Average acceleration and deceleration capacity of fetal heart rate in normal pregnancy and in pregnancies complicated by fetal growth restriction.
OBJECTIVE
To study fetal heart rate (FHR), its short term variability (STV), average acceleration capacity (AAC), and average deceleration capacity (ADC) throughout uncomplicated gestation, and to perform a preliminary comparison of these FHR parameters between small-for dates (SFD) and control fetuses.


METHODS
Prospective observational study of 7 h FHR-recordings obtained with a fetal-ECG monitor in the second half of uncomplicated pregnancies (n = 90) and pregnancies complicated by fetal SFD (n = 30). FHR and STV were calculated according to established analysis. True beat-to-beat FHR, recorded at 1 ms accuracy, was used to calculate AAC and ADC using Phase Rectified Signal Averaging (PRSA). Mean values of FHR, STV, AAC, and ADC derived from recordings in SFD fetuses were compared with the reference curves.


RESULTS
Compared with the control group the mean z-scores for STV, AAC, and ADC in SFD fetuses were lower by 1.0 SD, 1.5 SD, and 1.7 SD, respectively (p < 0.0001 for all comparisons). In SFD fetuses, both the AAC and ADC z-scores were lower than the STV z-scores (p < 0.02 and p < 0.002, respectively).


CONCLUSIONS
Analysis of the AAC and ADC as recorded with a high resolution fECG recorder may differentiate better between normal and SFD fetuses than STV.
Department of Obstetrics & Gynaecology, University Medical Centre Utrecht , The Netherlands. e.m.graatsma@umcutrecht.nl
E M
EM
Graatsma
E J H
EJ
Mulder
B
B
Vasak
S M
SM
Lobmaier
S
S
Pildner von Steinburg
K T M
KT
Schneider
G
G
Schmidt
G H A
GH
Visser
D000054:Acceleration; D001724:Birth Weight / Q000502:physiology; D016022:Case-Control Studies; D003654:Deceleration; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005323:Fetal Monitoring; D005865:Gestational Age; D006262:Health; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000503:physiopathology; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology