Key result
In a fetal sheep model of severe hypoxia, the number of brainstem lesions correlated inversely with fetal heart rate short-term variability (r = -0.837; p = 0.005).
Why the study?
The study evaluated the association between fetal heart rate variability and the occurrence of hypoxic-ischemic encephalopathy in a fetal sheep model.
Is fetal heart rate variability associated with neural injury induced by severe hypoxia in a fetal sheep model?
Is fetal heart rate variability associated with neural injury induced by severe hypoxia in a fetal sheep model?
In a fetal sheep model, specific fetal heart rate variability markers correlate with brainstem damage following severe hypoxia.
Hypothesis-generating for short-term variability as a brainstem injury marker in hypoxia; leaves open human validation before any monitoring change.
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.
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Ghesquière et al. (2022) studied Hypoxic-ischemic encephalopathy (n=9). Repeated umbilical cord occlusions was evaluated on Correlation between fetal heart rate variability and number of brainstem lesions (r = -0.837, p=0.005). In a fetal sheep model of severe hypoxia, the number of brainstem lesions correlated inversely with fetal heart rate short-term variability (r = -0.837; p = 0.005).
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