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![Time series plot of fetal heart rate (FHR) for a normal fetus at 34 weeks of gestation. (A) mild tachycardia, (B) normal range, and (C) mild bradycardia. FHR tracings were recorded for a total of 50 min including the first and second 20 min of the NST and 10 min of the VAS test. However, only data collected during the 30-40 min interval of the NST and the 40-50 min interval of the VAS were analyzed. (1) Baseline FHR (bpm, NST vs VAST): (A) 177 bpm vs 176 bpm (B) 148 bpm vs 154 bpm and (C) 109 bpm vs 132 bpm. (2) Number of acceleration [deceleration] for 15 bpm-15 seconds (NST vs VAST): (A) 2[2] vs 2[5] (B) 2[2] vs 3[3] and (C) 0[0] vs 7[3]. NST, nonstress test; VAST, vibroacoustic stimulation test; bpm, beats per minute.](profile/Moon-Il-Park-2/publication/229075623/figure/fig1/AS:203016574640128@1425414331019/Time-series-plot-of-fetal-heart-rate-FHR-for-a-normal-fetus-at-34-weeks-of-gestation.png)
Time series plot of fetal heart rate (FHR) for a normal fetus at 34 weeks of gestation. (A) mild tachycardia, (B) normal range, and (C) mild bradycardia. FHR tracings were recorded for a total of 50 min including the first and second 20 min of the NST and 10 min of the VAS test. However, only data collected during the 30-40 min interval of the NST and the 40-50 min interval of the VAS were analyzed. (1) Baseline FHR (bpm, NST vs VAST): (A) 177 bpm vs 176 bpm (B) 148 bpm vs 154 bpm and (C) 109 bpm vs 132 bpm. (2) Number of acceleration [deceleration] for 15 bpm-15 seconds (NST vs VAST): (A) 2[2] vs 2[5] (B) 2[2] vs 3[3] and (C) 0[0] vs 7[3]. NST, nonstress test; VAST, vibroacoustic stimulation test; bpm, beats per minute.
Source publication
The purpose of this study was to investigate the feasibility of different fetal heart rate (FHR) ranges in the nonstress test (NST) and to better understand the meaning of mild bradycardia and/or tachycardia without non-reassuring patterns. We employed the heredity to show that mild bradycardia (100-119 beats per minute, bpm) and mild tachycardia (...
Context in source publication
Context 1
... study was approved by the institutional review board of Hanyang University Hospital, Seoul, Korea (IRB approval num- ber: HYIRB-201010-10). Informed consent was exempted by the board due to the retrospective design. Fig. 1 shows typical FHR tracings for the three groups defined as: (A) mild tachycardia, (B) normal range, and (C) mild brady- cardia. In the mild bradycardia group, the baseline FHR after VAS testing increased from 109 bpm to 132 bpm and the num- ber of accelerations for 15 bpm-15 seconds (Acc1515) increased from 0 to 7. On the other hand, ...Similar publications
Objective:
The aim of this study was to determine normal values for fetal left ventricular (LV)-myocardial performance index (MPI) in Indian population and to assess its relation to advancing gestation and fetal heart rate (FHR).
Materials and methods:
Two hundred pregnant women without any pregnancy-related complications and whose fetuses were...
Citations
... Consequently, they evaluated 1.5 billion CTGs from 78852 tracings recorded from three German hospitals and proposed that normal FHR should lie between 120 and 160bpm. 1 Park et al., also supported this view in a study of 4589 CTG FHR tracings in Korea. 35 Although these studies recommended a range for the normal FHR, they did not consider variations that exists across the three trimesters in pregnancy. This is fundamentally important because studies to date exist in support of variations in FHR throughout gestation. ...
Introduction
The aim of this study was to evaluate and report normal sonographic FHR values among low-risk singleton women across the three trimesters of pregnancy and determine FHR role in gestational age prediction.
Method
A prospective cross-sectional study of 2727 low-risk singleton pregnant women was undertaken. FHR measurements were obtained by a consultant radiologist and three experienced sonographers using transabdominal approach from January 2019 to December 2020. Two FHR measurements were taken for each participant. The fetal lie and presentation were also documented in the first trimester. Data were analysed using SPSS version 24 (IBM, Armonk, NY, USA).
Result
The maternal mean ± SD age was 25.8 ± 6.5 years and mean FHR for first, second and third trimesters were 151 ± 16, 145 ± 6 and 125±6 bpm respectively. The mean ± SD gestational age were 10 ± 2, 19 ± 3 and 34 ± 2 weeks for the first, second and third trimester respectively. Using ANOVA, there were statistically significant differences in FHR across the three trimesters (p ≤ 0.05). A positive correlation existed between maternal age and FHR (r = 0.57, p ≤ 0.05).
Conclusion
This study has established normal values for FHR in first, second and third trimester respectively. Referring physicians, radiologists, sonographers, obstetricians and gynaecologists may consider FHR of (135–167) bpm (139–151) bpm and (119–131) bpm as normal FHR ranges for the first, second and third trimester respectively. This study has also revealed the possibility of gestational age prediction using FHR with the equation [Gestational Age = 87.8 – (0.47) FHR].
Implications for practice
This paper provides the most up-to-date sonographic FHR recommendations for fetal management. More importantly, findings from this study also suggests that ultrasound practitioners can use FHR measurements as a reliable alternative for fetal dating.
... Mild bradycardia (100-119 b.p.m.) or mild tachycardia (161-180 b.p.m.) may also be present during the NST. In the third trimester, FHR tends to regress toward the mean, and mild bradycardia/tachycardia is not regarded as a pathologic signal in nonacute situations [16]. Abused substances and medications [17] may also affect the test results and they should not be overlooked. ...
The most common method of antepartum fetal surveillance is the nonstress test (NST). Although it has satisfactory false-negative rates, dubious nonreactive results may challenge the physician. Any method or factor increasing the reactive NST results or shortening the time to attain a reactive test may be considerably useful.
Most of the studies have found no effect of maternal glucose administration on fetal heart rate and fetal activity, specificity of NST, time to reactivity and percentage of reactive NST results when compared with the control group. Maternal intake of 70% cocoa or caffeine had stimulating action on the fetal reactivity, and this effect on the fetal heart rate was more marked with high concentrations of cocoa (80%). Studies on maternal positioning during NST had equivocal results. Fetal manipulation has no impact on the NST reactivity. Vibroacoustic and halogen light stimulation may be associated with a reduction in time to reactivity.
These methods may increase the reactivity during a NST and may facilitate the antenatal fetal surveillance.
Labioplasty discomfort can be prevented by inhibiting the infraorbital nerve. Ketamine can be utilized as an adjuvant to lengthen the duration of analgesia in the infraorbital block when bupivacaine is used for infraorbital blocks within a relatively short period. This study aimed to assess the analgesic duration of bupivacaine and bupivacaine-ketamine on the infraorbital block in patients undergoing labioplasty, using the FLACC pain score.The research is a prospective approach, randomized, controlled clinical experiment with double-blinding. Thirty subjects, 3-12month-old children with ASA I and II status, received labioplasty surgery. Subjects were administered 1mL of each infraorbital block with 0.25% Bupivacaine and 0.25% Bupivacaine with Ketamine 0.5mg/kg BW to each group. The Paired T-test was used to compare subject characteristics, while the Independent T-test was used to compare heart rate. Chi-square (Fisher's exact) analysis revealed a significance level of p 0.005 for the FLACC value comparison. All statistical test results were examined with SPSS version 25.0. In the Bupivacaine group, there was an increase in mild pain within 4-5hours (7:46.7%); by 6 hours, there was an increase in mild pain in all 15 participants. At eight hours, it progressed to moderate pain (7:46.7%) with 496 minutes of analgesia and light pain (8:53.7%). The individuals in the Bupivacaine-Ketamine group had pain between 5-8 hours. Six patients (40%) with a pain-free analgesia duration of 1.440 minutes and nine (60%) with a minor pain status had FLACC values 4 during 24-hour observations.Bupivacaine and Bupivacaine-Ketamine have no side effects and no change in heart rate. Combining Bupivacaine with Ketamine has a more prolonged postoperative analgesic effect (24 hours) than the bupivacaine group in the infraorbital block in labioplasty patients (8 hours).
