Abstract
Objectives:To describe maternal heart rate patterns observed during antenatal monitoring under resting conditions between the gestational ages of 34 to 38 weeks and to demonstrate its associations with uterine activity.Methods:Each participant had five high quality ECG electrodes attached to her anterior abdominal wall which were connected to the Monica AN24 device to collect raw electrical signals from the maternal and fetal ECG and signals of uterine activity. Proprietary software was then used to download the raw data and extract the maternal and fetal heart rate patterns and uterine activity.Results:Several distinct maternal heart rate patterns were observed. These included unusually high or low levels of variability, tachycardia, bradycardia, regular and irregular periodic changes and sporadic changes where the heart rate suddenly decreased or increased. Some of the fluctuations, especially decelerations of maternal heart rate, seemed to be associated with uterine activity.Conclusion:The clinical implications of these different patterns, for both the mother and fetus, needs to be explored further. There is a need for computerized analyses of the different maternal patterns during different gestational ages to determine its relevance.SynopsisVarious maternal heart rate patterns under resting conditions in late pregnancy are described.
Highlights
Poor maternal cardiac function is associated with reduced fetal growth as reflected by reduced birth weight and preterm delivery, with reduced cardiac output and maternal cyanosis suggested as underlying mechanisms [1]
As heart rate is one of the determinants of cardiac output [3], it is essential to know more about the significance of ranges of maternal heart rates in pregnancy
There is a paucity of literature regarding maternal heart rate (MHR) under resting conditions during pregnancy, before the onset of labour
Summary
Poor maternal cardiac function is associated with reduced fetal growth as reflected by reduced birth weight and preterm delivery, with reduced cardiac output and maternal cyanosis suggested as underlying mechanisms [1]. As heart rate is one of the determinants of cardiac output [3], it is essential to know more about the significance of ranges of maternal heart rates in pregnancy. Another developing field of interest is assessment of heart rate variability (HRV) as a biomarker for autonomic nervous system (ANS) function [4]. There is a paucity of literature regarding maternal heart rate (MHR) under resting conditions during pregnancy, before the onset of labour. There is little information about the periodic effects of uterine activity on the MHR prior to the onset of labour. Reports on incidental monitoring of the MHR by scalp electrodes [5,6] or ultrasound transducers provide little information on different MHR patterns [7,8]
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