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

Objective: To study fetal heart rate (FHR), its short term variability (STV), average acceleration capacity (AAC), and average deceleration capacity (ADC) throughout uncomplicated gestation, and to perform a preliminary comparison of these FHR parameters between small-for dates (SFD) and control fet...

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Bibliographic Details
Published in:The journal of maternal-fetal & neonatal medicine 2012-12, Vol.25 (12), p.2517-2522
Main Authors: Graatsma, E. M., Mulder, E. J. H., Vasak, B., Lobmaier, S. M., Pildner von Steinburg, S, Schneider, K. T. M., Schmidt, G., Visser, G. H. A.
Format: Article
Language:English
Subjects:
Acceleration
Antenatal monitoring
Birth Weight - physiology
Case-Control Studies
Deceleration
Female
Fetal Growth Retardation - physiopathology
fetal heart rate
Fetal Monitoring
Gestational Age
growth restriction
Health
Heart Rate, Fetal - physiology
Humans
Infant, Newborn
Pregnancy - physiology
Pregnancy Complications - physiopathology
Pregnancy Trimester, Second - physiology
Pregnancy Trimester, Third - physiology
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Summary:Objective: To study fetal heart rate (FHR), its short term variability (STV), average acceleration capacity (AAC), and average deceleration capacity (ADC) throughout uncomplicated gestation, and to perform a preliminary comparison of these FHR parameters between small-for dates (SFD) and control fetuses. Methods: Prospective observational study of 7 h FHR-recordings obtained with a fetal-ECG monitor in the second half of uncomplicated pregnancies (n = 90) and pregnancies complicated by fetal SFD (n = 30). FHR and STV were calculated according to established analysis. True beat-to-beat FHR, recorded at 1 ms accuracy, was used to calculate AAC and ADC using Phase Rectified Signal Averaging (PRSA). Mean values of FHR, STV, AAC, and ADC derived from recordings in SFD fetuses were compared with the reference curves. Results: Compared with the control group the mean z-scores for STV, AAC, and ADC in SFD fetuses were lower by 1.0 SD, 1.5 SD, and 1.7 SD, respectively (p < 0.0001 for all comparisons). In SFD fetuses, both the AAC and ADC z-scores were lower than the STV z-scores (p < 0.02 and p < 0.002, respectively). Conclusions: Analysis of the AAC and ADC as recorded with a high resolution fECG recorder may differentiate better between normal and SFD fetuses than STV.
ISSN:1476-7058
1476-4954
DOI:10.3109/14767058.2012.704446