Alangari Haitham M, Kimura Yoshitaka, Khandoker Ahsan H
Annu Int Conf IEEE Eng Med Biol Soc. 2018 Jul;2018:251-254. doi: 10.1109/EMBC.2018.8512272.
Monitoring fetal heart rate in an important aspect in evaluating fetal well being. Maternal-fetal interaction has shown evolution during fetal maturation. In this work, we studied maternal-fetal heart rate synchronization in early and late gestation fetuses. We also evaluated variations in the synchronization due to congenital heart defect (CHD). Maternal-fetal heart rate synchronization for 22 early gestation (Age < 32 weeks), $late gestation (Age >32 weeks) and 7 CHD fetuses (5 of them with gestational age < 32 weeks). The synchronization ratio between the mother and the fetus was more localized at certain fetus heart rate in the early gestation group while it was spreading over more fetal heart rate for the late group. For example, for maternal primary cycle of 3 beat- to-beat (m=3), the synchronization ratio of 5 fetus beats (n=5) contributed 60±30% of the whole coupling ratios for the early group while it contributed 30°30% for the late group (p< 0.01). On the other hand, the coupling ratio of m:n=3:7 contributed 4±17% of the early group and 13±24% for the late group (p< 0.05). The standard deviation of the phase coherence index $(\lambda_{-\mathrm{S}\mathrm{D}})$ for both the late and the CHD groups were significantly higher than the early group at different values. For example, $\lambda -\mathrm{S}\mathrm{D} was 0.006\pm 0.004$ for the early group while it was 0.009±0.008 for the late group (p< 0.01) and 0.01± 0.002 for the CHD group (p< 0.01) for m=3. The variation between the early and late normal groups might indicate a healthy development of the autonomic nervous system while the higher variation in the CHD group could be a good marker for impairment of the cardiac autonomic activity. Further coupling analysis with more abnormal cases is needed to verify these findings.
监测胎儿心率是评估胎儿健康状况的一个重要方面。母婴互动在胎儿成熟过程中呈现出演变。在这项研究中，我们研究了妊娠早期和晚期胎儿的母婴心率同步情况。我们还评估了由于先天性心脏病（CHD）导致的同步变化。对22例妊娠早期（年龄<32周）、晚期妊娠（年龄>32周）和7例先天性心脏病胎儿（其中5例孕周<32周）进行母婴心率同步研究。妊娠早期组母婴同步率在特定胎儿心率处更为集中，而晚期组则分布在更多的胎儿心率上。例如，对于母亲3次逐搏的主周期（m = 3），5次胎儿搏动（n = 5）的同步率在早期组中占整个耦合率的60±30%，而在晚期组中占30±30%（p<0.01）。另一方面，m:n = 3:7的耦合率在早期组中占4±17%，在晚期组中占13±24%（p<0.05）。在不同值时，晚期组和先天性心脏病组的相位相干指数标准差（λ-SD）均显著高于早期组。例如，对于m = 3，早期组的λ-SD为0.006±0.004，晚期组为0.009±0.008（p<0.01），先天性心脏病组为0.01±0.002（p<0.01）。早期和晚期正常组之间的差异可能表明自主神经系统的健康发育，而先天性心脏病组中较高的差异可能是心脏自主活动受损的良好标志。需要对更多异常病例进行进一步的耦合分析以验证这些发现。
