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Reproductive Sciences
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Heart Rate Variability Analysis Allows Early Asphyxia Detection in Ovine Fetus

Martin G. Frasch, MD, PhD

Department of Obstetrics and Gynaecology, Children Health Research Institute, University of Western Ontario, London, Canada, mfrasch{at}uwo.ca, Department of Neurology, Friedrich Schiller University, D-07740 Jena, Germany

Thomas Müller, DVM

Institute of Laboratory Animal Science, Friedrich Schiller University, D-07740 Jena, Germany

Christian Weiss, MD

Department of Neurology, Friedrich Schiller University, D-07740 Jena, Germany

Karin Schwab, MSc

Institute of Medical Statistics, Computer Sciences and Documentation, Friedrich Schiller University, D-07740 Jena, Germany

Harald Schubert, PhD

Institute of Laboratory Animal Science, Friedrich Schiller University, D-07740 Jena, Germany

Matthias Schwab, MD, PhD

Department of Neurology, Friedrich Schiller University, D-07740 Jena, Germany

Fetal heart rate (FHR) monitoring is commonly used to predict asphyxia but clinical and experimental studies have questioned its diagnostic value. We examined the usefulness of fetal heart rate variability (fHRV) measures in detecting early asphyxia using chronically instrumented fetal sheep under normoxic (n = 6) and asphyxic conditions (3 umbilical cord occlusions, n = 6). The occlusions consistently led to pH decreases from 7.35 + 0.01 to 7.09 + 0.03 ( P < .05). FHR showed biphasic deceleration during each occlusion, associated with increasing arterial blood pressure ( P < .05). RMSSD, an index of vagal modulation of fHRV, increased consistently during repeated occlusion induced FHR decelerations ( P < .05). Under normoxic conditions, RMSSD did not change during FHR decelerations and decreased during FHR accelerations ( P < .05). Our results suggest that an increase of RMSSD in association with FHR decelerations reflects initial vagal activation during fetal asphyxia. RMSSD may accurately identify asphyxic fetuses early. Clinical validation is needed.

Key Words: fetal asphyxia • heart rate variability • RMSSD • autonomic nervous system • vagus • monitoring

This version was published on May 1, 2009

Reproductive Sciences, Vol. 16, No. 5, 509-517 (2009)
DOI: 10.1177/1933719108327597
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 Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
M. G. Frasch, T. Muller, D. Hoyer, C. Weiss, H. Schubert, and M. Schwab
Nonlinear properties of vagal and sympathetic modulations of heart rate variability in ovine fetus near term
Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2009; 296(3): R702 - R707.
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