Heart Rate Variability Analysis Allows Early Asphyxia Detection in Ovine Fetus

Fetal heart rate (FHR) monitoring is commonly used to predict asphyxia but clinical and experimental studies have questioned its diagnostic value. We examined the usefulness of fetal heart rate variability (fHRV) measures in detecting early asphyxia using, chronically), instrumented fetal sheep under normoxic (n = 6) mid asphyxic conditions (3 umbilical cord occlusions, n = 6), The occlusions consistently led to pH decreases from 7.35 +/- 0.01 to 7.09 +/- 0.03 (P < .05). FHR showed biphasic deceleration during each occlusion, associated with increasing arterial blood pressure (P <. 05). RMSSD, an index of vagal modulation of fHRV increased consistently during repeated occlusion induced FHR deceleration (P < .05). Under normoxic conditions, RMSSD did not change during FHR decelerations and decreased during FHR accelerations (P < .05). Our results suggest that an increase of RMSSD in association with FHR decelerations reflects initial vagal activation during fetal ashyxia. RMSSd may accurately identify asphyxic fetuses early. Clinical validation is needed.