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Relationship Between Deceleration Morphology and Phase Rectified Signal Averaging-Based Parameters During Labor.

Massimo W Rivolta¹, Moira Barbieri², Tamara Stampalija^2,3

¹Dipartimento di Informatica, Università degli Studi di Milano, Milan, Italy.

Frontiers in Medicine

|December 13, 2021

Summary

Fetal hypoxia alters heart rate deceleration patterns during labor. Chronic hypoxia in fetuses changes autonomic nervous system regulation, impacting fetal heart rate (FHR) deceleration morphology and response times.

Keywords:

animal model electronic fetal monitoring (EFM)fetal heart rate (FHR)fetal hypoxia heart rate variability (HRV)labor phase-rectified signal averaging (PRSA)

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Area of Science:

Perinatal medicine
Fetal physiology
Autonomic nervous system research

Background:

Fetal heart rate (FHR) decelerations during labor reflect autonomic nervous system (ANS) activity.
Chronic hypoxia is known to alter ANS regulation in fetuses compared to normoxic fetuses.

Purpose of the Study:

To investigate if chronic hypoxia alters FHR deceleration morphology during umbilical cord occlusions (UCOs).
To assess the correlation between FHR deceleration morphology and Phase-Rectified Signal Averaging (PRSA) parameters.

Main Methods:

Utilized an animal model with normoxic and chronically hypoxic fetuses undergoing UCOs.
Modeled FHR deceleration morphology using a trapezoid with parameters: baseline (b), depth (a), response time (τ_r), and recovery time (τ_d).
Computed acceleration capacity (AC), deceleration capacity (DC), and deceleration reserve (DR) using PRSA and correlated them with morphological parameters.

Main Results:

Hypoxic fetuses exhibited significantly longer response times (τ_r) and greater asymmetry (Δτ = τ_r - τ_d) compared to normoxic fetuses.
DC, AC, and DR were significantly correlated with τ_r, τ_d, and Δτ across various PRSA parameter T values (ρ > 0.8, p < 0.05).

Conclusions:

Fetal hypoxia distinctly alters FHR deceleration morphology in response to UCOs.
PRSA-derived parameters (AC, DC, DR) can effectively assess these differences, suggesting potential for clinical application in human pregnancies.