The effects of intrapartum hypoxia on the fetal QT interval.

Détails

ID Serval
serval:BIB_33194
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The effects of intrapartum hypoxia on the fetal QT interval.
Périodique
BJOG
Auteur(s)
Oudijk M.A., Kwee A., Visser G.H., Blad S., Meijboom E.J., Rosén K.G.
ISSN
1470-0328
Statut éditorial
Publié
Date de publication
2004
Volume
111
Numéro
7
Pages
656-660
Langue
anglais
Résumé
BACKGROUND: The morphology of the fetal ECG complex provides information on the fetal condition during labour, such as the ST segment and T-wave configuration. We hypothesised that the intrapartum fetal QT interval may provide additional information on the condition of the fetus, as it is known that the QT interval reacts to situations of stress and exercise. DESIGN: Retrospective study. SETTING: Data were substracted from a European community multicentre trial. METHODS: The intrapartum QT interval was measured in 68 fetuses who were acidemic at birth (pH <7.05 and BD (ecf) >12 mmol/L) and in a control group of similar size. All of these cases were monitored by STAN S21. Measurements were performed at the start of the recording at baseline heart rate, during variable decelerations and at the end of the recording. The QTc was calculated using Bazett's formula: QT/ radical RR. The intervals were compared using the Wilcoxon signed ranks test. MAIN OUTCOME MEASURES: Fetal QT interval, and the corrected QT interval: QTc. RESULTS: In the acidemic fetuses, there was a significant shortening of the QTc interval at the end of the recording compared with the start of the recording (397 ms at the end vs 359.3 ms at start; P < 0.001), in association with a significantly lowered heart rate (136.3 vs 110.9 bpm, P < 0.001). Measurements of QT and QTc during variable decelerations at the start and end of the recording also showed a shortening of the QT interval (301.9 vs 273.3 ms, P< or = 0.001) and QTc interval (381.6 vs 340.3, P < 0.001), and this was not dependent on heart rate. In the control cases, no differences in FHR, QT and QTc intervals were present. CONCLUSIONS: In intrapartum hypoxia, resulting in metabolic acidosis, a significant shortening of the fetal QT and QTc is present, irrespective of changes in heart rate. In control cases, this shortening does not occur. The intrapartum fetal QT interval may therefore provide additional information on the condition of the fetus.
Mots-clé
Cardiotocography, Delivery, Obstetric, Electrocardiography, Female, Fetal Hypoxia/physiopathology, Heart Rate, Fetal/physiology, Humans, Pregnancy, Retrospective Studies
Pubmed
Web of science
Open Access
Oui
Création de la notice
19/11/2007 12:32
Dernière modification de la notice
20/08/2019 13:18
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