Key result
Bilateral cervical vagotomy delayed the recovery of fetal heart rate variability at 72 hours post-surgery, identifying AsymI, DFA α1, KLPE, and SDLE α as specific measures of vagal modulation.
Why the study?
Fetal heart rate variability is an important health indicator, but its physiological origins and neural contributions are not well understood.
Does bilateral cervical vagotomy alter fetal heart rate variability measures in near-term ovine fetuses?
Does bilateral cervical vagotomy alter fetal heart rate variability measures in near-term ovine fetuses?
Bilateral cervical vagotomy in a fetal ovine model delays the recovery of fetal heart rate variability after surgery and identifies specific HRV measures that reflect vagal withdrawal.
Answers are grounded in this paper and cite their sources.
Requires accounting for vagal effects in post-surgical fetal HRV; leaves open human translation.
OBJECTIVE: Fetal heart rate variability (fHRV) is an important indicator of health and disease, yet its physiological origins, neural contributions, in particular, are not well understood. We aimed to develop novel experimental and data analytical approaches to identify fHRV measures reflecting the vagus nerve contributions to fHRV. APPROACH: In near-term ovine fetuses, a comprehensive set of 46 fHRV measures was computed from fetal pre-cordial electrocardiogram recorded during surgery and 72 h later without (n = 24) and with intra-surgical bilateral cervical vagotomy (n = 15). MAIN SIGNIFICANCE: We provide a systematic delineation of vagal contributions to fHRV across signal-analytical domains which should be relevant for the emerging field of bioelectronic medicine and the deciphering of the 'vagus code'. Our findings also have clinical significance for in utero monitoring of fetal health during surgery. Key points •Fetal surgery causes a complex pattern of changes in heart rate variability measures with an overall reduction of complexity or variability. •At 72 h after surgery, many of the HRV measures recover and this recovery is delayed by an intrasurgical cervical bilateral vagotomy. •We identify HRV pattern representing complete vagal withdrawal that can be understood as part of 'HRV code', rather than any single HRV measure. •We identify HRV biomarkers of recovery from fetal surgery and discuss the effect of anticholinergic medication on this recovery.
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A 2019 study studied Fetal heart rate variability (n=39). Bilateral cervical vagotomy vs. Sham surgery was evaluated on Changes in 46 fetal heart rate variability (fHRV) measures at 72 hours post-surgery. Bilateral cervical vagotomy delayed the recovery of fetal heart rate variability at 72 hours post-surgery, identifying AsymI, DFA α1, KLPE, and SDLE α as specific measures of vagal modulation.
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