Understanding Fetal Heart Rate Patterns That May Predict Antenatal and Intrapartum Neural Injury

Christopher A. Lear, Jenny A. Westgate, Austin Ugwumadu, Jan G. Nijhuis, Peter R. Stone, Antoniya Georgieva, Tomoaki Ikeda, Guido Wassink, Laura Bennet, AlistairJ. Gunn*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

16 Citations (Web of Science)

Abstract

Electronic fetal heart rate (FHR) monitoring is widely used to assess fetal well-being throughout pregnancy and labor. Both antenatal and intrapartum FHR monitoring are associated with a high negative predictive value and a very poor positive predictive value. This in part reflects the physiological resilience of the healthy fetus and the remarkable effectiveness of fetal adaptations to even severe challenges. In this way, the majority of "abnormal" FHR patterns in fact reflect a fetus' appropriate adaptive responses to adverse in utero conditions. Understanding the physiology of these adaptations, how they are reflected in the FHR trace and in what conditions they can fail is therefore critical to appreciating both the potential uses and limitations of electronic FHR monitoring. (C) 2018 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)3-16
Number of pages14
JournalSeminars in Pediatric Neurology
Volume28
DOIs
Publication statusPublished - Dec 2018

Keywords

  • UMBILICAL-CORD OCCLUSION
  • FOR-GESTATIONAL-AGE
  • CARDIOVASCULAR REFLEX RESPONSES
  • GROWTH-RETARDED FETUSES
  • ARTERY BLOOD-FLOW
  • ACID-BASE-BALANCE
  • RATE-VARIABILITY
  • PROLONGED HYPOXEMIA
  • PRETERM INFANTS
  • NEONATAL ENCEPHALOPATHY

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