The fetal electrocardiogram to detect the effects of betamethasone on fetal heart rate variability

Autor: S.G. Oei, J.O.E.H. van Laar, G.J.J. Warmerdam, Kim M. J. Verdurmen, Rik Vullings, Lore Noben
Přispěvatelé: Signal Processing Systems, Center for Care & Cure Technology Eindhoven, Biomedical Diagnostics Lab
Rok vydání: 2019
Předmět:
Fetal heart rate variability
Adult
medicine.medical_specialty
Fetal Heart Rate Variability
Electrocardiography/methods
medicine.drug_class
Obstetric Labor
Premature/drug therapy
Betamethasone
Obstetric Labor
Electrocardiography
03 medical and health sciences
Obstetric Labor
Premature
0302 clinical medicine
Pregnancy
Heart Rate
030225 pediatrics
Internal medicine
medicine
Fetal distress
Corticosteroid
Corticosteroids
Humans
Heart Rate
Fetal/drug effects
Prospective cohort study
Glucocorticoids
Fetus
business.industry
Glucocorticoids/administration & dosage
Obstetrics and Gynecology
Heart Rate
Fetal
Fetal electrocardiogram
medicine.disease
Premature/drug therapy
Fetal/drug effects
Betamethasone/administration & dosage
Pediatrics
Perinatology and Child Health
Cardiology
Female
business
030217 neurology & neurosurgery
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
medicine.drug
Zdroj: Early Human Development, 130, pp. 57-64
Early Human Development, 130, 57-64. Elsevier Ireland Ltd
Early Human Development, 130, 57-64
ISSN: 0378-3782
Popis: Item does not contain fulltext BACKGROUND: Betamethasone is widely used to enhance fetal lung maturation in case of threatened preterm birth. Antenatal corticosteroids are known to reduce fetal heart rate variability (fHRV) in the days following administration. Since decreased fHRV is a marker for fetal distress, this transient decrease of fHRV can cause unnecessary medical intervention. AIM: To describe the effect of betamethasone on fHRV, by applying spectral analysis on non-invasive fetal electrocardiogram (fECG) recordings. STUDY DESIGN: Secondary analysis of a prospective cohort study. SUBJECTS: Women with a singleton pregnancy, at risk for preterm delivery and receiving betamethasone, admitted to the obstetric high care unit in the period from March 2013 until July 2016. OUTCOME MEASURES: The primary outcome measure was fHRV in both time- and frequency-domain. Secondary outcome measures included basal fetal heart rate (fHR) and fHR variance. FHRV parameters were then calculated separately for the quiet and active state. RESULTS: Following 68 inclusions, 22 patients remained with complete series of measurements and sufficient data quality. FHRV parameters and fHR showed a decrease on day 2 compared to day 1, significant for short-term variability and high-frequency power. Similar results were found when analyzing for separate behavioral states. The number of segments in quiet state increased during days 1 and 2. Normalized values showed no difference for all behavioral states. CONCLUSION: FHRV decreases on day 2 after betamethasone administration, while periods of fetal quiescence increase. No changes were found in the normalized values, indicating that the influence of autonomic modulation is minor. Clinical trial registration number NL43294.015.13.
Databáze: OpenAIRE
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