power in the low‐frequency and high‐frequency bands. Results No differences were found between fetuses with and without acidaemia in absolute low or high frequency power ( P = 0.2 and P = 0.3, respectively). During the last 30 minutes of labour, acidaemic fetuses had significantly increased normalised low‐frequency power ( P = 0.01) and decreased normalised high‐frequency power ( P = 0.03) compared with non‐acidaemic fetuses. These differences were not observed from 3 to 2 hours before birth ( P = 0.7 and P = 0.9, respectively). Conclusion The autonomic nervous system of human fetuses at term responds adequately to severe stress during labour. Normalised low and high frequency power of heart‐rate variability might be able to discriminate between normal and abnormal fetal condition.