Fetal adaptation to cardiotocography as a criterion of fetal condition

Aim. To investigate fetal adaptation profile during antenatal cardiotocography (CTG) with subsequent analysis of neonatal outcomes. Materials and methods. The retrospective study included 1927 observations at 33 to 40 weeks of gestation. Consecutive RR intervals were recorded using a UNICOS fetal computerized cardiac monitor. Heart rate variability (HRV) was assessed during the first 30 measurements. Based on cluster analysis, observations were divided into two groups categorized by fetal adaptation profiles as 1 [habituation, n=1702 (88.3%)] and 2 [dishabituation, n=225 (11.7%)]. The relationship between adaptation profiles and data on the early neonatal complications was analyzed. Results. Fetal HRV analysis showed that in most cases, fetuses quickly adapted to the CTG and maintained parameters throughout the procedure. In the first group, the profile showed a decrease in RR interval variance with relatively low basal heart rate and fetal condition indicator (FCI). In the second group (newborns with complicated neonatal course), the profile was characterized by a high basal heart rate, high RR interval variance, and higher mean FCI. HRV changes during adaptation to the CTG were associated with complications identified in newborns. Conclusion. Fetal HRV assessment during adaptation to CTG is essential for assessing the fetal condition and predicting the complicated neonatal course.

habituations, habituations, cardiotocography, heart rate variability