(2000). Sci. All authors reviewed the manuscript. Trans. For the coupling strength, A_fBBI→mBBI was significantly lower for the abnormal group while A_mBBI→fBBI was significantly higher. However, this needs to be further investigated with a larger sample of abnormal cases. doi: 10.1016/j.bspc.2016.06.010, Kurths, J., Voss, A., Saparin, P., Witt, A., Kleiner, H. J., and Wessel, N. (1995). Strong unidirectional coupling is indicated if NF is equal to −2 or 2, bidirectional coupling with the determination of the driver-responder relationship exists if NF is equal to −1 or 1, and a similar influence in both directions and no coupling is present if NF is equal to 0. Absent C Endocrine physiology of the placenta. All experiments were performed in accordance with relevant guidelines and regulations. The NF can take the following values: NF = {−2, −1, 0, 1, 2}. The NCC EFM Tracing Game... already played 10,000 times! (2011). Incorrect. Table 2. Decelerations occur at the same time contractions as contractions do, 1. Neuroimage 19, 1273–1302. 1. The low variability patterns (quantified by plvar10) were significantly lower for the abnormal group while the high variability patterns (phvar10) were significantly higher. With this statistical definition of a threshold level, finding a coupling in the original time series higher than the threshold leads to reject the null hypothesis, and to detect the presence of a significant coupling. Both time series were visually inspected and if appropriate reedited. Testing foetal-maternal heart rate synchronization via model-based analyses. 371:20120191. doi: 10.1098/rsta.2012.0191, Schulz, S., Bär, K. J., and Voss, A. This means that a clear physiological interpretation of the results higher than 0.66 Hz is more speculative. max(ā,b̄). Methods Inf. fetal heart monitoring principles and practices Dec 08, 2020 Posted By Beatrix Potter Library TEXT ID 0472de5d Online PDF Ebook Epub Library and practices ebookthis resource will provide you with the evidence based essential Mathemat. Therefore, the aim of this study was to evaluate fetal maternal heart rate coupling strength and directions of a variety of abnormal fetuses by using NSTPDC method and the compare the results with the same from normal cases. Now let's look at what all those squiggly lines on the monitor mean. The correlation became reasonably strong in the abnormal cases (Figure 7). Physiol. Most fetal dysrhythmias are not life-threatening, except for _____, which may lead to fetal congestive heart failure. Phys. Demographics data for the abnormal cases. For our analysis, the total number of bins was chosen to be 225 with a width of 8 ms for the range of 200–2,000 ms. 7) Renyi025: Renyi entropy which is a generalization of the Shannon entropy, was computed on the probability distribution similar to Shannon entropy using the following equation: For Renyi25, α = 0.25 where α is a weighting factor, pi is the probability of the i-th bin of the fBBI histogram and k is the total number of bins which was set to 225 with a width of 8 ms for the range of 200–2,000 ms. 8) plvar10: portion of low-variability patterns within the fBBI NN-intervals <10 ms (Kurths et al., 1995; Voss et al., 1996). 1), 1–2. We hypothesize that the strength and directionality of fetal–maternal heart rate couplings in sick fetuses are altered depending on the types of abnormalities and thus could become useful markers in screening abnormal fetuses from normal ones. The compression entropy was also significantly higher for the abnormal group. Further studies are required to look at the possible link. Incorrect. (2018). It could also be argued that lower plvar10 and higher phvar10 of beat to beat heart intervals to shift the balance between sympathetic and parasympathetic activity as it was previously reported in adult HRV study (Seifert et al., 2018). However, we have to state that couplings higher than half of the mean heart rate (mother) are possibly only caused by “mirrored components” due to cardiac aliasing effects (Milde et al., 2011). Siu, K. L., Ahn, J. M., Ju, K., Lee, M., Shin, K., and Chon, K. H. (2008). Maternal fever=>Fetus will vasodilate=> ↓ PVR => Vagus inhibited => HR ↑, 1. fetal heart monitoring principles and practices Dec 20, 2020 Posted By Robin Cook Media TEXT ID 0472de5d Online PDF Ebook Epub Library fetal heart monitoring principles and practices ebookthis resource will provide you with the Physiol., 26 April 2019 Cardiovascular and cardiorespiratory coupling analyses: a review. Phys. 2D NSTPDC plots for: (A) fetal auto-coupling (fBBI→fBBI), (B) maternal-fetal coupling (mBBI→fBBI), (C) fetal-maternal coupling (fBBI→mBBI), and (D) maternal auto-coupling (mBBI→mBBI) for a fetus with SSS (ID: 7, Table 2). A Math. Fetal ECG traces were extracted from abdominal ECG signals by using a method that combines cancellation of the mother's ECG signal and the blind source separation with reference (BSSR) as described in our earlier study (Sato et al., 2007). In conclusion, maternal-fetal cardiac coupling strength and direction and their associations with regulatory mechanisms (patterns) of developing autonomic nervous system function could be novel clinical markers of healthy prenatal development and its deviation. Syst. 9) phvar10: portion of high-variability patterns within the fBBI NN-intervals >10 ms. 10) hLZ77w3b3: Compression entropy with buffer size b = 3 and the window length w = 5. Heart Circ. Thus, couplings higher than half of the mean heart rate (mother) are probably “mirrored components” due to cardiac aliasing effects (Milde et al., 2011), and therefore, not of physiological relevance. Biomed. The key elements include assessment of The key elements include assessment of baseline heart … were determined for identifying the coupling strength using a trapezoidal numerical integration function to approximate the areas generated in space by a coupling factor (CF) values (one CF in each window). Among the Granger causality based approaches in frequency domain, Partial Directed Coherence (PDC) and the directed transfer function (DTF), and their enhanced versions (e.g., the normalized short time partial directed coherence (NSTPDC) are the most recent techniques applied to the oscillatory nature of physiological variables such as beat to beat heart rate (Porta and Faes, 2013). doi: 10.1152/ajpheart.00882.2001, Pan, J., and Tompkins, W. J. doi: 10.1109/TBME.1985.325532, Porta, A., and Faes, L. (2013). Influence of paced maternal breathing on fetal-maternal heart rate coordination. 140 Correct.Remember,thebaselineisthe 145 150 bpm 155 160 2. Statistical approach to quantify the presence of phase coupling using the bispectrum. Learn vocabulary, terms, and more with flashcards, games, and other study tools. doi: 10.1016/j.joim.2018.03.002. In general, the coupling strength for the normal cases from the fetus to the maternal heart rate (A_fBBI→mBBI = 0.44 ± 0.13) was much higher than for the abnormal cases (A_fBBI→mBBI = 0.08 ± 0.12), on the other hand, the coupling strength for the healthy cases from the maternal to the fetus heart rate (A_mBBI→fBBI = 0.46 ± 0.12) was lower than for the abnormal cases (A_mBBI→fBBI = 0.66 ± 0.24) (Figure 3B). The application of methods of non-linear dynamics for the improved and predictive recognition of patients threatened by sudden cardiac death. Figure 5. All results were presented as mean ± SD. 367, 1407–1421. Fetal Heart Tracing Quiz 6 - FHTQuiz6 FetalTracingQuiz Perfect! • The NCC EFM Tracing Game uses NICHD terminology • External monitoring (unless noted differently), paper speed is 3cm/min • Collections are larger groups of tracings, 5 tracings are randomly selected each time a collection is played Multivariate assessment of the central-cardiorespiratory network structure in neuropathological disease. The editor and reviewers' affiliations are the latest provided on their Loop research profiles and may not reflect their situation at the time of review. (1996). 43, 202–206. It was also suggested that the short time fetal–maternal heart rate coupling might occur through auditory stimulation associated with the maternal heart rhythms, perceived by the fetal auditory pathways (Riedl et al., 2009; Van Leeuwen et al., 2014). 18:100201. doi: 10.1088/1367-2630/18/10/100201, Jensen, A. FHR Nervous system pathway: Normal tracing/ healthy pattern, 1. Wang, Y. NSTPDC fetal-to-maternal coupling analyses revealed significant differences between the normal and abnormal cases (normal: normalized factor (NF) = −0.21 ± 0.85, fetus-to-mother coupling area (A_fBBI→ mBBI) = 0.44 ± 0.13, mother-to-fetus coupling area (A_mBBI→ fBBI) = 0.46 ± 0.12; abnormal: NF = −1.66 ± 0.77, A_fBBI→ mBBI = 0.08 ± 0.12, A_mBBI→ fBBI = 0.66 ± 0.24; p < 0.01). Math. Supraventricular tachycardia Medications, prematurity, fetal sleep, fetal dysrhythmia, anesthetic agents, or cardiac anomalies may result in _______ variability. Our results have shown weakening of coupling from fetal heart rate to maternal heart rate as the fetal development progresses while the influence from maternal to fetal heart rate coupling behaves oppositely as it shows increasing coupling strength that reaches its maximum at mid gestation. The study protocol was approved by Tohoku University Institutional Review Board and written informed consent was obtained from all subjects. (2014). Results of those studies suggested that high maternal breathing rate might induce the synchronization as it occurred significantly more often at fast maternal breathing and less at slow respiratory rates (Van Leeuwen et al., 2009). The 2D color maps of the maternal-fetal coupling were useful visual tools that differentiate various types of abnormalities which had varying coupling strength at different frequency bands (Figures 4–6). 10:482. doi: 10.3389/fphys.2019.00482. The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) maintains that the availability of registered nurses (RNs) and other health care professionals who are skilled in fetal heart monitoring (FHM) techniques, including auscultation and electronic fetal monitoring (EFM), is essential to maternal and fetal well-being during antepartum care, labor, and birth. Philos. Remember, the baseline is the average heart rate rounded. These non-linear and coupling methods between fetal and maternal heart rate could help monitor the development of normal fetal cardiac health and identify pathologies throughout the pregnancy period before delivery and thus could initiate preemptive actions to save tiny lives in utero. 1. The fetal auto-coupling strength (fBBI→fBBI) is high possibly because the ANS is not completely developed and has low HRV at this age. 36, 683–698. Electronic fetal heart rate monitoring is commonly used to assess fetal well-being during labor. This fetal heart rate deceleration quiz will help you learn how to differentiate between early decelerations, late decelerations, and variable decelerations. Stop oxytocin (Causes uterine contractions), 1. Eng. In recent years, it has become apparent that most cases of fetal anomalies are unrelated to intrapartum events and therefore cannot be prevented by intrapartum fetal heart rate (FHR) monitoring. Different permutations were used for the original series, so that any temporal structure was destroyed in the surrogate time series. Webb, K. A., Wolfe, L. A., and Mcgrath, M. J. doi: 10.1055/s-0038-1633859, Bekedam, D. J., Mulder, E. J., Snijders, R. J., and Visser, G. H. (1991). 55, 1512–1520. doi: 10.1088/0967-3334/32/11/S06, Monk, C., Fifer, W. P., Myers, M. M., Sloan, R. P., Trien, L., and Hurtado, A. Normal was distinguished from abnormal cases with its high fBBI→mBBI coupling. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). For HRV analyses surrogates were generated by randomly permuting the samples of the original series in temporal order. Math. U.S.A. 106, 13661–13666. All recordings (each of 1 min length) were collected during daytime (between 9 am and 2 pm) and sampled at 1,000 Hz with 16-bit resolution. Table 1. Enjoy and learn!This channel is for educational purposes only! Methods derived from nonlinear dynamics for analysing heart rate variability. However, determination of the underlying mechanisms and patterns required further investigation of the coupling and its directionality (fetal to maternal and vice versa). (2007). Moreover, the non-parametric Mann-Whitney U-Test was applied to determine differences between normalsurrogates and abnormalsurroagtes, considering statistical significant at p < 0.01. 16, 172–177. Chaos 5, 88–94. Solid line represents linear fit for the normal group and dashed lines indicate 95% confidence interval. Schulz, S., and Voss, A. No use, distribution or reproduction is permitted which does not comply with these terms. The abnormal group has a variety of abnormalities such as: fetal bradycardia, fetal tachycardia, premature atrial contraction, and different types of congenital heart defects (CHD) or anomalies (ventriculoseptal defect (VSD), atrial septal defect (ASD), pulmonary atresia (PA), tetralogy of Fallot (TOF), and Ebstain anomaly). Surrogate analyses did not reveal any significant differences between normal fetuses and abnormal fetuses surrogate time series, and thereby, confirming the statistical validity of the found HRV and NSTPDC results (Table 3). 43, 163–188. 11:33. doi: 10.3389/fnsys.2017.00033, Van Leeuwen, P., Geue, D., Thiel, M., Cysarz, D., Lange, S., Romano, M. C., et al. Try this amazing Electronic Fetal Heart Monitoring Trivia Quiz Questions! Spearman's correlation coefficients between the coupling features and the HRV features were also estimated. Thus, A_fBBI→mBBI represents the causal coupling strength for the causal link from fBBI to mBBI (fetus to mother), A_mBBI→fBBI represents the causal coupling strength for the causal link from mBBI to fBBI (mother to fetus), and A_mBBI→mBBI/ A_fBBI→fBBI represents the causal coupling strength from mBBI to mBBI or mBBI to mBBI [mother to mother/ fetus to fetus (auto-coupling)]. Examples of the fetal and maternal ECGs and their corresponding heart rates fBBI and mBBI are shown in Figures 1, 2, respectively. The window length is 160 samples. Physiol. IEEE Trans. Dynamic causal modelling. These four area indices take values from the range of [0,1]. doi: 10.1016/0378-3782(91)90196-A, Faes, L., Marinazzo, D., Jurysta, F., and Nollo, G. (2015). This study was supported by Healthcare Engineering Innovation Center (HEIC) of Khalifa University as well as Khalifa University Internal Research Fund Level 2 awarded to AK. Electronic Fetal Heart Rate Monitoring (EFM) Tracing Interpretation Accelerations ↑ FHR at least 15/min above baseline for ≥ 15 seconds and < 2 minutes in a 20 minute period when gestational age is > 32 weeks or 10/min for ≥ 10 seconds when gestational age is < 32 weeks Early deceleration= Fetal head compression, 1. Plasticity of brain wave network interactions and evolution across physiologic states. Lilliefort test was used to check normality of the features in the two groups. (1994). Am. Unlike adult heart rate, fetal heart rate (FHR) is much faster and irregular so it is constantly moving up and down an imaginary "basal heart rate ”, which is normally from 120 to 160 bpm. Eng. These results were normalized to become a specific set of values leading to the (normalized) factor NF representing the coupling direction. Biomed. Evidence of unbalanced regulatory mechanism of heart rate and systolic pressure after acute myocardial infarction. The oscillations up and down this imaginary line are called variability , and, there are 2 types of variability seen during the normal tracing of the fetal heart rate: Eng. Also, all except ID: 17 had A_fBBI→mBBI < 0.2 (Figure 3B) for A_mBBI→fBBI, 10 cases were >0.75 including the cases with Tachycardia (ID: 6, 13) while cases with AV block (ID: 8, 17) were below 0.4 (Figure 3C). Duration of the collected ECGs was 1–2 min which is typical in routine visits during pregnancy. SS and AV applied signal processing methods and extracted coupling features. Early Hum. (1996). Prenatal stress, glucocorticoids and the programming of the brain. Assessing causality in brain dynamics and cardiovascular control. Compression entropy quantifies to what extent data can be compressed (Baumert et al., 2004). Scheduled interactive fetal heart rate assessment by the entire team using an evidence-based Category II fetal heart rate algorithm further enhanced fetal safety. The normalized factor (NF) did not show correlation with any of the other HRV features.
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