Parasympathetic tone variations according to umbilical cord pH at birth: a computerized fetal heart rate variability analysis

Non-reassuring fetal heart rate tracings reflect an imbalance between the parasympathetic and sympathetic nervous systems. In this situation, fetal asphyxia can be suspected and may be confirmed by metabolic measurements at birth like low pH or high base deficit values. The objective of this study w...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2017-12, Vol.31 (6), p.1197-1202
Main Authors: Butruille, Laura, De jonckheere, Julien, Flocteil, Mathilde, Garabedian, Charles, Houfflin-Debarge, Véronique, Storme, Laurent, Deruelle, Philippe, Logier, Régis
Format: Article
Language:English
Subjects:
Adult
Anesthesiology
Asphyxia
Autonomic Nervous System
Cardiology - methods
Childbirth & labor
Critical Care Medicine
Delivery, Obstetric
Female
Fetal Monitoring - methods
Health risk assessment
Health Sciences
Heart rate
Heart Rate, Fetal
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Infants
Intensive
Labor
Labor, Obstetric
Medicine
Medicine & Public Health
Models, Statistical
Nervous system
Original Research
Parasympathetic Nervous System - physiopathology
Pilot Projects
Pregnancy
Retrospective Studies
Signal Processing, Computer-Assisted
Software
Statistics for Life Sciences
Ultrasonic imaging
Umbilical cord
Umbilical Cord - pathology
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Summary:Non-reassuring fetal heart rate tracings reflect an imbalance between the parasympathetic and sympathetic nervous systems. In this situation, fetal asphyxia can be suspected and may be confirmed by metabolic measurements at birth like low pH or high base deficit values. The objective of this study was to determine whether fetal asphyxia during labor is related to parasympathetic nervous system activity. This is a retrospective study of a database collected in 5 centers. Two hundred and ninety-nine fetal heart rate tracings collected during labor were analyzed. Autonomic nervous system, especially the parasympathetic nervous system, was analyzed using an original index: the FSI (Fetal Stress Index). The FSI is a parasympathetic activity evaluation based on fetal heart rate variability analysis. Infants were grouped based on normal or low pH value at birth. FSI was measured during the last 30 min of labor before birth and compared between groups. The minimum value of the FSI during the last 30 min before delivery was significantly lower in the group with the lower umbilical cord arterial pH value. In this pilot study during labor, FSI was lower in the group of infants with low arterial pH at birth.
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-016-9957-y