Associations between fetal heart rate variability and umbilical cord occlusions‐induced neural injury: An experimental study in a fetal sheep model. (3rd May 2022)

• Record Type: Journal Article
• Authors: Ghesquière, Louise; Perbet, Romain; Lacan, Laure; Hamoud, Yasmine; Stichelbout, Morgane; Sharma, Dyuti; Nguyen, Sylvie; Storme, Laurent; Houfflin‐Debarge, Véronique; De Jonckheere, Julien; Garabedian, Charles
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 101:Number 7(2022)
• Page Start: 758
• Page End: 770
• Publication Date: 2022-05-03
• Subjects: autonomic nervous system -- fetal heart rate -- heart rate variability -- intrapartum hypoxic–ischemia -- neural injury -- umbilical cord compression; Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.14352
• Languages: English
• ISSNs: 0001-6349

Abstract

Abstract: Introduction: This study evaluated the association between fetal heart rate variability (HRV) and the occurrence of hypoxic–ischemic encephalopathy in a fetal sheep model. Material and methods: The experimental protocol created a hypoxic condition with repeated cord occlusions in three phases (A, B, C) to achieve acidosis to pH <7.00. Hemodynamic, gasometric and HRV parameters were analyzed during the protocol, and the fetal brain, brainstem and spinal cord were assessed histopathologically 48 h later. Associations between the various parameters and neural injury were compared between phases A, B and C using Spearman's rho test. Results: Acute anoxic–ischemic brain lesions in all regions was present in 7/9 fetuses, and specific neural injury was observed in 3/9 fetuses. The number of brainstem lesions correlated significantly and inversely with the HRV fetal stress index ( r = −0.784; p = 0.021) in phase C and with HRV long‐term variability ( r = −0.677; p = 0.045) and short‐term variability ( r = −0.837; p = 0.005) in phase B. The number of neurological lesions did not correlate significantly with other markers of HRV. Conclusions: Neural injury caused by severe hypoxia was associated with HRV changes; in particular, brainstem damage was associated with changes in fetal‐specific HRV markers.