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

doi:10.1016/j.spen.2018.05.002

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 journal › (Systematic) Review article › peer-review

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 language	English
Pages (from-to)	3-16
Number of pages	14
Journal	Seminars in Pediatric Neurology
Volume	28
DOIs	https://doi.org/10.1016/j.spen.2018.05.002
Publication status	Published - 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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10.1016/j.spen.2018.05.002

Cite this

@article{c15466d2106442e0944e55a1e292f92a,

title = "Understanding Fetal Heart Rate Patterns That May Predict Antenatal and Intrapartum Neural Injury",

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.",

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",

author = "Lear, {Christopher A.} and Westgate, {Jenny A.} and Austin Ugwumadu and Nijhuis, {Jan G.} and Stone, {Peter R.} and Antoniya Georgieva and Tomoaki Ikeda and Guido Wassink and Laura Bennet and AlistairJ. Gunn",

year = "2018",

month = dec,

doi = "10.1016/j.spen.2018.05.002",

language = "English",

volume = "28",

pages = "3--16",

journal = "Seminars in Pediatric Neurology",

issn = "1071-9091",

publisher = "W B Saunders Co-Elsevier Inc",

}

TY - JOUR

T1 - Understanding Fetal Heart Rate Patterns That May Predict Antenatal and Intrapartum Neural Injury

AU - Lear, Christopher A.

AU - Westgate, Jenny A.

AU - Ugwumadu, Austin

AU - Nijhuis, Jan G.

AU - Stone, Peter R.

AU - Georgieva, Antoniya

AU - Ikeda, Tomoaki

AU - Wassink, Guido

AU - Bennet, Laura

AU - Gunn, AlistairJ.

PY - 2018/12

Y1 - 2018/12

N2 - 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.

AB - 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.

KW - UMBILICAL-CORD OCCLUSION

KW - FOR-GESTATIONAL-AGE

KW - CARDIOVASCULAR REFLEX RESPONSES

KW - GROWTH-RETARDED FETUSES

KW - ARTERY BLOOD-FLOW

KW - ACID-BASE-BALANCE

KW - RATE-VARIABILITY

KW - PROLONGED HYPOXEMIA

KW - PRETERM INFANTS

KW - NEONATAL ENCEPHALOPATHY

U2 - 10.1016/j.spen.2018.05.002

DO - 10.1016/j.spen.2018.05.002

M3 - (Systematic) Review article

C2 - 30522726

SN - 1071-9091

VL - 28

SP - 3

EP - 16

JO - Seminars in Pediatric Neurology

JF - Seminars in Pediatric Neurology

ER -