title: Simulation of fetal heart rate variability with a mathematical model.
abstract: In the clinic, the cardiotocogram (CTG), the combined registration of fetal heart rate (FHR) and uterine contractions, is used to predict fetal well-being. Amongst others, fetal heart rate variability (FHRV) is an important indicator of fetal distress. In this study we add FHRV to our previously developed CTG simulation model, in order to improve its use as a research and educational tool. We implemented three sources of variability by applying either 1/f or white noise to the peripheral vascular resistance, baroreceptor output, or efferent vagal signal. Simulated FHR tracings were evaluated by visual inspection and spectral analysis. All power spectra showed a 1/f character, irrespective of noise type and source. The clinically observed peak near 0.1 Hz was only obtained by applying white noise to the different sources of variability. Similar power spectra were found when peripheral vascular resistance or baroreceptor output was used as source of variability. Sympathetic control predominantly influenced the low frequency power, while vagal control influenced both low and high frequency power. In contrast to clinical data, model results did not show an increase of FHRV during FHR decelerations. Still, addition of FHRV improves the applicability of the model as an educational and research tool.
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Department of Gynecology and Obstetrics, Máxima Medical Center, PO Box 7777, 5500 MB Veldhoven, The Netherlands. Electronic address: g.j.l.m.jongen@tue.nl.
authors.forename: Germaine J L M
authors.initials: GJLM
authors.lastname: Jongen
authors.affiliation: Department of Gynecology and Obstetrics, Máxima Medical Center, PO Box 7777, 5500 MB Veldhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: M Beatrijs
authors.initials: MB
authors.lastname: van der Hout-van der Jagt
authors.affiliation: Department of Gynecology and Obstetrics, Máxima Medical Center, PO Box 7777, 5500 MB Veldhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: S Guid
authors.initials: SG
authors.lastname: Oei
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: Frans N
authors.initials: FN
authors.lastname: van de Vosse
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: p.h.m.bovendeerd@tue.nl.
authors.forename: Peter H M
authors.initials: PHM
authors.lastname: Bovendeerd
mesh_terms: D015148:Cardiotocography; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D008962:Models, Theoretical; D011247:Pregnancy; D012815:Signal Processing, Computer-Assisted; D059629:Signal-To-Noise Ratio
keywords: Cardiotocogram; Computer simulation model; Fetal heart rate variability; Fetal monitoring; Spectral analysis