Kim M J Verdurmen1, Guy J J Warmerdam2, Carlijn Lempersz3, Alexandra D J Hulsenboom3, Joris Renckens3, Jeanne P Dieleman4, Rik Vullings2, Judith O E H van Laar3, S Guid Oei5. 1. Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands. Electronic address: kimverdurmen@live.nl. 2. Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. 3. Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands. 4. MMC Academy, Máxima Medical Centre, Veldhoven, The Netherlands. 5. Department of Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Abstract
BACKGROUND: Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm labour. Fetal heart rate variability is one of the most important parameters to assess in fetal monitoring, since it is a reliable indicator for fetal distress. AIM: To describe the effect of betamethasone on fetal heart rate variability, by applying spectral analysis on non-invasive fetal electrocardiogram recordings. STUDY DESIGN: Prospective cohort study. SUBJECTS: Patients that require betamethasone, with a gestational age from 24 weeks onwards. OUTCOME MEASURES: Fetal heart rate variability parameters on day 1, 2, and 3 after betamethasone administration are compared to a reference measurement. RESULTS: Following 68 inclusions, 12 patients remained with complete series of measurements and sufficient data quality. During day 1, an increase in absolute fetal heart rate variability values was seen. During day 2, a decrease in these values was seen. All trends indicate to return to pre-medication values on day 3. Normalised high- and low-frequency power show little changes during the study period. CONCLUSIONS: The changes in fetal heart rate variability following betamethasone administration show the same pattern when calculated by spectral analysis of the fetal electrocardiogram, as when calculated by cardiotocography. Since normalised spectral values show little changes, the influence of autonomic modulation seems minor.
BACKGROUND:Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm labour. Fetal heart rate variability is one of the most important parameters to assess in fetal monitoring, since it is a reliable indicator for fetal distress. AIM: To describe the effect of betamethasone on fetal heart rate variability, by applying spectral analysis on non-invasive fetal electrocardiogram recordings. STUDY DESIGN: Prospective cohort study. SUBJECTS:Patients that require betamethasone, with a gestational age from 24 weeks onwards. OUTCOME MEASURES: Fetal heart rate variability parameters on day 1, 2, and 3 after betamethasone administration are compared to a reference measurement. RESULTS: Following 68 inclusions, 12 patients remained with complete series of measurements and sufficient data quality. During day 1, an increase in absolute fetal heart rate variability values was seen. During day 2, a decrease in these values was seen. All trends indicate to return to pre-medication values on day 3. Normalised high- and low-frequency power show little changes during the study period. CONCLUSIONS: The changes in fetal heart rate variability following betamethasone administration show the same pattern when calculated by spectral analysis of the fetal electrocardiogram, as when calculated by cardiotocography. Since normalised spectral values show little changes, the influence of autonomic modulation seems minor.
Authors: Kajal K Tamber; Dexter J L Hayes; Stephen J Carey; Jayawan H B Wijekoon; Alexander E P Heazell Journal: PLoS One Date: 2020-12-01 Impact factor: 3.240