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Prolonged fetal pre-ejection period corrected for PR interval associated with cerebral palsy
1Department of Obstetrics and Gynaecology, University of Glasgow, Queen Mother's Hospital, Yorkhill, UK.
Objective:
To identify whether the correction of human fetal pre-ejection period (PEP) for the effect of catecholamines, as estimated by the PR interval (the interval of time measured between the P and R waves of the electrocardiogram (ECG)), might improve PEP as a measure of fetal cardiac contractility.
Methods:
A retrospective analysis of PEP and PR intervals was carried out, using tape recordings of fetal ECG and Doppler ultrasound recordings of cardiac valve movements, from 43 human fetuses in the first stage of labour.
Results:
There was a strong positive correlation between PEP and PR intervals in the population studied: r = 0.641, P < 0.0001, indicating that about 40% of the inter-patient variation in PEP could be corrected for by concomitant measurement of the PR interval. Only one fetus had markedly prolonged PEP when corrected for PR interval. This individual developed cerebral palsy over the first year of life.
Conclusion:
Correction of PEP for the effects of catecholamines may greatly improve its usefulness in detecting fetal compromise. Combined measurement of the PEP and PR interval needs to be evaluated as a technique of fetal monitoring.