title: Relationship of systolic/diastolic ratios from umbilical velocimetry to fetal heart rate.
abstract: We assessed the relationship between systolic/diastolic ratios as determined by umbilical velocimetry to fetal heart rate. Umbilical velocimetry was performed with continuous-wave Doppler ultrasound and systolic/diastolic ratios and fetal heart rate for the corresponding cardiac cycles were calculated in four groups of patients. Group 1 consisted of 30 patients undergoing antepartum fetal testing; systolic/diastolic ratios were found to be significantly lower (mean +/- SD, 2.0 +/- 0.15) during an evoked fetal heart rate acceleration with an artificial larynx than either before (2.4 +/- 0.14) or after the acceleration (2.35 +/- 0.10, p less than 0.01). In 20 patients with pyelonephritis (group 2), systolic/diastolic ratios were significantly lower during initial fetal tachycardia (1.6 +/- 0.21) as compared with those obtained after its resolution (2.1 +/- 0.12, p less than 0.08). In the 25 patients with chorioamnionitis in group 3, systolic/diastolic ratios were significantly higher during initial fetal tachycardia (1.4 +/- 0.21) than after its resolution (1.9 +/- 0.15, p less than 0.05). Twenty patients in labor (group 4) had 10 serial measurements at 1 to 2-hour intervals of systolic/diastolic ratio and FHR. Least-squares regression of each patient showed a negative slope that differed statistically from zero (p less than 0.05). There were no patients with elevated systolic/diastolic ratios greater than 3.0 in any group and all patients delivered fetuses appropriate for gestational age. These findings suggest an inverse relationship between systolic/diastolic ratio and fetal heart rate. Additionally, an alteration in fetal heart rate within the range studied does not itself produce abnormal ratios. Therefore normalization of the systolic/diastolic ratio for heart rate may be considered in clinical studies for statistical analysis and comparison but may have little practical or clinical relevance when the ratios are abnormal.
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
authors.forename: H S
authors.initials: HS
authors.lastname: Brar
authors.forename: A L
authors.initials: AL
authors.lastname: Medearis
authors.forename: L D
authors.initials: LD
authors.lastname: Platt
mesh_terms: D001783:Blood Flow Velocity; D003971:Diastole; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy / Q000502:physiology*; D012044:Regression Analysis; D013599:Systole; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000502:physiology*; D014655:Vascular Resistance