American Journal of Obstetrics & Gynecology
Volume 200, Issue 4 , Pages 407.e1-407.e6, April 2009

Antepartum high-frequency fetal heart rate sinusoidal rhythm: computerized detection and fetal anemia

Nuffield Department of Obstetrics and Gynecology, University of Oxford, John Radcliffe Hospital, Oxford, UK

Received 21 March 2008; received in revised form 8 August 2008; accepted 7 October 2008. published online 29 December 2008.

Objective

Our aim was to identify antepartum fetal heart rate (FHR) records of high-frequency (HF) sinusoidal rhythms from an electronic database (1983-2003) and determine clinical outcomes.

Study Design

At the John Radcliffe Hospital (Oxford, UK), 72,297 traces from 19,506 women were analyzed using an algorithm that identifies HF sinusoidal rhythms. The case records were reviewed.

Results

There were 15 (0.21/1000) traces from 8 (0.41/1000) women with an HF sinusoidal rhythm. In 5 of 8 women (62.5%), this pattern was associated with fetal anemia (hemoglobin < 10.0 g/dL). Their FHR patterns were distinguished from those of the other nonanemic fetuses by significantly lower long-term variability.

Conclusion

An antepartum HF sinusoidal rhythm is rare but associated with fetal anemia, particularly if it is combined with reduced long-term variability without episodes of high FHR variability within 60 minutes. The automated system can alert inexperienced staff, who supervise FHR monitoring, by an online warning.

Key words: antepartum fetal anemia, computerized fetal heart rate patterns, high-frequency sinusoidal rhythm, sinusoidal rhythm

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 This study was supported in part by Oxford National Institute of Health Research Biomedical Research Centre Programme.

 Reprints not available from the authors.

 Cite this article as: Reddy A, Moulden M, and Redman CWG. Antepartum high-frequency fetal heart rate sinusoidal rhythm: computerized detection and fetal anemia. Am J Obstet Gynecol 2009;200:407.e1-407.e6.

PII: S0002-9378(08)02039-5

doi:10.1016/j.ajog.2008.10.026

American Journal of Obstetrics & Gynecology
Volume 200, Issue 4 , Pages 407.e1-407.e6, April 2009