L S Cahill1,2, G Stortz3, A Ravi Chandran4, N Milligan5, S Shinar4, C L Whitehead4,6, S R Hobson4, S Millard7, C K Macgowan3,8, J C Kingdom4,9, J G Sled1,3,8,9, A A Baschat7. 1. Mouse Imaging Centre, The Hospital for Sick Children, Toronto, ON, Canada. 2. Department of Chemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada. 3. Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada. 4. Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON, Canada. 5. Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada. 6. Pregnancy Research Centre, Department of Obstetrics and Gynaecology, Royal Women's Hospital, Parkville, Australia. 7. Centre for Fetal Therapy, Johns Hopkins Medicine, Baltimore, MD, USA. 8. Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada. 9. Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.
Abstract
OBJECTIVE: To evaluate the feasibility of using umbilical artery (UA) Doppler waveforms to measure fetal heart rate (FHR) short-term variation (STV) across gestation. METHODS: This was a prospective longitudinal study, conducted at two study sites, of 195 pregnancies considered low risk. Pulsed-wave Doppler of the UAs was performed at 4-weekly intervals, between 14 and 40 weeks of gestation, using a standardized imaging protocol. Up to 12 consecutive UA Doppler waveforms were analyzed using offline processing software. FHR STV was calculated using average R-R intervals extracted from the waveforms and baseline corrected for FHR. RESULTS: Baseline-corrected FHR STV increased significantly with gestational age (conditional R2 = 0.37; P < 0.0001) and was correlated inversely with FHR (conditional R2 = 0.54; P < 0.0001). The STV ranged (median (interquartile range)) from 3.5 (2.9-4.1) ms at 14-20 weeks' gestation to 6.3 (4.8-7.7) ms at 34-40 weeks' gestation. The change in heart rate STV did not differ between study sites or individual sonographers. CONCLUSIONS: UA Doppler waveforms offer a robust and feasible method to derive STV of the FHR. It should be emphasized that the UA Doppler-derived STV is not interchangeable with measurements derived with computerized cardiotocography. Accordingly, further investigations are needed to validate associations with outcome, in order to determine the value of concurrent fetal cardiovascular and heart rate evaluations that are possible with the technique described here.
OBJECTIVE: To evaluate the feasibility of using umbilical artery (UA) Doppler waveforms to measure fetal heart rate (FHR) short-term variation (STV) across gestation. METHODS: This was a prospective longitudinal study, conducted at two study sites, of 195 pregnancies considered low risk. Pulsed-wave Doppler of the UAs was performed at 4-weekly intervals, between 14 and 40 weeks of gestation, using a standardized imaging protocol. Up to 12 consecutive UA Doppler waveforms were analyzed using offline processing software. FHR STV was calculated using average R-R intervals extracted from the waveforms and baseline corrected for FHR. RESULTS: Baseline-corrected FHR STV increased significantly with gestational age (conditional R2 = 0.37; P < 0.0001) and was correlated inversely with FHR (conditional R2 = 0.54; P < 0.0001). The STV ranged (median (interquartile range)) from 3.5 (2.9-4.1) ms at 14-20 weeks' gestation to 6.3 (4.8-7.7) ms at 34-40 weeks' gestation. The change in heart rate STV did not differ between study sites or individual sonographers. CONCLUSIONS: UA Doppler waveforms offer a robust and feasible method to derive STV of the FHR. It should be emphasized that the UA Doppler-derived STV is not interchangeable with measurements derived with computerized cardiotocography. Accordingly, further investigations are needed to validate associations with outcome, in order to determine the value of concurrent fetal cardiovascular and heart rate evaluations that are possible with the technique described here.
Authors: A Pels; N A Mensing van Charante; C A Vollgraff Heidweiller-Schreurs; J Limpens; H Wolf; M A de Boer; W Ganzevoort Journal: Eur J Obstet Gynecol Reprod Biol Date: 2019-01-22 Impact factor: 2.435
Authors: M S Kramer; R W Platt; S W Wen; K S Joseph; A Allen; M Abrahamowicz; B Blondel; G Bréart Journal: Pediatrics Date: 2001-08 Impact factor: 7.124
Authors: Greg Stortz; Lindsay S Cahill; Anjana Ravi Chandran; Ahmet Baschat; John G Sled; Christopher K Macgowan Journal: IEEE Trans Med Imaging Date: 2020-10-28 Impact factor: 10.048
Authors: H Wolf; B Arabin; C C Lees; D Oepkes; F Prefumo; B Thilaganathan; T Todros; G H A Visser; C M Bilardo; J B Derks; A Diemert; J J Duvekot; E Ferrazzi; T Frusca; K Hecher; N Marlow; P Martinelli; E Ostermayer; A T Papageorghiou; H C J Scheepers; D Schlembach; K T M Schneider; A Valcamonico; A van Wassenaer-Leemhuis; W Ganzevoort Journal: Ultrasound Obstet Gynecol Date: 2017-07 Impact factor: 7.299
Authors: C Lees; N Marlow; B Arabin; C M Bilardo; C Brezinka; J B Derks; J Duvekot; T Frusca; A Diemert; E Ferrazzi; W Ganzevoort; K Hecher; P Martinelli; E Ostermayer; A T Papageorghiou; D Schlembach; K T M Schneider; B Thilaganathan; T Todros; A van Wassenaer-Leemhuis; A Valcamonico; G H A Visser; H Wolf Journal: Ultrasound Obstet Gynecol Date: 2013-10 Impact factor: 7.299