The intrapartum deceleration in center stage: a physiologic approach to the interpretation of fetal heart rate changes in labor

Westgate, Jenny A.; Wibbens, Bert; Wassink, Guido; Parer, Julian T.; Gunn, Alistair J.

doi:10.1016/j.ajog.2007.03.063

Cited by 111 publications

(118 citation statements)

References 92 publications

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“…We assume that the sympathetic and vagal activities in system are mutually inhibitory and mediated via the chemoreceptors and baroreceptors (see Eqs. 50 and 51), which is consistent with physiological explanations (Westgate et al 2007). …”

Section: Afferent/efferent Pathwayssupporting

confidence: 79%

“…In our model, it is assumed that the sympathetic and vagal activities are mutually inhibitory and mediated via baro-and chemoreceptors (Eqs. 50, 51) (Westgate et al 2007). FHR does not change markedly when these mechanisms are blocked (van der Hout-van der Jagt et al 2013).…”

Section: Model Calibration: Baseline Values and Sensitivity Analysismentioning

confidence: 99%

“…The sudden compression of the umbilical cord leads to fetal hypertension and fetal heart rate (FHR) decelerations, which are mediated through chemoreflex and sympathetic stimulation (Low et al 1995;Westgate et al 1999;Bennet et al 2005). Fetal oxygen delivery via the umbilical cord is interrupted and leads to hypoxemia and acute cerebral hypoxia (Mallard et al 1995;Koos et al 1995;Bishai et al 2003;Hunter et al 2003;Westgate et al 2007;Thakor and Giussani 2008). In addition, FHR reduction and oxygen deficiency also activate sympathetic and parasympathetic brainstem centers resulting in changes of afferent and threshold efferent firing rates (Frasch et al 2009a(Frasch et al , 2012.…”

mentioning

confidence: 99%

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Mathematical Model of Cardiovascular and Metabolic Responses to Umbilical Cord Occlusions in Fetal Sheep

et al. 2015

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Fetal acidemia during labor is associated with an increased risk of brain injury and lasting neurological deficits. This is in part due to the repetitive occlusions of the umbilical cord (UCO) induced by uterine contractions. Whereas fetal heart rate (FHR) monitoring is widely used clinically, it fails to detect fetal acidemia. Hence, new approaches are needed for early detection of fetal acidemia during labor. We built a mathematical model of the UCO effects on FHR, mean arterial blood pressure (MABP), oxygenation and metabolism. Mimicking fetal experiments, our in silico model reproduces salient features of experimentally observed fetal cardiovascular and metabolic behavior including FHR overshoot, gradual MABP decrease and mixed metabolic and respiratory acidemia during UCO. Combined with statistical analysis, our model provides valuable insight into the labor-like fetal distress and guidance for refining FHR monitoring algorithms to improve detection of fetal acidemia and cardiovascular decompensation.

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Section: Afferent/efferent Pathwayssupporting

confidence: 79%

Section: Model Calibration: Baseline Values and Sensitivity Analysismentioning

confidence: 99%

mentioning

confidence: 99%

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Mathematical Model of Cardiovascular and Metabolic Responses to Umbilical Cord Occlusions in Fetal Sheep

et al. 2015

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“…[55,62,75]. Ограничивает примене-ние исследования отсутствие соответствующего технического навыка персонала и необходимость проведения неоднократных исследований [73]. Учитывая недостатки рН-метрии было предложе-но оценивать уровень лактата.…”

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“…Определение актуальной рН, как и определение лактата оказались одинако-во эффективны. Не было выявлено значимых раз-личий в частоте оперативных родоразрешений, оценке по шкале апгар и необходимости наблю-дении новорожденного в отделениях интенсивной терапии [73]. схожие результаты были получены L. Nordstrom [57], R. Rahman et al [60].…”

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Complex research of the functional status of fetal in labour

Kucherjavyy

2014

Z.akus.zen.bolezn

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Intermittent auscultation (IA) of fetal heart rate in labour for fetal well-being

Martis

Emilia

Nurdiati

et al. 2017

Cochrane Database of Systematic Reviews

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The intrapartum deceleration in center stage: a physiologic approach to the interpretation of fetal heart rate changes in labor

Cited by 111 publications

References 92 publications

Mathematical Model of Cardiovascular and Metabolic Responses to Umbilical Cord Occlusions in Fetal Sheep

Mathematical Model of Cardiovascular and Metabolic Responses to Umbilical Cord Occlusions in Fetal Sheep

Complex research of the functional status of fetal in labour

Intermittent auscultation (IA) of fetal heart rate in labour for fetal well-being

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