Louise Ghesquière1,2, Julien De Jonckheere1,3, Elodie Drumez4, Dyuti Sharma1,5, Estelle Aubry1,5, Philippe Deruelle1,2, Laurent Storme1,6, Véronique Houfflin-Debarge1,2, Charles Garabedian1,2. 1. EA 4489 - Perinatal Environment and Health, University of Lille, Lille, France. 2. Department of Obstetrics, University Hospital Center (CHU) Lille, Lille, France. 3. Clinical Investigation Center - Technological Innovation (CIC-IT) 1403, University Hospital Center (CHU) Lille, Lille, France. 4. EA 2694 - Public Health: Epidemiology and Quality of Care, Department of Biostatistics, University of Lille, University Hospital Center (CHU) Lille, Lille, France. 5. Department of Pediatric Surgery, University Hospital Center (CHU) Lille, Lille, France. 6. Department of Neonatology, University Hospital Center (CHU) Lille, Lille, France.
Abstract
INTRODUCTION: Heart rate variability and fetal heart rate decelerations are impacted by parasympathetic function and reflect acid-base status. Our team developed a new heart rate variability index, the fetal stress index (FSI), which has lower interindividual variability and higher sensitivity for detecting fluctuations in parasympathetic nervous system activity. The aim of this study was to explore the ability of the FSI to predict fetal acidosis in a fetal sheep model. MATERIAL AND METHODS: Repeated 1-minute total umbilical cord occlusions (UCOs) were performed every 2.5 minutes over 3 hours to generate fetal acidosis mimicking that which occurs during labor and contractions. Fetal hemodynamic parameters, blood gas, the FSI and the magnitude (from the beginning to the nadir) of the fetal heart rate deceleration were recorded at regular intervals. The data were analyzed over three time intervals because of variation in the duration of the experiments: period A (first 12 UCOs), period B (middle 12 UCOs) and period C (last 12 UCOs). RESULTS: Nine experiments were performed. Acidosis was progressive with a significant difference between the pH, lactate levels and base deficit values for the three periods of occlusion (P < 0.05). Both FSI and the magnitude of fetal heart rate decelerations gradually increased during the UCOs and both differed significantly between periods A and C (P = 0.0008 for FSI and P = 0.003 for deceleration). CONCLUSION: This experimental protocol allowed the development of progressive acidosis in a good model of the physiology of labor. Parasympathetic nervous system activity increased during acidosis and could be measured using our index, the FSI, and the magnitude of fetal heart rate decelerations.
INTRODUCTION: Heart rate variability and fetal heart rate decelerations are impacted by parasympathetic function and reflect acid-base status. Our team developed a new heart rate variability index, the fetal stress index (FSI), which has lower interindividual variability and higher sensitivity for detecting fluctuations in parasympathetic nervous system activity. The aim of this study was to explore the ability of the FSI to predict fetal acidosis in a fetal sheep model. MATERIAL AND METHODS: Repeated 1-minute total umbilical cord occlusions (UCOs) were performed every 2.5 minutes over 3 hours to generate fetal acidosis mimicking that which occurs during labor and contractions. Fetal hemodynamic parameters, blood gas, the FSI and the magnitude (from the beginning to the nadir) of the fetal heart rate deceleration were recorded at regular intervals. The data were analyzed over three time intervals because of variation in the duration of the experiments: period A (first 12 UCOs), period B (middle 12 UCOs) and period C (last 12 UCOs). RESULTS: Nine experiments were performed. Acidosis was progressive with a significant difference between the pH, lactate levels and base deficit values for the three periods of occlusion (P < 0.05). Both FSI and the magnitude of fetal heart rate decelerations gradually increased during the UCOs and both differed significantly between periods A and C (P = 0.0008 for FSI and P = 0.003 for deceleration). CONCLUSION: This experimental protocol allowed the development of progressive acidosis in a good model of the physiology of labor. Parasympathetic nervous system activity increased during acidosis and could be measured using our index, the FSI, and the magnitude of fetal heart rate decelerations.
Authors: Erika R Schwarz; Malgorzata A Pozor; Ruiyu Pu; Kelli L Barr; Sarah E Beachboard; N James MacLachlan; Dhani Prakoso; Maureen T Long Journal: Viruses Date: 2019-08-29 Impact factor: 5.048
Authors: Louise Ghesquière; C Ternynck; D Sharma; Y Hamoud; R Vanspranghels; L Storme; V Houfflin-Debarge; J De Jonckheere; C Garabedian Journal: Sci Rep Date: 2022-06-23 Impact factor: 4.996