Obstet Gynecol Sci.  2019 Nov;62(6):469-473. 10.5468/ogs.2019.62.6.469.

Fetal autonomic malfunction as a marker of fetal distress in growth-restricted fetuses: three case reports

• Lakhno IV
• Alexander

• KMID: 2462126
• DOI: http://doi.org/10.5468/ogs.2019.62.6.469

Abstract

Fetal growth restriction (FGR) is characterized by fetal compromise and delayed neurological maturation. We report 3 cases of early FGR in the 26th week of gestation, based on hemodynamic Doppler monitoring, conventional cardiotocography, and non-invasive fetal electrocardiography (NI-FECG). Fetal heart rate variability (HRV), beat-to-beat variations, and fetal autonomic brain age scores (fABASs) were normal despite the absence of umbilical diastolic flow in the first case and the pregnancy continued to 30 weeks. NI-FECG helped achieve better fetal maturity. Fetal HRV and fABASs were low in the second and third cases. Fetal demise occurred soon in both cases. We conclude that NI-FECG could be a prospective method for the detection of fetal distress in early FGR.

Keyword

Fetal distress; Fetal growth restriction; Embryonic and fetal development

MeSH Terms

Brain
Cardiotocography
Electrocardiography
Embryonic and Fetal Development
Female
Fetal Death
Fetal Development
Fetal Distress*
Fetus*
Heart Rate, Fetal
Hemodynamics
Methods
Pregnancy
Prospective Studies

Figure

• 

  Fig. 1 The tracing of beat-to-beat variations (an analog of the ultrasound cardiotocography curve) in case 1. Blue line is fetal beat-to-beat variatiations curve and green one is maternal. The blue line crossing the fetal heart rate pattern shows the estimated basal heart rate (baseline). The gray shaded areas show the detected accelerations and decelerations.

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