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At least 19 recordsLinked to original sources
PubMed1991

Troponin T isoform expression in humans. A comparison among normal and failing adult heart, fetal heart, and adult and fetal skeletal muscle.

The expression of troponin (Tn) T, a thin-filament regulatory protein, was examined in left ventricular myocardium from normal and from failing adult human hearts. The differences in isoform expression between normal and failing myocardium led us to examine the ontogenic expression of TnT in human striated muscle. Left ventricular samples were obtained from patients with severe heart failure undergoing cardiac transplantation and normal adult organ donors. Fetal muscle was obtained from aborted fetuses after 14-15 weeks of gestation, and adult skeletal muscle was obtained from surgical biopsies. Western blots of normal and failing adult heart proteins demonstrated that two isoforms, TnT1 and TnT2, are expressed in different amounts, with TnT2 being significantly greater in failing hearts (p less than 0.004). Western blots of two-dimensional gels of these proteins resolved two predominant spots of both TnT1 and TnT2 and several minor TnT species. Alkaline phosphatase treatment converted the two major spots of each isoform into the single more basic spots. A comparison of the ATPase activities and the TnT2 percentage of total TnT in individual failing and normal adult hearts demonstrated an inverse and negative relation (r = 0.7, p less than 0.02). In the fetal heart, four TnT isoforms were found, two of which had the same electrophoretic mobilities as the adult cardiac isoforms TnT1 and TnT2. Fetal skeletal muscle expressed two of the four fetal cardiac TnT isoforms, one of which comigrated with adult cardiac TnT1. These cardiac isoforms were expressed in low abundance in fetal skeletal muscle relative to seven fast skeletal muscle TnT isoforms. No cardiac isoforms were present in adult skeletal muscle. Because many etiologies caused heart failure in the transplant patients, we propose that the disease-associated increased expression of the TnT isoform TnT2 is an adaptation to the heart failure state and a partial recapitulation of the fetal expression of cardiac TnT isoforms.

Adult↗
PubMed1986

The relationship between antepartum fetal heart rate, intrapartum fetal heart rate, and fetal acid-base status.

The relationships between antepartum baseline fetal heart rate, baseline variability, accelerations, decelerations, and fetal movement and intrapartum fetal heart rate, fetal acid-base assessment at delivery, and Apgar scores 1 and 5 minutes after delivery were studied in 290 mature pregnancies. There was a significant relationship between antepartum and intrapartum baseline fetal heart rate and baseline variability. There was no relationship between antepartum and intrapartum accelerations or decelerations. There was no correlation between antepartum fetal heart rate or fetal movement and fetal acid-base status at delivery or Apgar scores 1 and 5 minutes after delivery. There was a trend for decreased accelerations and decreased fetal movements to be associated with a low Apgar score 1 minute after delivery.

Acid-Base Equilibrium↗
PubMed1977

The effect of lumbar epidural analgesia on the fetal heart.

Fetal heart rate was monitored by continuous cardiotocography in 67 patients who were subjected to standard epidural block. In 43% of cases a deterioration in the fetal heart rate pattern was observed. The abnormal heart rate usually responded to conservative treatment. In 3 cases caesarean section was necessary. The deterioration of the fetal heart rate was usually associated with maternal hypotension.

Anesthesia, Epidural↗
PubMed1994

Amniotic sac, fetal heart area, fetal curvature, and other morphometrics using first trimester vaginal ultrasonography and color Doppler imaging.

Ultrasonographic morphometric measurements were obtained with transvaginal ultrasonography from 121 patients with first trimester singleton pregnancies. Amniotic and gestational sac diameters, fetal heart area, and fetal length increased in a linear rate relative to crown-rump length, whereas the amniotic and gestational sac volumes increased at an exponential rate. The yolk sac exhibited a biphasic growth pattern with a peak at a crown-rump length of 3.5 cm. The ratio of crown-rump length to anteroposterior dimension increased over the first trimester, suggesting less curvature in older fetuses. In conclusion, vaginal ultrasonography permits accurate measurement of many new morphometric parameters.

Amnion↗
PubMed1981

Antepartum fetal heart rate monitoring. III. Fetal movements and accelerations in fetal heart rate.

This third part of the paper deals with the study of the relationships between fetal movements, fetal heart rate accelerations associated with such movements, fetal heart rate instability and neonatal outcome. No correlations has been found between absence of fetal movements and neonatal distress. A correlation has been found between the lack of fetal heart rate accelerations, the flatness of the record and poor neonatal outcome. In extreme situations (i.e. flatness in less than 10% of the record or in more than 80%) the presence or absence of accelerations does not add further useful information. Such information, however, is gained in the intermediary situations (the 'combined' recordings) and particularly when the record is between 51 and 80% flat where there appears to be an 85.6% risk to the fetus. Consequently, when trying to analyse an antenatal record it seems advisable to take primarily into account the percentage of flat recordings (providing the records are numerous enough and of sufficient length). Then, in records between 10 and 50% flat, the presence or the lack of spontaneous decelerations requires consideration whereas, when the record is between 51 and 80% flat, it is the presence or absence of fetal heart rate accelerations which is important.

Apgar Score↗
PubMed2001

Doppler echocardiographic studies of diastolic cardiac function in the human fetal heart.

Fetal echocardiography has been used for the noninvasive evaluation of human fetal cardiac anatomy, function, and hemodynamics. The purpose of the present study was to use Doppler echocardiographic methods to measure diastolic flow velocity patterns across the tricuspid and mitral valves in human fetuses during gestation. Fifty normal fetuses, 35 fetuses with intrauterine growth retardation (IUGR), and 30 fetuses of diabetic mothers (DM) were studied. Peak flow velocities during early diastole (peak E wave) and peak flow velocities during atrial contraction (peak A wave) were measured, and the peak E/A ratio was calculated. The peak E/A ratio of the left ventricle in fetuses increased gradually with increasing gestational age (r = 0.57, p < 0.05), and the peak E/A ratio of the right ventricle in fetuses increased linearly with increasing gestational age (r = 0.48, p < 0.05). In early gestational age, the peak E/A ratios of both the left and right ventricle in fetuses with IUGR and of DM were not significantly different from those in the controls. However, in late gestational age, the peak E/A ratios of both the left and right ventricle in fetuses with IUGR and of DM were significantly smaller than those in the controls. This gradual decrease in the peak E/A ratio during gestation may represent the maturational or developmental alteration of diastolic cardiac properties in utero. Fetuses with IUGR and of DM may have abnormal diastolic cardiac function in later gestation.

Diastole↗
PubMed1988

Fetal heart rate and fetal activity patterns after vibratory acoustic stimulation at thirty to thirty-two weeks' gestational age.

Twenty pregnant women between 30 and 32 weeks' gestational age were studied to examine the effects of a 5-second external vibratory acoustic stimulus on the fetal heart rate, fetal heart rate variability, and fetal activity patterns. There was an immediate significant increase in the basal fetal heart rate for 10 minutes compared with controls. There was also a significant increase in the mean duration of fetal heart rate accelerations without any change in the number of fetal heart rate accelerations. There were no changes in long-term fetal heart rate variability, fetal breathing, and gross fetal body movements.

Acoustic Stimulation↗
PubMed1981

Intrapartum fetal heart rate monitoring. V. Fetal heart rate patterns in the second stage of labor.

A total of 1,755 fetal heart rate (FHR) tracings of the second stage of labor was analyzed. The FHR patterns were classified according to the behavior of the baseline FHR and are listed in decreasing order of benignity: normocardia, transitory bradycardia, tachycardia, persistent bradycardia, and progressive bradycardia. Each category was further subdivided into four groups on the basis of association or nonassociation with early, variable, or late decelerations. Cord compression pattern were noted in over 50% of the FHR tracings and account for the majority of low Apgar scores and fetal acidosis. FHR abnormalities occurred in 91% of second-stage labor patterns, and were mild in most cases or of too short duration to influence fetal outcome. An effort was made to establish therapeutic guidelines based on the morphologic features, prognostic grading, and the etiology of the FHR patterns in the second stage of labor.

Bradycardia↗
PubMed1992

Fetal heart rate accelerations, fetal movement, and fetal behavior patterns in twin gestations.

OBJECTIVE: Previous studies have shown that twins, when monitored simultaneously, show a remarkably high incidence of coincident fetal heart rate accelerations (about 58%). The current study examines synchrony of behavior patterns in twins. STUDY DESIGN: We examined 37 fetal monitor strips from 15 sets of twins with simultaneous fetal heart rate and fetal movement recorded by means of Doppler techniques (Toitu MT-430 fetal actocardiograph). The strips were analyzed for coincidence of fetal heart rate accelerations and fetal movement episodes and then conceptually for synchrony of fetal behavior patterns on the basis of descriptions of behavioral states by Prechtl. RESULTS: Thirty-six percent of fetal heart rate accelerations were found to be simultaneous. Forty-three percent of movement epochs were considered simultaneous. We found that twins exhibited synchronous behavior patterns (basically sleep or awake state) 94.7% of the time. CONCLUSION: Twin-twin interactions are more consistently related than suspected when observation is limited to heart rate alone, and the synchrony and role of fetal behavior states must be considered when twin interactions and behavior are studied.

Adult↗
PubMed1991

The effect of short-term heat stress on uterine contractility, fetal heart rate and fetal movements at late pregnancy.

The effects of short-term, moderate heat stress (20 min, 70 degrees C) on uterine contractility, fetal heart rate and fetal movements were investigated in 23 healthy subjects 36 to 37 weeks pregnant. The thermal stress caused minimal uterine contractility in five subjects but did not induce labor. Fetal heart rate increased from 146 beats per minute to a maximum of 157 beats per minute (P less than 0.05) by 10 min after termination of thermal stress. Fetal movements increased from 2.3 per minute to 4.9 per minute 35 minutes after heat stress (P less than 0.05). Throughout the experiment fetal heart rate variability remained normal but in four cases the tracings were temporarily non-reactive during or after the heat stress. The newborn infants were all in good condition at delivery which, generally, took place at the estimated time of delivery. The results suggest that moderate thermal stress does not induce regular uterine contractility nor is it harmful to the fetus at late pregnancy.

Adult↗
PubMed1979

Antepartum fetal heart rate testing. II. Intrapartum fetal heart rate observation and newborn outcome following a positive contraction stress test.

The positive contraction stress test (CST) has been looked upon as a predictor of fetal compromise. On this basis, some reports advise routine cesarean delivery on the assumption that the compromised fetus should not tolerate labor. Other authors advocate selective cesarean delivery, based on obstetrical factors such as the inducibility of the cervix and the practicality of fetal monitoring. Finally, an attempted trial of labor may be allowed on the basis of occurrence of fetal heart rate acceleration with fetal movement, or "reactivity." The occurrence of "false positive" tests is not infrequent (20 to 45 per cent). The definition of such is unclear and little quantitative information regarding intrapartum performance is available. In this series of 27 patients, a trial of labor was undertaken in 20. Vaginal delivery occurred in 11 (55 per cent) and cesarean section in nine (45 per cent). Fetal heart rate abnormalities thought to indicate "distress" occurred in five patients (25 per cent). The "positive" window or repetitive late deceleration as equivalent to the positive CST was seen in only three patients during labor. A trial of labor should be attempted in the face of a positive CST whenever obstetric factors are favorable and careful intrapartum monitoring can be performed.

Apgar Score↗
PubMed1992

Vibro-acoustic stimulation in high-risk pregnancies; maternal perception of fetal movements, fetal heart rate and fetal outcome.

Maternal perception of fetal movement in response to vibro-acoustic stimulation was compared with antenatal fetal heart rate monitoring as a test of fetal well-being in a population of gravidae with high-risk pregnancies (n = 517), admitted to the high-risk ward at Danderyd Hospital, Karolinska Institutet; a total of 2,015 tests were performed. The sensitivity and the specificity of the test compared to the fetal heart rate tracing was 81% and 89% respectively. If the test was performed within 24 hours of delivery, its predictive value for fetal asphyxia (i.e. a 5-minute Apgar score < 7) was 14% (7/49). Ten per cent of the patients felt no fetal movement in response to stimulation (irrespective of gestational age). In five cases where fetal heart rate tracings were pathological, stimulation nonetheless produced fetal movement and fetal outcome was good. Pathological heart rate tracings and no fetal movement in response to stimulation were present in 30 cases (out of 251 with no fetal movements at stimulation), in seven of which the infants had 5-minute Apgar scores < 7. Although many patients underwent repeated vibro-acoustic stimulation, there was no evidence of fetal habituation to the test. On 24 occasions (i.e. 1.2%), the patient denied vibro-acoustic stimulation, mostly because of previous discomfort due to vigorous fetal response. Where resources are limited, maternal perception of fetal movements in response to vibro-acoustic stimulation might be a useful alternative for preliminary screening of high-risk pregnancies.

Acoustic Stimulation↗