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Fetal heart rate variability

MedGen UID:
452518
•Concept ID:
C0429478
•
Finding
Synonyms: Beat to Beat Variability; Beat to beat variability; Fetal Heart Rate Variability; FHRV - Fetal heart rate variability; FHRV - Foetal heart rate variability; Foetal heart rate variability
SNOMED CT: FHRV - Fetal heart rate variability (251671002); Beat to beat variability (251671002); FHRV - Foetal heart rate variability (251671002); Foetal heart rate variability (251671002); Fetal heart rate variability (251671002)

Definition

Fluctuations in the baseline fetal heart rate, determined in a 10 minute window while excluding accelerations and decelerations. They are irregular in amplitude and frequency and are visually quantitated as the amplitude of the peak to trough in beats per minute. Sinusoidal patterns are also excluded. [from NCI]

Professional guidelines

PubMed

Optimizing the management of acute, prolonged decelerations and fetal bradycardia based on the understanding of fetal pathophysiology.
Chandraharan E, Ghi T, Fieni S, Jia YJ
Am J Obstet Gynecol 2023 Jun;228(6):645-656. doi: 10.1016/j.ajog.2022.05.014. PMID: 37270260
Effect of maternal magnesium sulfate treatment on fetal heart rate variability.
Cañez MS, Reed KL, Shenker L
Am J Perinatol 1987 Apr;4(2):167-70. doi: 10.1055/s-2007-999765. PMID: 3566885
Fetal heart rate during treatment of maternal hypertension with beta-adrenergic antagonists. A preliminary report.
Ingemarsson I, Liedholm H, Montan S, Westgren M, Melander A
Acta Obstet Gynecol Scand Suppl 1984;118:95-7. doi: 10.3109/00016348409157132. PMID: 6145289

Recent clinical studies

Etiology

Optimizing the management of acute, prolonged decelerations and fetal bradycardia based on the understanding of fetal pathophysiology.
Chandraharan E, Ghi T, Fieni S, Jia YJ
Am J Obstet Gynecol 2023 Jun;228(6):645-656. doi: 10.1016/j.ajog.2022.05.014. PMID: 37270260
A Comprehensive Review of Techniques for Processing and Analyzing Fetal Heart Rate Signals.
Ponsiglione AM, Cosentino C, Cesarelli G, Amato F, Romano M
Sensors (Basel) 2021 Sep 13;21(18) doi: 10.3390/s21186136. PMID: 34577342Free PMC Article
Induction of labor in late FGR.
Oronzii L, D'Antonio F, Tinari S, D'Amico A, DI Sebastiano F, DI Mascio D, Liberati M, Buca D
Minerva Obstet Gynecol 2021 Aug;73(4):490-493. Epub 2021 May 5 doi: 10.23736/S2724-606X.21.04820-X. PMID: 33949825
Fetal heart rate variability analysis for neonatal acidosis prediction.
Gatellier MA, De Jonckheere J, Storme L, Houfflin-Debarge V, Ghesquiere L, Garabedian C
J Clin Monit Comput 2021 Aug;35(4):771-777. Epub 2020 May 25 doi: 10.1007/s10877-020-00535-6. PMID: 32451749
Intrapartum Fetal Monitoring.
Arnold JJ, Gawrys BL
Am Fam Physician 2020 Aug 1;102(3):158-167. PMID: 32735438

Diagnosis

Association between marked fetal heart rate variability and neonatal acidosis: A prospective cohort study.
Loussert L, Berveiller P, Magadoux A, Allouche M, Vayssiere C, Garabedian C, Guerby P
BJOG 2023 Mar;130(4):407-414. Epub 2022 Dec 12 doi: 10.1111/1471-0528.17345. PMID: 36398385Free PMC Article
Induction of labor in late FGR.
Oronzii L, D'Antonio F, Tinari S, D'Amico A, DI Sebastiano F, DI Mascio D, Liberati M, Buca D
Minerva Obstet Gynecol 2021 Aug;73(4):490-493. Epub 2021 May 5 doi: 10.23736/S2724-606X.21.04820-X. PMID: 33949825
Fetal heart rate variability analysis for neonatal acidosis prediction.
Gatellier MA, De Jonckheere J, Storme L, Houfflin-Debarge V, Ghesquiere L, Garabedian C
J Clin Monit Comput 2021 Aug;35(4):771-777. Epub 2020 May 25 doi: 10.1007/s10877-020-00535-6. PMID: 32451749
Simulation of fetal heart rate variability with a mathematical model.
Jongen GJLM, van der Hout-van der Jagt MB, Oei SG, van de Vosse FN, Bovendeerd PHM
Med Eng Phys 2017 Apr;42:55-64. Epub 2017 Feb 11 doi: 10.1016/j.medengphy.2017.01.016. PMID: 28196652
What is fetal distress?
Parer JT, Livingston EG
Am J Obstet Gynecol 1990 Jun;162(6):1421-5; discussion 1425-7. doi: 10.1016/0002-9378(90)90901-i. PMID: 2193513

Therapy

The effect of perceptual decision-making on the interpretation of twin fetal heart rate tracings.
Ploran EJ, Soni S, Snellings JT, Rausch A, Rochelson B
J Matern Fetal Neonatal Med 2022 Jun;35(11):2116-2121. Epub 2020 Jun 29 doi: 10.1080/14767058.2020.1779695. PMID: 32594812
Higher maternal weight is related to poorer fetal autonomic function.
Christifano DN, Taylor MK, Carlson SE, Colombo J, Gustafson KM
J Dev Orig Health Dis 2021 Jun;12(3):354-356. Epub 2020 Jul 14 doi: 10.1017/S2040174420000653. PMID: 32662379
Fetal heart rate variability responsiveness to maternal stress, non-invasively detected from maternal transabdominal ECG.
Lobmaier SM, Müller A, Zelgert C, Shen C, Su PC, Schmidt G, Haller B, Berg G, Fabre B, Weyrich J, Wu HT, Frasch MG, Antonelli MC
Arch Gynecol Obstet 2020 Feb;301(2):405-414. Epub 2019 Nov 28 doi: 10.1007/s00404-019-05390-8. PMID: 31781889
Effect of tocolytic drugs on fetal heart rate variability: a systematic review.
Verdurmen KMJ, Hulsenboom ADJ, van Laar JOEH, Oei SG
J Matern Fetal Neonatal Med 2017 Oct;30(20):2387-2394. Epub 2016 Nov 8 doi: 10.1080/14767058.2016.1249844. PMID: 27756155
The influence of corticosteroids on fetal heart rate variability: a systematic review of the literature.
Verdurmen KM, Renckens J, van Laar JO, Oei SG
Obstet Gynecol Surv 2013 Dec;68(12):811-24. doi: 10.1097/OGX.0000000000000002. PMID: 25102018

Prognosis

Pathophysiological interpretation of fetal heart rate tracings in clinical practice.
Jia YJ, Ghi T, Pereira S, Gracia Perez-Bonfils A, Chandraharan E
Am J Obstet Gynecol 2023 Jun;228(6):622-644. doi: 10.1016/j.ajog.2022.05.023. PMID: 37270259
Fetal heart rate variability analysis for neonatal acidosis prediction.
Gatellier MA, De Jonckheere J, Storme L, Houfflin-Debarge V, Ghesquiere L, Garabedian C
J Clin Monit Comput 2021 Aug;35(4):771-777. Epub 2020 May 25 doi: 10.1007/s10877-020-00535-6. PMID: 32451749
Intrapartum Fetal Monitoring.
Arnold JJ, Gawrys BL
Am Fam Physician 2020 Aug 1;102(3):158-167. PMID: 32735438
Influence of ECG sampling rate in fetal heart rate variability analysis.
De Jonckheere J, Garabedian C, Charlier P, Champion C, Servan-Schreiber E, Storme L, Debarge V, Jeanne M, Logier R
Annu Int Conf IEEE Eng Med Biol Soc 2017 Jul;2017:2027-2030. doi: 10.1109/EMBC.2017.8037250. PMID: 29060294
Simulation of fetal heart rate variability with a mathematical model.
Jongen GJLM, van der Hout-van der Jagt MB, Oei SG, van de Vosse FN, Bovendeerd PHM
Med Eng Phys 2017 Apr;42:55-64. Epub 2017 Feb 11 doi: 10.1016/j.medengphy.2017.01.016. PMID: 28196652

Clinical prediction guides

Pathophysiological interpretation of fetal heart rate tracings in clinical practice.
Jia YJ, Ghi T, Pereira S, Gracia Perez-Bonfils A, Chandraharan E
Am J Obstet Gynecol 2023 Jun;228(6):622-644. doi: 10.1016/j.ajog.2022.05.023. PMID: 37270259
Increased variability of fetal heart rate during labour: a review of preclinical and clinical studies.
Tarvonen MJ, Lear CA, Andersson S, Gunn AJ, Teramo KA
BJOG 2022 Nov;129(12):2070-2081. Epub 2022 Jun 5 doi: 10.1111/1471-0528.17234. PMID: 35596699Free PMC Article
Physiological control of fetal heart rate variability during labour: implications and controversies.
Tournier A, Beacom M, Westgate JA, Bennet L, Garabedian C, Ugwumadu A, Gunn AJ, Lear CA
J Physiol 2022 Feb;600(3):431-450. Epub 2022 Jan 17 doi: 10.1113/JP282276. PMID: 34951476
Fetal heart rate variability analysis for neonatal acidosis prediction.
Gatellier MA, De Jonckheere J, Storme L, Houfflin-Debarge V, Ghesquiere L, Garabedian C
J Clin Monit Comput 2021 Aug;35(4):771-777. Epub 2020 May 25 doi: 10.1007/s10877-020-00535-6. PMID: 32451749
Intrapartum Fetal Monitoring.
Arnold JJ, Gawrys BL
Am Fam Physician 2020 Aug 1;102(3):158-167. PMID: 32735438

Recent systematic reviews

Neonatal and Maternal Outcomes of Lower Versus Standard Doses of Antenatal Corticosteroids for Women at Risk of Preterm Delivery: A Systematic Review of Randomized Controlled Trials.
Ninan K, Morfaw F, Murphy KE, Beyene J, McDonald SD
J Obstet Gynaecol Can 2021 Jan;43(1):74-81. Epub 2020 Mar 26 doi: 10.1016/j.jogc.2020.02.127. PMID: 32660867
Effect of tocolytic drugs on fetal heart rate variability: a systematic review.
Verdurmen KMJ, Hulsenboom ADJ, van Laar JOEH, Oei SG
J Matern Fetal Neonatal Med 2017 Oct;30(20):2387-2394. Epub 2016 Nov 8 doi: 10.1080/14767058.2016.1249844. PMID: 27756155
The influence of corticosteroids on fetal heart rate variability: a systematic review of the literature.
Verdurmen KM, Renckens J, van Laar JO, Oei SG
Obstet Gynecol Surv 2013 Dec;68(12):811-24. doi: 10.1097/OGX.0000000000000002. PMID: 25102018

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