Differences in the Asymmetry of Beat-to-Beat Fetal Heart Rate Accelerations and Decelerations at Preterm and Term Active Labor
Carolina López-Justo,
Adriana Cristina Pliego-Carrillo,
Claudia Ivette Ledesma-Ramírez,
Hugo Mendieta-Zerón,
Miguel Ángel Peña-Castillo,
Juan Carlos Echeverría,
Jorge Rodríguez-Arce,
José Javier Reyes-Lagos
Affiliations
Carolina López-Justo
Facultad de Medicina (School of Medicine), Universidad Autónoma del Estado de México (Autonomous University of Mexico State), Toluca de Lerdo 50180, Mexico
Adriana Cristina Pliego-Carrillo
Facultad de Medicina (School of Medicine), Universidad Autónoma del Estado de México (Autonomous University of Mexico State), Toluca de Lerdo 50180, Mexico
Claudia Ivette Ledesma-Ramírez
Facultad de Medicina (School of Medicine), Universidad Autónoma del Estado de México (Autonomous University of Mexico State), Toluca de Lerdo 50180, Mexico
Hugo Mendieta-Zerón
Facultad de Medicina (School of Medicine), Universidad Autónoma del Estado de México (Autonomous University of Mexico State), Toluca de Lerdo 50180, Mexico
Miguel Ángel Peña-Castillo
División de Ciencias Básicas e Ingeniería (Basic Science and Engineering Division), Universidad Autónoma Metropolitana Unidad Iztapalapa (Metropolitan Autonomous University Campus Iztapalapa), Iztapalapa 09340, Mexico
Juan Carlos Echeverría
División de Ciencias Básicas e Ingeniería (Basic Science and Engineering Division), Universidad Autónoma Metropolitana Unidad Iztapalapa (Metropolitan Autonomous University Campus Iztapalapa), Iztapalapa 09340, Mexico
Jorge Rodríguez-Arce
Facultad de Ingeniería (School of Engineering), Universidad Autónoma del Estado de México (Autonomous University of Mexico State), Toluca de Lerdo 50100, Mexico
José Javier Reyes-Lagos
Facultad de Medicina (School of Medicine), Universidad Autónoma del Estado de México (Autonomous University of Mexico State), Toluca de Lerdo 50180, Mexico
The fetal autonomic nervous system responds to uterine contractions during active labor as identified by changes in the accelerations and decelerations of fetal heart rate (FHR). Thus, this exploratory study aimed to characterize the asymmetry differences of beat-to-beat FHR accelerations and decelerations in preterm and term fetuses during active labor. In an observational study, we analyzed 10 min of fetal R-R series collected from women during active preterm labor (32–36 weeks of pregnancy, n = 17) and active term labor (38–40 weeks of pregnancy, n = 27). These data were used to calculate the Deceleration Reserve (DR), which is a novel parameter that quantifies the asymmetry of the average acceleration and deceleration capacity of the heart. In addition, relevant multiscale asymmetric indices of FHR were also computed. Lower values of DR, calculated with the input parameters of T = 50 and s = 10, were associated with labor occurring at the preterm condition (p = 0.0131). Multiscale asymmetry indices also confirmed significant (p < 0.05) differences in the asymmetry of FHR. Fetuses during moderate premature labor may experience more decaying R-R trends and a lower magnitude of decelerations compared to term fetuses. These differences of FHR dynamics might be related to the immaturity of the fetal cardiac autonomic nervous system as identified by this system response to the intense uterine activity at active labor.
