Characteristics of Heart Rate Tracings in Preterm Fetus

<i>Background and Objectives:</i> Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determ...

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Main Authors: Maria F. Hurtado-Sánchez, David Pérez-Melero, Andrea Pinto-Ibáñez, Ernesto González-Mesa, Juan Mozas-Moreno, Alberto Puertas-Prieto
Format: Article
Language:English
Published: MDPI AG 2021-05-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/57/6/528
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author Maria F. Hurtado-Sánchez
David Pérez-Melero
Andrea Pinto-Ibáñez
Ernesto González-Mesa
Juan Mozas-Moreno
Alberto Puertas-Prieto
author_facet Maria F. Hurtado-Sánchez
David Pérez-Melero
Andrea Pinto-Ibáñez
Ernesto González-Mesa
Juan Mozas-Moreno
Alberto Puertas-Prieto
author_sort Maria F. Hurtado-Sánchez
collection DOAJ
description <i>Background and Objectives:</i> Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM). The aims of this narrative review were to summarize the most relevant concepts in the field of CTG interpretation in preterm fetuses, and to provide a practical approach that can be useful in clinical practice. <i>Materials and Methods:</i> A MEDLINE search was carried out, and the published articles thus identified were reviewed. <i>Results:</i> Compared to term fetuses, preterm fetuses have a slightly higher baseline FHR. Heart rate is faster in more immature fetuses, and variability is lower and increases in more mature fetuses. Transitory, low-amplitude decelerations are more frequent during the second trimester. Transitory increases in FHR are less frequent and become more frequent and increase in amplitude as gestational age increases. <i>Conclusions:</i> The main characteristics of FHR tracings changes as gestation proceeds, and it is of fundamental importance to be aware of these changes in order to correctly interpret CTG patterns in preterm fetuses.
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spelling doaj.art-b3a5219e1da2460883c9b1c21ed749112023-11-21T21:12:59ZengMDPI AGMedicina1010-660X1648-91442021-05-0157652810.3390/medicina57060528Characteristics of Heart Rate Tracings in Preterm FetusMaria F. Hurtado-Sánchez0David Pérez-Melero1Andrea Pinto-Ibáñez2Ernesto González-Mesa3Juan Mozas-Moreno4Alberto Puertas-Prieto5Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, SpainAnesthesiology, Resuscitation and Pain Therapy Service, Virgen de las Nieves University Hospital, 18014 Granada, SpainObstetrics and Gynecology Service, Poniente Hospital, 04700 El Ejido (Almería), SpainObstetrics and Gynecology Service, Regional University Hospital of Malaga, 29011 Malaga, SpainObstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, SpainObstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, Spain<i>Background and Objectives:</i> Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM). The aims of this narrative review were to summarize the most relevant concepts in the field of CTG interpretation in preterm fetuses, and to provide a practical approach that can be useful in clinical practice. <i>Materials and Methods:</i> A MEDLINE search was carried out, and the published articles thus identified were reviewed. <i>Results:</i> Compared to term fetuses, preterm fetuses have a slightly higher baseline FHR. Heart rate is faster in more immature fetuses, and variability is lower and increases in more mature fetuses. Transitory, low-amplitude decelerations are more frequent during the second trimester. Transitory increases in FHR are less frequent and become more frequent and increase in amplitude as gestational age increases. <i>Conclusions:</i> The main characteristics of FHR tracings changes as gestation proceeds, and it is of fundamental importance to be aware of these changes in order to correctly interpret CTG patterns in preterm fetuses.https://www.mdpi.com/1648-9144/57/6/528fetal heart ratepreterm fetuscardiotocographyfetal heart rate patternselectronic fetal monitoring
spellingShingle Maria F. Hurtado-Sánchez
David Pérez-Melero
Andrea Pinto-Ibáñez
Ernesto González-Mesa
Juan Mozas-Moreno
Alberto Puertas-Prieto
Characteristics of Heart Rate Tracings in Preterm Fetus
Medicina
fetal heart rate
preterm fetus
cardiotocography
fetal heart rate patterns
electronic fetal monitoring
title Characteristics of Heart Rate Tracings in Preterm Fetus
title_full Characteristics of Heart Rate Tracings in Preterm Fetus
title_fullStr Characteristics of Heart Rate Tracings in Preterm Fetus
title_full_unstemmed Characteristics of Heart Rate Tracings in Preterm Fetus
title_short Characteristics of Heart Rate Tracings in Preterm Fetus
title_sort characteristics of heart rate tracings in preterm fetus
topic fetal heart rate
preterm fetus
cardiotocography
fetal heart rate patterns
electronic fetal monitoring
url https://www.mdpi.com/1648-9144/57/6/528
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