Determination of fetal heart rate short-term variation from umbilical artery Doppler waveforms

L. S. Cahill, G. Stortz, A. Ravi Chandran, N. Milligan, S. Shinar, C. L. Whitehead, S. R. Hobson, S. Millard, C. K. Macgowan, J. C. Kingdom, J. G. Sled, A. A. Baschat

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the feasibility of using umbilical artery (UA) Doppler waveforms to measure fetal heart rate (FHR) short-term variation (STV) across gestation. Methods: This was a prospective longitudinal study, conducted at two study sites, of 195 pregnancies considered low risk. Pulsed-wave Doppler of the UAs was performed at 4-weekly intervals, between 14 and 40 weeks of gestation, using a standardized imaging protocol. Up to 12 consecutive UA Doppler waveforms were analyzed using offline processing software. FHR STV was calculated using average R–R intervals extracted from the waveforms and baseline corrected for FHR. Results: Baseline-corrected FHR STV increased significantly with gestational age (conditional R2 = 0.37; P < 0.0001) and was correlated inversely with FHR (conditional R2 = 0.54; P < 0.0001). The STV ranged (median (interquartile range)) from 3.5 (2.9–4.1) ms at 14–20 weeks' gestation to 6.3 (4.8–7.7) ms at 34–40 weeks' gestation. The change in heart rate STV did not differ between study sites or individual sonographers. Conclusions: UA Doppler waveforms offer a robust and feasible method to derive STV of the FHR. It should be emphasized that the UA Doppler-derived STV is not interchangeable with measurements derived with computerized cardiotocography. Accordingly, further investigations are needed to validate associations with outcome, in order to determine the value of concurrent fetal cardiovascular and heart rate evaluations that are possible with the technique described here.

Original languageEnglish (US)
Pages (from-to)70-74
Number of pages5
JournalUltrasound in Obstetrics and Gynecology
Volume57
Issue number1
DOIs
StatePublished - Jan 2021

Keywords

  • Doppler ultrasound
  • cardiotocography
  • fetal growth restriction
  • fetal heart rate
  • fetal monitoring
  • gestational age
  • late onset
  • longitudinal
  • short-term variation
  • umbilical artery

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

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