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Heart rate patterns in normoxemic, hypoxemic, and anemic second-trimester fetuses

  • K.H. Nicolaides
    Correspondence
    Reprint requests: K. H. Nicolaides, MRCOG, Harris Birthright Research Centre, Department of Obstetrics and Gynaecology, King's College Hospital, Denmark Hill, London SE5 8RX, England.
    Affiliations
    Harris Birthright Research Centre for Fetal Medicine, Department of Obstetrics and Gynaecology, King's College Hospital, London, England
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  • G. Sadovsky
    Affiliations
    Harris Birthright Research Centre for Fetal Medicine, Department of Obstetrics and Gynaecology, King's College Hospital, London, England
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  • G.H.A. Visser
    Affiliations
    Harris Birthright Research Centre for Fetal Medicine, Department of Obstetrics and Gynaecology, King's College Hospital, London, England
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      Abstract

      Fetal heart rate monitoring was performed immediately before cordocentesis on 71 occasions on 49 patients at 20 to 26 weeks' gestation. In the normoxemic, nonanemic fetuses, the basal fetal heart rate was 120 to 160 beats/minute, the baseline variability was more than 5 beats/min, and there were no prolonged decelerations. Accelerations were present in 19 of the 25 recordings. In the tracings from the hypoxemic (n = 11) or anemic (n = 35) fetuses, there was tachycardia, baseline variability of <5 beats/min, and prolonged fetal heart rate decelerations. However, the sensitivity of these pathologic patterns in predicting moderate-to-severe hypoxemia or anemia was 45% and 33%, respectively. The data demonstrate a gestation-dependent maturation of both normal and pathologic fetal heart rate patterns. (Ann J OBSTET GYNECOI. 1989;160:1034-7.)

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      References

        • Visser GHA
        • Redman CWG
        • Huisjes HJ
        • Turnbull AC
        Nonstressed antepartum heart rate monitoring: implication of deceleration after spontaneous contractions.
        Am J Obstet Gynecol. 1980; 138: 429
        • Bekedam DJ
        • Visser GHA
        • Mulder EJH
        • PoelmannWeesies G
        Heart rate variation and movement incidence in growth-retarded fetuses: the significance of antenatal late heart rate deceleration.
        Am J OBsrET GYNECOL. 1987; 157: 126
        • Meyer RE
        • Muller-Jeubach E
        • Adamsons K
        Predictability of the state of fetal oxygenation from a quantitative analysis of the components of late deceleration.
        Am J Obstet Gynecol. 1973; 115: 1083
        • Nicolaides KH
        • Soothill PW
        • Rodeck CH
        • Campbell S
        Ultrasound-guided sampling of the umbilical cord and placental blood to assess fetal well being..
        Lancet. 1986; i: 1065
        • Nicolaides KH
        • Soothill PW
        • Clewell WH
        • Rodeck CH
        • Mibashan RS
        • Campbell S.
        Fetal haemoglobin measurement in the assessment of red cell isoimmunization..
        Lancet. 1988; i: 1073
        • Soothill PW
        • Nicolaides KH
        • Rodeck CH
        • Campbell S
        Effect of gestational age on fetal and intervillous blood gas and acid-base values in human pregnancy.
        Fetal Ther. 1986; 1: 168
        • Smith CV
        • Phelan JP
        • Paul RH
        A prospective analysis of the influence of gestational age on the baseline fetal heart rate and reactivity in a low-risk population.
        Am J Obstet Gynecol. 1985; 153: 780
        • Druzin ML
        • Fox A
        • Kogut E
        • Carlson C
        The relationship of the nonstress test to gestational age.
        Am J OBS"tm' GYNECOL. 1985; 153: 386
        • Natale R
        • Nasello C
        • Turlink R
        The relationship between movements and accelerations in fetal heart rate at 24 to 32 weeks' gestation.
        Am j OBSTE-r GYNECOL. 1984; 148: 591
        • De Vries JIP
        • Visser GHA
        • Mulder EJH
        • Prechtl HFR
        Diurnal and other variations in fetal movement and heart rate patterns at 20-22 weeks.
        Early Hum Dev. 1987; 15: 333
        • Wheeler T
        • et al.
        heart rate during normal pregnancy..
        Br j Obstet Gynaecol. 1978; 85: 18
        • Visser GHA
        Antepartum sinusoidal and decelerative heart rate patterns in Rh disease.
        Am J OBsrET GYNECOL. 1982; 143: 538
        • Brown R
        • Patrick J
        The nonstress test: how long is enough?.
        Am J Obstet Gynecol. 1981; 141: 646
        • Devoe LD
        • Yankowitch G
        • Azor H
        The application of multiparameter scoring to antepartum fetal heart rate testing.
        J Reprod Med. 1981; 26: 250
        • Lenstrup C
        • Haase N
        Predictive value of antepartum fetal heart rate nonstress test in high-risk pregnancy.
        Acta Obstet Gynaecol Scand. 1985; 64: 133
        • Gagnon R
        • Campbell K
        • Hunse C
        • Patrick J
        Patterns of human fetal heart rate accelerations from 26 weeks to term.
        Am J OBSTEi GYNECOL. 1987; 157: 743