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PubMed1982

Fetal heart rate acceleration: fetal movement ratio in the management of high-risk pregnancy.

The nonstress test (NST) was used as the primary tool in the management of 318 high-risk pregnancies. A simple and reliable method for interpreting the NST is obtained by dividing the total number of fetal heart rate accelerations associated with fetal movements by the total number of fetal movements. This is expressed as a percentage called the acceleration:fetal movement ratio. Fetuses at risk who were delivered within 7 days of the last NST from the basis of this report. The incidence of fetal distress and small-for-gestational-age infants was significantly higher (P less than .05) in 47 fetuses with an acceleration:fetal movement ratio below 10% than in the group with a ratio over 10%. Also, perinatal mortality was more common in this group. The advantages and limitations of applying this quantitative method of interpreting the NST to the management of high-risk pregnancies are discussed.

Female↗
PubMed1990

[Studies on cross correlation coefficient of fetal heart rate and fetal movement signals detected by ultrasonic Doppler fetal actocardiograph].

Cross correlation coefficients of fetal heart rate (FHR) and fetal movement (FM) signals detected by ultrasonic Doppler actocardiograph were studies. Actocardiographic output was stored in a floppy disk through an AD converter. The parameters for every 5 minute period were calculated in 461 periods for 68 normal pregnant women at 14 to 41 weeks of gestation. 1) Between FHR acceleration (ACC) and the maximum coefficient, the averages for the maximum coefficients in 5 minute periods without and with ACC were 0.141 and 0.275, respectively. The respective lag time averages were 13.1 and 7.6 seconds. These results may indicate that the FHR ACC temporarily follow FM with a time lag of several seconds in the active state. 2) The largest value for the maximum coefficients and the lag times in each examination were investigated according for each gestational week. The coefficients increased and the lag times decreased as gestation advanced. 3) The coefficients in the periods showing typical fetal breathing movement and fetal hiccups were very small. Periodic fetal suckling observed with real-time B mode showed large coefficient with a 3 sec' delay in FM.

Female↗
PubMed2002

Computerised intrapartum diagnosis of fetal hypoxia based on fetal heart rate monitoring and fetal pulse oximetry recordings utilising wavelet analysis and neural networks.

OBJECTIVE: To develop a computerised system that will assist the early diagnosis of fetal hypoxia and to investigate the relationship between the fetal heart rate variability and the fetal pulse oximetry recordings. DESIGN: Retrospective off-line analysis of cardiotocogram and FSpO2 recordings. SETTING: The Maternity Unit of the 2nd Department of Obstetrics and Gynaecology, Aretaieion Hospital, University of Athens. POPULATION: Sixty-one women of more than 37 weeks of gestation were monitored throughout labour. METHODS: Multiresolution wavelet analysis was applied in each 10-minute period of second stage of labour focussing on long term variability changes in different frequency ranges and statistical analysis was performed in the associated 10-minute FSpO2 recordings. Self-organising map neural network was used to categorise the different 10-minute fetal heart rate patterns and the associated 10-minute FSpO2 recordings. MAIN OUTCOME MEASURES: Umbilical artery pH of < or = 7.20 and Apgar score at 5 minutes of < or = 7 formed the inclusion criteria of the risk group. RESULTS: After using k-means clustering algorithm, the two-dimensional output layer of the self-organising map neural network was divided into three distinct clusters. All the cases that mapped in cluster 3 belonged in the risk group except one. The sensitivity of the system was 83.3% and the specificity 97.9% for the detection of risk group cases. CONCLUSIONS: A relationship between the fetal heart rate variability in different frequency ranges and the time in which FSpO2 is less than 30% was noticed. Fetal pulse oximetry seems to be an important additional source of information. Computerised analysis of the fetal heart rate monitoring and pulse oximetry recordings is a promising technique in objective intrapartum diagnosis of fetal hypoxia. Further evaluation of this technique is mandatory to evaluate its efficacy and reliability in interpreting fetal heart rate recordings.

Adult↗
PubMed1976

Fetal heart rate and fetal movements.

Fetal Heart Rate (F.H.R.) in association with fetal movement was evaluated in 141 normal and pathological pregnancies. In the normal cases only 31% showed an acceleration of F.H.R. in association with fetal movement. The majority of the normal cases, 62%, did not demonstrate changes in F.H.R. in association with fetal movement. In the pathological pregnancies there were no characteristic changes in F.H.R. associated with fetal movement. It appears that F.H.R. acceleration associated with fetal movement cannot be used as an index for fetal well being.

Female↗
PubMed1985

Fetal heart rate accelerations and fetal movements in twin pregnancies.

The rate of fetal heart rate accelerations associated with fetal movements to total fetal movements of twin pregnancies was found to be significantly lower than that of pregnancies with singleton infants. The number of fetal heart rate accelerations was similar. As fetal heart rate accelerations are reflective of fetal movements, the results indicate increased fetal activity in twins that is related to an additive effect of two normally active fetuses.

Female↗
PubMed1979

Intrapartum fetal heart rate monitoring. I. Classification and prognosis of fetal heart rate patterns.

A total of 1,996 direct fetal heart rate (FHR) tracings in labor were analyzed using the first and last 30 minutes of monitoring in order to evaluate individual FHR characteristics as to their ability to predict the fetal status. Comparisons were made between individual FHR characteristics occurring alone ("uncomplicated") and those occurring in association with others ("complicated") in predicting fetal status as judged by 1 and 5 minute Apgar scores. These comparisons were made separately for the first 30 minutes and the last 30 minutes of monitoring.

Apgar Score↗
PubMedDate not supplied

[Normalization of fetal heart rate and fetal blood pressure following reduction of uterine blood circulation].

UNLABELLED: To analyze the variability of fetal heart rate (FHR) after a temporary definite hypoxia, uterine blood flow (QUT) was totally reduced in 8 pregnant sheep. In 13 experiments the reduction lasted 60 sec and in 13 further experiments 180 sec. The normalization of FHR after reduction of QUT was compared with the change of fetal blood pressure (BP) and fetal oxygen saturation (SO2). RESULTS: During reduction of QUT the fall of FHR and the decrease of SO2 was significant (r = -0,43, 2 alpha less than 0,05). With the start of normalization there was a temporary correlation between the increase of FHR and the restauration of SO2 after 12-18 sec (r = 0,79, 2 alpha less than 0,001). Thus the initial rise of FHR might be caused by the chemoreceptors. Above all after longer reduction of QUT there were three typical reactions during the recovery period: increase of FHR and BP, short fall of FHR and BP and increase of FHR and continous fall of BP. The start of normalization of FHR after reduction of QUT depends on the restauration of SO2. Because of the variable FHR response it is not possible to describe the duration of the preceding hypoxia.

Animals↗
PubMed2002

[Predictive value of umbilical artery lactate levels and fetal heart rate monitoring for fetal distress].

OBJECTIVE: Measuring umbilical artery lactate levels to evaluating the predictive value of abnormal fetal heart rate (FHR) monitoring patterns for fetal distress. METHODS: There were 73 neonates with abnormal fetal heart monitoring patterns in the distress group. The abnormal patterns included abnormal baseline FHR, severe variable decelerations, mild variable decelerations and tachycardia. There were 118 normal neonates (Apgar score > or = 9) in the control group. Twenty min fetal heart monitoring was performed at the time of admitting, laboring and in labor and in active phase. Continuous fetal heart monitoring was performed during the second stage of labor. All neonatal umbilical artery lactate levels were measured at delivery. RESULTS: The rate of using forceps in distress group was significantly higher than that of the control (P < 0.01), the rate of spontaneous labor was significantly lower than the control group (P < 0.01). In the distress group, severe variable decelerations were generally emerged in the second stage of labor. The incidence of neonatal Apgar score < or = 7 in neonates with abnormal baseline FHR was higher than those with severe variable decelerations, mild variable decelerations and tachycardia (P < 0.05). As for neonatal umbilical artery lactate levels, the neonatatuses with abnormal baseline FHR was (4.55 +/- 0.23) mmol/L, the neonatatuses with severe variable decelerations was (3.84 +/- 0.40) mmol/L, all significantly higher than the control group's (P < 0.01). The neonatatuses with mild variable decelerations was (2.63 +/- 0.32) mmol/L, the neonatatuses with tachycardia was (2.55 +/- 0.46) mmol/L, and there are no significant differences between the neonatatuses with mild variable decelerations and tachycardia and the control group's (P > 0.05). CONCLUSIONS: Measuring umbilical artery lactate levels is an efficient and accurate technique for fetal distress diagnosis. There was a close correlation between baseline FHR with abnormal changes and severe variable deceleration with fetal distress. There was no certainly correlation between mild variable decelerations and tachycardia with fetal distress. It should be evaluated later.

Female↗
PubMed1987

Combined electronic fetal heart rate and fetal movement monitor--a preliminary report.

We have tested a new Doppler ultrasound apparatus which registers both fetal movements and fetal heart rate with a single transducer. To evaluate the reliability of the recognition of movements we also observed them simultaneously by real time ultrasound. In 20 patients with normal pregnancies between the 30th and 42nd week of gestation, taking the real time ultrasound as reference the positive predictive value was 0.93 and the sensitivity 0.94. Maternal hiccups or coughing were recorded as fetal movements. Neither gestational age, the amount of amniotic fluid or the position of the placenta influenced the recognition of movement; nor did fetal breathing, maternal breathing, speaking or laughing.

Female↗
PubMed1994

Hourly fetal urinary production rate and blood velocity waveforms in the fetal renal artery relative to fetal heart rate pattern and fetal eye movements in normal pregnancies at 30-32 weeks of gestation.

In 14 normal pregnancies at 30-32 weeks of gestation, bloodflow velocity waveforms in the fetal renal artery and fetal micturition were studied in relation to fetal heart rate pattern (FHRP) and fetal eye movements. PI in the fetal renal artery was significantly lower in the presence of FHRP-B and eye movements separately and in combination compared with FHRP-A and absent eye movements separately and in combination. Fetal urinary output was higher in the absence of fetal eye movements. There was an inverse relationship between renal artery PI and fetal heart rate. However, since mean fetal heart rate in the various state variables was not essentially different, no standardization for heart rate was necessary. No correlation existed between renal artery PI and fetal urinary production rate. It can be concluded that in the normal fetus at 30-32 weeks of gestation, renal artery PI demonstrates a significant reduction in the presence of FHRP-B and fetal eye movements separately and in combination, suggesting reduced downstream impedance at renal level. However, the decrease in fetal micturition in the presence of fetal eye movements, suggests that reduced urinary output is determined by changes in fetal central nervous system activity rather than by changes in fetal renal perfusion.

Adult↗
PubMed2004

Influence of gestational age and fetal heart rate on the fetal mechanical PR interval.

OBJECTIVE: The fetal mechanical PR interval obtained via pulsed Doppler has previously been demonstrated to correlate with electrocardiographic PR interval measured in the neonate. We sought to further analyze the influence of fetal heart rate and gestational age upon the fetal mechanical PR interval. METHODS: We searched our database for mechanical PR intervals, which were obtained during fetal echocardiography performed in our antenatal diagnostic unit. We included fetuses with a normal cardiac structural survey. The mechanical PR interval is measured from the A wave of the mitral valve to the beginning of ventricular systole corresponding to the opening of the aortic valve. Linear regression curves were generated to examine the correlation of mechanical PR interval with gestational age and fetal heart rate. Analysis of variance was used to compare the mean variation across three gestational age groups: 17-21.9 weeks (n = 24), 22-25.9 weeks (n = 52) and 26-38 weeks (n = 20). RESULTS: Mechanical PR intervals were measured in 96 fetuses with normal fetal echocardiography. The mechanical PR interval was 123.9 +/- 10.3 ms (mean +/- SD), with a range of 90-150 ms. Linear regression curves correlating mechanical PR interval with fetal heart rate and gestational age demonstrated a flat slope with R2 = 0.016, p = 0.22 and R2 = 0.0004, p = 0.85, respectively. The mechanical PR interval measured over the three gestational ages was as follows (mean +/- SD): 122.3 +/- 10.5 ms for 17-21.9 weeks; 125.0 +/- 9.6 ms for 22-25.9 weeks; and 123.1 +/- 11.9 ms for 26-38 weeks. Analysis of variance revealed no difference among the mechanical PR interval means measured over the three gestational age groups (p = 0.53). CONCLUSIONS: Fetal mechanical PR interval ranges from 90 to 150 ms in fetuses with sonographically normal fetal cardiac structure and rate. The mechanical PR interval appears to be independent of gestational age and fetal heart rate.

Echocardiography↗
PubMed1999

The effect of maternal hypothermia on the fetal heart rate.

Fetal bradycardia is a recognized response to maternal hypothermia but has not previously been reported in conjunction with diabetes. A 30-year-old insulin-dependent diabetic was admitted at 35 weeks gestation for control of her diabetes. She developed maternal hypothermia and hypoglycemia and the fetal heart rate fell to 100 beats per minute (b.p.m.). However, the fetal heart rate gradually returned to normal after rewarming the patient.

Adult↗
PubMed1984

Effect of intravenous glucose injection on human maternal and fetal heart rate at term.

The effects of maternal intravenous glucose administration (25 gm) on maternal heart rate, fetal heart rate, gross fetal body movements, and fetal heart rate accelerations was measured in 11 healthy pregnant women at 38 to 40 weeks' gestational age. Mean maternal heart rate increased from 78.3 +/- 0.8 bpm during the control period to 82.7 +/- 0.5 bpm at 30 to 85 minutes following glucose injections (p less than 0.01). Mean fetal heart rate rose from 137.8 +/- 0.4 bpm to 142.4 +/- 0.3 bpm at 50 to 95 minutes following injections (p less than 0.001). The incidence of gross fetal body movements and the number, duration, and amplitude of fetal heart rate accelerations did not change following glucose injection. We conclude that maternal glucose administration near term results in a small but significant increase in the mean maternal heart rate and fetal heart rate and no change in the incidence of gross fetal body movements or in fetal heart rate accelerations.

Blood Glucose↗
PubMed1991

Automated analysis of near-term antepartum fetal heart rate in relation to fetal behavioral states: the Sonicaid System 8000.

Fetal heart rate and fetal movements were recorded in 16 uncomplicated near-term pregnancies. The recordings were used to evaluate a system for automated fetal heart rate analysis (Sonicaid System 8000). Fetal rest-activity patterns were considered in the analysis. The mean duration of C2F periods "active sleep," 33 minutes) was significantly greater than that of C1F periods ("quiet sleep," 19 minutes) (p less than 0.001). The incidence of accelerations and decelerations and the overall fetal heart rate variations were greater during C2F than during C1F (p less than 0.001). In 11 of 16 C1F periods, the system classified the fetal heart rate variation as "questionable" or "abnormal." Episodes of high variation were identified in only 3 of 16 C1F periods, but they were found in all 18 C2F periods. Episodes of low variation were identified in 14 of the 16 C1F periods but were not found in any C2F periods. During C2F periods, the system's criteria of normality were met in all cases but one; they were not met during any of the C1F periods. Thus the diagnosis of fetal distress should not be based merely on the absence of accelerations, low fetal heart rate variation, or absence of episodes of high variation in recordings with a duration of less than 45 minutes.

Diagnosis, Computer-Assisted↗
PubMed1985

Effect of maternal intravenous glucose administration on fetal heart rate patterns and fetal breathing.

This study was undertaken to evaluate the effect of maternal intravenous (IV) administration of glucose on fetal breathing and its associated fetal heart patterns. Sixteen healthy women at term gestation participated in the study. The outcome of each of the pregnancies was normal. Fetal breathing and fetal electrocardiograms were simultaneously recorded by real time sonography and a fetal monitor respectively, and then digitized into a microcomputer. These women were studied for a 25-minute control period, given 50 gm of glucose IV and then, 20 minutes later, restudied for an additional 25-minute period. The results indicate that fetal breathing movements lasted for 24.8 +/- 6.2 percent of the time during the control period (mean +/- SEM) and were increased to 63.2 +/- 11.5 percent following the injection of glucose (P less than 0.01). Fetal heart rate decreased during fetal breathing by 2.3 and 2.1 beats per minute, before and after glucose administration, respectively (NS). Fetal breathing was associated with increased beat-to-beat variability by 1.32 +/- 0.5 and 1.27 +/- 0.3, before and after glucose administration, respectively (NS). This study confirms previous reports that the amount of time the fetus spends making breathing movements is significantly increased following maternal glucose administration, and demonstrates that the injection of glucose does not alter the modulation of fetal heart rate and beat-to-beat variability by fetal breathing.

Clinical Trials as Topic↗
PubMed1979

Echocardiography and fetal heart sounds in the diagnosis of fetal heart block.

A 32-week fetus was demonstrated phonocardiographically and echocardiographically to have a regular atrial rate of 150 per minute and a regular ventricular rate of 39 per minute, indicating complete heart block. The diagnosis was suspected when two groups of heart sounds at two distinct rates were heard on auscultation, and was confirmed by the postnatal ECG. The maternal history was significant for the presence of systemic lupus erythematosus. The basis for the echocardiographic diatnosis of complete heart block, the presence of atrial heart sounds in complete heart block, and the relationship of maternal SLE to congenital heart block are discussed.

Adult↗
PubMed2000

[Ultrasonographically normal fetal heart].

The fetal heart must be systematically checked in routine ultrasonographic examination to detect any cardiac abnormality. The quality of the examination requires good knowledge of development and anatomy of the fetal heart. A complete examination will study inflow and outflow tracts: inflow tract on the four-chamber view, outflow tract by a static and dynamic study of the great arteries (on section in fetal axial and saggital planes). All cardiac abnormalities indicate the need for a fetal karyotype after a complete morphologic study. Atrioventricular septal defect (ASD) for Down's syndrome and malaligment septal defect of cono-truncal pathology are both excellent signs of chromosome abnormality. Special attention must be paid to cardiac abnormalities without a prenatal diagnosis due to the prognosis risk: complete transposition and total abomalous venous connection. These cardiac abnormalities, as well as complex isolated congenital heart disease, require a cardiopediatric evaluation to determine prognosis and management strategy.

Echocardiography↗
PubMed1980

A proposed international scoring system for predicting fetal status derived from fetal heart rate patterns: compatible with current tests. (The fetal heart rate response as an aid in predicting perinatal status).

Fetal response is measured from the reaction shown in the FHR pattern. This response can be predictive of fetal health. Testing the response can be started usefully after 30 weeks of amenorrhea. Repeat testing every 3 weeks may be helpful. In high risk cases and those with medical complications testing once or twice a week may be required. There is a need for adoption of an international scoring system of the fetal response, based on percentages. Such a system is presented consisting of 10 parameters.

Animals↗