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Parasympathetic tone variations according to umbilical cord pH at birth: a computerized fetal heart rate variability analysis

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Abstract

Non-reassuring fetal heart rate tracings reflect an imbalance between the parasympathetic and sympathetic nervous systems. In this situation, fetal asphyxia can be suspected and may be confirmed by metabolic measurements at birth like low pH or high base deficit values. The objective of this study was to determine whether fetal asphyxia during labor is related to parasympathetic nervous system activity. This is a retrospective study of a database collected in 5 centers. Two hundred and ninety-nine fetal heart rate tracings collected during labor were analyzed. Autonomic nervous system, especially the parasympathetic nervous system, was analyzed using an original index: the FSI (Fetal Stress Index). The FSI is a parasympathetic activity evaluation based on fetal heart rate variability analysis. Infants were grouped based on normal or low pH value at birth. FSI was measured during the last 30 min of labor before birth and compared between groups. The minimum value of the FSI during the last 30 min before delivery was significantly lower in the group with the lower umbilical cord arterial pH value. In this pilot study during labor, FSI was lower in the group of infants with low arterial pH at birth.

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Acknowledgements

We acknowledge all the medical staff who participated to the data collection: Monaco maternity (Valenciennes, France), Saint Vincent-de-Paul hospital (Lille, France), Jeanne de Flandre maternity (Lille, France), Poissy-Saint-Germain hospital (Poissy, France) and Robert-Debré hospital (Paris, France).

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Authors and Affiliations

  1. Faculté de médecine Pôle Recherche, EA 4489, Environnement Périnatal et Santé, 1, place de Verdun, 59045, Lille Cedex, France

    Laura Butruille, Julien De jonckheere, Charles Garabedian, Véronique Houfflin-Debarge, Laurent Storme & Philippe Deruelle

  2. Maison Régionale de la Recherche Clinique, INSERM CIC-IT 1403, Lille, France

    Julien De jonckheere, Mathilde Flocteil & Régis Logier

  3. Hôpital Jeanne de Flandre, Clinique de Gynécologie-Obstétrique, Lille, France

    Charles Garabedian, Véronique Houfflin-Debarge & Philippe Deruelle

  4. Hôpital Jeanne de Flandre, Clinique de médecine néonatale, Lille, France

    Laurent Storme

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  1. Laura Butruille
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  2. Julien De jonckheere
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Correspondence to Laura Butruille.

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Conflict of interest

JDJ and RL are shareholders and LB was a team member of Mdoloris Medical Systems (that commercializes ANI and NIPE monitors which are based on the presented technology). The remaining authors report no conflict of interest.

Ethics approval

The present retrospective study was approved by the French committee of obstetrics and gynaecology research ethics (CEROG OBS 2015-11-18).

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Butruille, L., De jonckheere, J., Flocteil, M. et al. Parasympathetic tone variations according to umbilical cord pH at birth: a computerized fetal heart rate variability analysis. J Clin Monit Comput 31, 1197–1202 (2017). https://doi.org/10.1007/s10877-016-9957-y

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  • DOI: https://doi.org/10.1007/s10877-016-9957-y

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