Patterns of human fetal heart rate accelerations from 26 weeks to term

Computerized analysis of the distribution of 2598 fetal heart rate accelerations in 83 healthy fetuses at 26 to 40 weeks' gestation demonstrated that the currently used definition of an acceleration as greater than or equal to 15 beats/min for greater than or equal to 15 seconds is applicable only after 30 weeks' gestational age in fetuses with a basal fetal heart rate of less than or equal to 128 beats/min. A significant negative correlation was found between the mean hourly basal fetal heart rate and the mean amplitude of fetal heart rate accelerations from 30 weeks to term. There was also a significant maturational process in the pattern of fetal heart rate and fetal heart rate accelerations that occurred between 26 and 28 and between 30 and 32 weeks; this was characterized by a decrease in basal fetal heart rate, an increase in the amplitude of fetal heart rate accelerations, and an increase in long-term fetal heart rate variability.