Average acceleration and deceleration capacity of fetal heart rate in normal pregnancy and in pregnancies complicated by fetal growth restriction

Graatsma, E M; Mulder, E.J.H.; Vasak, Blanka; Lobmaier, Silvia M.; Steinburg, S Pildner von; Schneider, K. T. M.; Schmidt, Georg; Visser, Gerard H.A.

doi:10.3109/14767058.2012.704446

Cited by 53 publications

(65 citation statements)

References 17 publications

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“…Dawes et al [17] defined a recording as sufficient for short-and long-term variability measurement if the recording had a high recording quality of ≥ 60%. First attempts to investigate fHRV by short-term variation using abdominal fECG were recently conducted in overnight recordings [18][19][20] . A new signal-processing technique, phase-rectified signal averaging, was used to minimize noise by averaging signals.…”

Section: Discussionmentioning

confidence: 99%

Quality Predictors of Abdominal Fetal Electrocardiography Recording in Antenatal Ambulatory and Bedside Settings

Huhn¹,

Müller

Meyer

et al. 2016

Fetal Diagn Ther

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Background: Fetal electrocardiography using an abdominal monitor (Monica AN24™) could increase the diagnostic use of fetal heart rate (fHR) variability measurements. However, signal quality may depend on factors such as maternal physical activity, posture, and bedside versus ambulatory setting. Methods: Sixty-three healthy women wore the monitor at home and 42 women during a hospital stay. All women underwent a posture experiment, and all home and 13 hospital participants wore the monitor during daytime and nighttime. The success rate (SR) of fHR detection was analyzed in relation to maternal physical activity, posture, daytime versus nighttime, and other maternal and fetal predictors. Results: Ambulatorily, the SR was 86.8% for nighttime and 40.2% for daytime. The low daytime SR was largely due to effects of maternal physical activity and posture. The in-hospital SR was lower during nighttime (71.1%) and similar during daytime (43.3%). SR was related to gestational age, but not affected by pre-pregnancy and current body mass index or fetal growth restriction. Conclusions: The success of beat-to-beat fHR detection strongly depends on the home/hospital setting and predictors such as time of recording, activity levels, and maternal posture. Its clinical utility may be limited in periods of unsupervised recording with physical activity or posture shifts.

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Section: Discussionmentioning

confidence: 99%

Quality Predictors of Abdominal Fetal Electrocardiography Recording in Antenatal Ambulatory and Bedside Settings

Huhn¹,

Müller

Meyer

et al. 2016

Fetal Diagn Ther

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show abstract

“…A decline in fetal HRV is thought to indicate fetal compromise. Several studies have shown reduced HRV in growth-restricted fetuses compared to AGA peers, indicating that these fetuses are compromised by the unfavorable intrauterine environment (59)(60)(61)(62). Moreover, lowered HRV has been clearly associated with fetal acidemia and hypoxia (63).…”

Section: Hrv In Growth-restricted Fetuses and Infantsmentioning

confidence: 99%

Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy

et al. 2016

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Intrauterine growth restriction (IUGR) refers to the situation where a fetus does not grow according to its genetic growth potential. One of the main causes of IUGR is uteroplacental vascular insufficiency. Under these circumstances of chronic oxygen and nutrient deprivation, the growth-restricted fetus often displays typical circulatory changes, which in part represent adaptations to the suboptimal intrauterine environment. These fetal adaptations aim to preserve oxygen and nutrient supply to vital organs such as the brain, the heart, and the adrenals. These prenatal circulatory adaptations are thought to lead to an altered development of the cardiovascular system and "program" the fetus for life long cardiovascular morbidities. In this review, we discuss the alterations to cardiovascular structure, function, and control that have been observed in growth-restricted fetuses, neonates, and infants following uteroplacental vascular insufficiency. We also discuss the current knowledge on early life surveillance and interventions to prevent progression into chronic disease. Intrauterine growth restriction (IUGR) refers to the situation where a fetus does not grow according to its genetic growth potential. The main cause of IUGR in developed countries is uteroplacental vascular insufficiency (1), which drives the fetus to redistribute its cardiac output to preserve oxygen and nutrient supply to the brain, heart, and adrenals. Although these adaptive circulatory changes are beneficial during intrauterine life, they are thought to cause dysfunctional development of the cardiovascular system and "program" the fetus for life long cardiovascular morbidities (2). This is also known as the Developmental Origins of Health and Disease hypothesis, which postulates that insults during intrauterine and early postnatal development can permanently change the body's structure, function, and metabolism and influence susceptibility to adult noncommunicable diseases (2). Despite their increased risk of cardiovascular disease, infants born growth restricted usually do not receive long-term cardiovascular follow-up. Depending on the definition used, IUGR can occur in up to 10% of pregnancies, and as cardiovascular disease is the number one cause of death worldwide (3), early identification of cardiovascular risk factors and targeted interventions in this high-risk population are of major clinical importance. In this review, we discuss the alterations of cardiovascular structure, function, and control that have been observed in infants born growth restricted and their implications for surveillance and intervention to prevent progression into chronic disease. CHALLENGES IN IDENTIFYING IUGRThe current literature uses many different definitions of IUGR, which may explain some of the contradicting findings discussed in this review. Traditionally, and most commonly, IUGR is defined as a birth weight below the 10th percentile for gestational age on the normative population growth curve (4). This definition, however, merely describes those who ...

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“…A gradual reduction of fetal sympatho-vagal balance in the last trimester of healthy pregnancy was previously showed (21,22,23). The increased parasympathetic regulation was a sign of the fetal maturation in the late gestation.…”

Section: Discussionmentioning

confidence: 74%

The Autonomic Repercussions of Fetal and Maternal Interaction in Pre-eclampsia

Лахно

2017

Serbian Journal of Experimental and Clinical Research

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Average acceleration and deceleration capacity of fetal heart rate in normal pregnancy and in pregnancies complicated by fetal growth restriction

Abstract: Analysis of the AAC and ADC as recorded with a high resolution fECG recorder may differentiate better between normal and SFD fetuses than STV.

Cited by 53 publications

References 17 publications

Quality Predictors of Abdominal Fetal Electrocardiography Recording in Antenatal Ambulatory and Bedside Settings

Quality Predictors of Abdominal Fetal Electrocardiography Recording in Antenatal Ambulatory and Bedside Settings

Intrauterine growth restriction: impact on cardiovascular development and function throughout infancy

The Autonomic Repercussions of Fetal and Maternal Interaction in Pre-eclampsia

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