The Insight into Obstetric Care near the Front Line in Kharkiv

Лахно, И. В.

doi:10.15388/amed.2022.29.2.10

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…Тому необхідним є пошук альтернативних недорогих методів діагностики ЗРП і моніторингу стану плода. Це особливо важливо в умовах гуманітарної кризи, що виникла внаслідок широкомасштабної агресії росії [8].…”

Section: The Value Of Some Indices Of Heart Rate Variability In the D...unclassified

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Lakhno,

Martynenko,

Raimondi

et al. 2023

RHW

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Fetal growth retardation (FGR) is one of the most serious problems in current perinatology. This pathology leads not only to the deterioration of perinatal outcomes but also significantly increases morbidity during adult life. FGR is known to be featured by its delayed “neurological maturation”. This is manifested in a decrease in autonomic nervous regulation according to the fetal heart rate variability (HRV) scores and indices. The objective: to study HRV in fetuses with normal biometric indices compared to similar parameters of growth retarded fetuses. Materials and methods. The 47 pregnant women who had fetuses with normal biometric indices (I group) and 33 patients with fetal growth retardation (II group) were included in the study. The investigation of the fetal HRV was performed by processing the R–R intervals obtained via non-invasive electrocardiogram (ECG) and involved the following indices: STV (short term variations), LTV (long term variations), AC/DC (acceleration capacity/deceleration capacity), TP (total power), SI (stress index), SDNN (standard deviation of normal to normal intervals), EnRE (entropy of the time series), D2 (correlation dimension of the time series), Z (temporary irreversibility) і FL (measure of fuzzy logic, integrated measure of HRV). Results. The obtained data indicated that the indices of fetal HRV were reduced in the patients with FGR. These indices have utility in screening programs for the detection of fetal intrauterine nutrition and growth disturbances. The results of the study allow us to believe that the ability to accelerate heart rate patterns is partly preserved even during FGR. This may indicate a very ancient phylogenetic nature of the reaction of the heart system of the fetus to its motile activity. However, decelerations according to the DC were typical for FGR. A non-invasive fetal ECG could become a useful supplementary method in the current methods’ spectrum used in perinatal medicine. Conclusions. Therefore, the development of algorithms for the diagnosis of FGR requires the inclusion of the following HRV indices: STV, LTV, DC, TP, SI, SDNN, D2, Z, and FL. These biophysical markers of FGR can be used as a screening program in conditions of lack of access to high-quality ultrasound diagnostics or be a valuable addition to existing perinatal strategies.

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Section: The Value Of Some Indices Of Heart Rate Variability In the D...unclassified

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Lakhno,

Martynenko,

Raimondi

et al. 2023

RHW

View full text Add to dashboard Cite

show abstract

“…Ультразвукова апаратура, яка використовується для таких досліджень, є дуже дорогою, а підготовка кваліфікованого спеціаліста займає тривалий час. Це особливо важливо в умовах гуманітарної криhttps://emergency.zaslavsky.com.ua Оригінальні дослідження / Original Researches зи, яка виникла в Україні на тлі вторгнення російських військ [4]. Отже, пошук недорогих неінвазивних методів дослідження стану плода і діагностики відхилень у його розвитку є дуже актуальним.…”

Section: вступunclassified

Prospects for the study of some electrophysiological parameters in the diagnosis of fetal growth restriction

Lakhno,

Martynenko,

Raimondi

et al. 2023

ЕМ

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Background. Fetal growth restriction is a clinical syndrome that has adverse effects on both perinatal outcomes and human health in adulthood. Traditional approaches to the diagnosis of this syndrome are based on ultrasound biometry and dopplerometry of uteroplacental and fetal-umbilical blood flow. The equipment used for such research is very expensive, and the training of a qualified specialist takes a long time. Non-invasive electrocardiography makes it possible to evaluate fetal heart rate variability and morphological parameters of the pQRST complex. The purpose: to determine indices of heart rate variability and morphological parameters based on the data of fetal non-invasive electrocardiography, which can be used to diagnose fetal growth restriction. Materials and methods. Two hundred and twenty pregnant women aged 18 to 40 years on 24–41 weeks of gestation were enrolled in the study. All of them were divided into two groups: 108 women with fetal growth restriction were included in group I, and 112 patients with healthy fetuses in group II. The fetal electrocardiogram was recorded in abdominal lead for 30–60 minutes. Results. The performed work made it possible to detect statistically significant changes in some indices of heart rate variability on the background of fetal growth restriction: SI, TP, AC/DC, LF, LF/HF ratio, as well as morphological parameters: QTc duration, QRS complex width and T/QRS ratio. The obtained data demonstrated a violation of autonomic regulation following fetal growth restriction and reflected the tension of regulatory systems, namely, the degree of dominance of the activity of central regulatory mechanisms over autonomous ones. Impaired de- and repolarization processes were a consequence of fetal myocardium remodeling due to ischemia. Conclusions. The development of algorithms for the diagnosis of fetal growth restriction using non-invasive electrocardiography requires further research of the following parameters: SI, TP, AC/DC, LF, LF/HF ratio, QTc duration, QRS complex width, and T/QRS ratio.

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On the relationship between fetal growth parameters and heart rate variability

Lakhno

2024

Preprint

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Background: Fetal growth restriction (FGR) is a challenging pathology causing short and long-term complications. Autonomic malfunction and delayed neurological maturation were found in growth-retarded fetuses. Fetal heart rate variability (HRV) is critically dependent on autonomic regulation. The study was focused on the detection of the relationship between neonatal biometry parameters and HRV variables. Methods: This descriptive cross-sectional study was performed among 40 pregnant women at 22-36 weeks of gestation. FGR was detected in 9 women. The fetal growth was appropriate in 31 patients. The fetal were obtained from an RR-interval time series registered from the maternal abdominal wall via fetal non-invasive electrocardiography (NI-ECG). The stress index (SI) was selected for evaluation among all linear HRV variables. The following conventional cardiotocographic parameters were determined: short-term variation (STV) and long-term variation (LTV). The variables of AC (acceleration capacity) and DC (deceleration capacity) were also detected. Results: The study's findings showed that the detected variables in the FGR were different. However, the small number of cases did not allow statistical significance to proceed. A strong linear correlation was detected between all checked variables of HRV: AC, DC, SI, STV, and LTV. AC and DC demonstrated a significant correlation between them and Apgar score. The results of the multivariate regression model with SI showed a statistically significant relationship with a term of birth and a tendency to have a statistically significant relationship with body weight and head circumference. This suggests that this temporal HRV index may be associated with the anthropometric parameters of newborns. The receiver operating characteristic analysis could be the next stage for the investigation of efficient diagnostic algorithms based on fetal NI-ECG. Conclusions: SI could have utility as a screening program based on fetal NI-ECG in case of a lack of access to high-quality ultrasound or be a valuable addition to existing perinatal strategies.

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The Insight into Obstetric Care near the Front Line in Kharkiv

Cited by 6 publications

References 34 publications

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

The value of some indices of heart rate variability in the diagnosis of fetal growth retardation

Prospects for the study of some electrophysiological parameters in the diagnosis of fetal growth restriction

On the relationship between fetal growth parameters and heart rate variability

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