Fetal gastroschisis: antepartum fetal heart rate analysis by computerized cardiotocography

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 30; no. 5; pp. 605 - 611
• Main Authors: Andrade, Walkyria S., Brizot, Maria de L., Miyadahira, Seizo, Osmundo Junior, Gilmar de Souza, Francisco, Rossana P.V., Zugaib, Marcelo
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 04-03-2017
• Subjects: Adolescent; Adult; Cardiotocography - methods; Chi-Square Distribution; Computerized cardiotocography; Female; fetal malformation; gastroschisis; Gastroschisis - diagnostic imaging; Gastroschisis - physiopathology; Gestational Age; Heart Rate, Fetal; Humans; Pregnancy; Retrospective Studies; Statistics, Nonparametric; Ultrasonography, Prenatal; Young Adult; Computerized cardiotocography; fetal malformation; gastroschisis; pregnancy
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2016.1181166

Objectives: To describe the antenatal fetal heart rate (FHR) parameters analyzed by computerizedcardiotocography (cCTG) in fetuses with gastroschisis and compare the FHR parameters with ultrasound gastrointestinal markers.
Methods: A retrospective analysis of antepartum cCTG records were conducted in 87 pregnant cases with fetal gastroschisis between 28and 36 weeks (plus 6 days). A comparative analysis of the median distribution of the following FHR parameters was performed: basal FHR, short-term variation (STV), FHR accelerations and decelerations, episodes of high and low variations, and variations in low and high episodes. FHR parameters and ultrasound gastrointestinal markers were also compared.
Results: The majority of FHR parameters did not present significant changes throughout gestation. An increased number of records with episodes of low variation (p = 0.019) and an increased number of accelerations >15 bpm (p = 0.001) were the only observed changes throughout gestation. Stomach herniation was significantly associated with a lower STV (p = 0.018) and a higher frequency of records with low episodes (p = 0.049).
Conclusions: The cCTG analysis indicated that the FHR parameters in fetuses with gastroschisis presented different patterns from those observed in normal fetuses. Stomach herniation was associated with altered FHR patterns.