Prospects for the study of some electrophysiological parameters in the diagnosis of fetal growth restriction

Abstract

Background. Fetal growth restriction is a clinical syndrome that has adverse effects on both perinatal outcomes and human health in adulthood. Traditional approaches to the diagnosis of this syndrome are based on ultrasound biometry and dopplerometry of uteroplacental and fetal-umbilical blood flow. The equipment used for such research is very expensive, and the training of a qualified specialist takes a long time. Non-invasive electrocardiography makes it possible to evaluate fetal heart rate variability and morphological parameters of the pQRST complex. The purpose: to determine indices of heart rate variability and morphological parameters based on the data of fetal non-invasive electrocardiography, which can be used to diagnose fetal growth restriction. Materials and methods. Two hundred and twenty pregnant women aged 18 to 40 years on 24–41 weeks of gestation were enrolled in the study. All of them were divided into two groups: 108 women with fetal growth restriction were included in group I, and 112 patients with healthy fetuses in group II. The fetal electrocardiogram was recorded in abdominal lead for 30–60 minutes. Results. The performed work made it possible to detect statistically significant changes in some indices of heart rate variability on the background of fetal growth restriction: SI, TP, AC/DC, LF, LF/HF ratio, as well as morphological parameters: QTc duration, QRS complex width and T/QRS ratio. The obtained data demonstrated a violation of autonomic regulation following fetal growth restriction and reflected the tension of regulatory systems, namely, the degree of dominance of the activity of central regulatory mechanisms over autonomous ones. Impaired de- and repolarization processes were a consequence of fetal myocardium remodeling due to ischemia. Conclusions. The development of algorithms for the diagnosis of fetal growth restriction using non-invasive electrocardiography requires further research of the following parameters: SI, TP, AC/DC, LF, LF/HF ratio, QTc duration, QRS complex width, and T/QRS ratio.