期刊
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
卷 101, 期 7, 页码 758-770出版社
WILEY
DOI: 10.1111/aogs.14352
关键词
autonomic nervous system; fetal heart rate; heart rate variability; intrapartum hypoxic-ischemia; neural injury; umbilical cord compression
资金
- French National Research Agency (ANR) [ANR--18--CE19--0015--01]
This study found an association between fetal heart rate variability and hypoxic-ischemic encephalopathy. Changes in fetal heart rate variability were associated with the occurrence of neural injury.
Introduction This study evaluated the association between fetal heart rate variability (HRV) and the occurrence of hypoxic-ischemic encephalopathy in a fetal sheep model. Material and methods The experimental protocol created a hypoxic condition with repeated cord occlusions in three phases (A, B, C) to achieve acidosis to pH <7.00. Hemodynamic, gasometric and HRV parameters were analyzed during the protocol, and the fetal brain, brainstem and spinal cord were assessed histopathologically 48 h later. Associations between the various parameters and neural injury were compared between phases A, B and C using Spearman's rho test. Results Acute anoxic-ischemic brain lesions in all regions was present in 7/9 fetuses, and specific neural injury was observed in 3/9 fetuses. The number of brainstem lesions correlated significantly and inversely with the HRV fetal stress index (r = -0.784; p = 0.021) in phase C and with HRV long-term variability (r = -0.677; p = 0.045) and short-term variability (r = -0.837; p = 0.005) in phase B. The number of neurological lesions did not correlate significantly with other markers of HRV. Conclusions Neural injury caused by severe hypoxia was associated with HRV changes; in particular, brainstem damage was associated with changes in fetal-specific HRV markers.
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