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Research paper
Published online: 2021-05-14
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Diagnosing antenatal fetal distress

Igor Victorovich Lakhno1, Kemine Uzel2
DOI: 10.5603/GP.a2021.0100
·
Pubmed: 34105749
Affiliations
  1. Kharkiv medical academy of postgraduate education, Amosov 58, 61070 Kharkiv, Ukraine
  2. Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital, Department of Gynecology and Obstetrics, Turkey

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2021-05-14

Abstract

Objectives: The values of acceleration capacity and deceleration capacity are known to capture fetal neurological development. The fetal growth restriction was found to be featured by decreased variables of phase rectified signal averaging. We have speculated that acceleration capacity and deceleration capacity could be of use in the detection of antenatal fetal distress during fetal growth restriction. The study was focused on the detection of the accuracy of acceleration capacity and deceleration capacity in diagnosing fetal distress.

Material and methods: In total, 124 pregnant women at 26–36 weeks of gestation were included in the study. The patients with appropriate to gestational age fetuses (n = 32) were enrolled in Group I.  The patients with fetal growth restriction and an absence of fetal distress (n = 48) were observed in Group II. Lastly, the patients with fetal growth restriction and fetal distress (n = 44) were included in Group III. Fetal cardiosignals were obtained via non-invasive fetal electrocardiography. The maximally decreased acceleration capacity and deceleration capacity values were found in Group III.

Results: A correlation was found between umbilical artery resistance index and acceleration capacity and deceleration capacity variables in all study groups.  We have found that the application of phase rectified signal averaging in the antenatal period showed high sensitivity and specificity in fetal distress detection.

Conclusions: Fetal acceleration capacity and deceleration capacity is a prospective option for the detection of fetal compromise during fetal growth restriction.

Abstract

Objectives: The values of acceleration capacity and deceleration capacity are known to capture fetal neurological development. The fetal growth restriction was found to be featured by decreased variables of phase rectified signal averaging. We have speculated that acceleration capacity and deceleration capacity could be of use in the detection of antenatal fetal distress during fetal growth restriction. The study was focused on the detection of the accuracy of acceleration capacity and deceleration capacity in diagnosing fetal distress.

Material and methods: In total, 124 pregnant women at 26–36 weeks of gestation were included in the study. The patients with appropriate to gestational age fetuses (n = 32) were enrolled in Group I.  The patients with fetal growth restriction and an absence of fetal distress (n = 48) were observed in Group II. Lastly, the patients with fetal growth restriction and fetal distress (n = 44) were included in Group III. Fetal cardiosignals were obtained via non-invasive fetal electrocardiography. The maximally decreased acceleration capacity and deceleration capacity values were found in Group III.

Results: A correlation was found between umbilical artery resistance index and acceleration capacity and deceleration capacity variables in all study groups.  We have found that the application of phase rectified signal averaging in the antenatal period showed high sensitivity and specificity in fetal distress detection.

Conclusions: Fetal acceleration capacity and deceleration capacity is a prospective option for the detection of fetal compromise during fetal growth restriction.

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Keywords

fetal growth restriction; fetal non-invasive electrocardiography; acceleration capacity and deceleration capacity; fetal distress

About this article
Title

Diagnosing antenatal fetal distress

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-05-14

DOI

10.5603/GP.a2021.0100

Pubmed

34105749

Keywords

fetal growth restriction
fetal non-invasive electrocardiography
acceleration capacity and deceleration capacity
fetal distress

Authors

Igor Victorovich Lakhno
Kemine Uzel

References (10)
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  2. Sholapurkar SL. Is fetal heart rate "deceleration area" the silver bullet for detection of acidemia? Am J Obstet Gynecol. 2018; 219(5): 510–512.
  3. Sholapurkar SL. Limits of current cardiotocography interpretation call for a major rethink. Am J Obstet Gynecol. 2017; 217(1): 92–93.
  4. Smith V, Nair A, Warty R, et al. A systematic review on the utility of non-invasive electrophysiological assessment in evaluating for intra uterine growth restriction. BMC Pregnancy Childbirth. 2019; 19(1): 230.
  5. Rivolta MW, Stampalija T, Frasch MG, et al. Theoretical value of Deceleration Capacity Points to Deceleration Reserve of Fetal Heart Rate. IEEE Trans Biomed Eng. 2020; 67(4): 1176–1185.
  6. Stampalija T, Casati D, Monasta L, et al. Brain sparing effect in growth-restricted fetuses is associated with decreased cardiac acceleration and deceleration capacities: a case-control study. BJOG. 2016; 123(12): 1947–1954.
  7. Hoyer D, Schmidt A, Gustafson KM, et al. Heart rate variability categories of fluctuation amplitude and complexity: diagnostic markers of fetal development and its disturbances. Physiol Meas. 2019; 40(6): 064002.
  8. Fuchs T, Grobelak K, Pomorski M, et al. Fetal heart rate monitoring using maternal abdominal surface electrodes in third trimester: can we obtain additional information other than CTG trace? Adv Clin Exp Med. 2016; 25(2): 309–316.
  9. Behar J, Andreotti F, Zaunseder S, et al. A practical guide to non-invasive foetal electrocardiogram extraction and analysis. Physiol Meas. 2016; 37(5): R1–R35.
  10. Lakhno IV, Alexander S. Fetal autonomic malfunction as a marker of fetal distress in growth-restricted fetuses: three case reports. Obstet Gynecol Sci. 2019; 62(6): 469–473.

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