Clinical & Experimental Cardiology
Open Access

The Impact of Fetal Behaviour on Acute Treatment

Philipp Dichtl^{* *}Correspondence: Philipp Dichtl, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria, Email:

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Description

Monitoring fetal behaviour has effects on acute treatment as well as the detection of developmental issues which affect later life in its entirety. Fetal programming, also referred to as the "developmental origins of adult disease hypothesis," is a theory that, among other issues, pertains to disorders of the heart, metabolism, hyperactivity, and brain. All of those systems involve the autonomic nervous system, so cardiac autonomic regulation may offer useful functional diagnostic and prognostic data. Fetal Heart Rate Patterns (HRP), one of the few functional signals in the prenatal stage that relate to autonomic regulation, plays a critical role in foetal autonomic evaluation. Consideration of physiological principles, recording technology, and HRP parameters of autonomic control are necessary for the creation of sensitive markers of fetal maturation and its disturbances.

This study discusses about (i) the functional foetal Autonomic Brain Age Score (fABAS), (ii) the Cardiotocography (CTG) validation of the fABAS based on magnetocardiography, and (iii) Recurrence Quantitative Analysis and Binary Symbolic Dynamics of complex HRP resolve specific maturation periods, time, (iv) A 30 minute recording is sufficient to obtain episodes of high variability, which are crucial for the detection of Intrauterine Growth Restriction (IUGR) in handheld Doppler, (v) foetal Electrocardiographic (ECG) recordings are evaluated, and (vi) preeclampsia disrupts the relationship between maternal and foetal Heart Rate Variability (HRV). The reported novel developments vastly increase the potential applications for the current CTG methodology. Due to their better consideration of complicated autonomic processes across recording technologies, novel HRP indices increase assessment accuracy (CTG, handheld Doppler, MCG, ECG). The ultimate goal is their adoption into typical practice and research on fetal developmental disturbances with consequences for adult disease programming. Fetal developmental disorders have consequences that may plague a person for the rest of their lives and cannot be made up for in adulthood. Therefore, it is crucial to spot these disruptions as soon as possible. As one of the few signs available, foetal heart rate patterns are ideally suited for early functional prenatal diagnosis. It involves thorough examination of autonomic physiological and pathophysiological behavior, suitable recording technology, elements of system theory underlying Heart Rate Variability (HRV) patterns, and clinical research. Cardiotocography (CTG), handheld Doppler, Magnetocardiography (MCG), and Electrocardiography (ECG) are four distinct recording technologies that should be taken into complementary consideration for routine applications.

An adaptive mechanism designed to sustain end-organ perfusion may be represented by the increased maternal sympathetic tone in mild to moderate Pulmonary Embolism (PE). The severe PE was characterised by a hypokinetic form of Congenital Malformation of the Heart (CMH), a markedly increased sympatho-vagal balance, and an end-organ hypo-perfusion. Only in healthy pregnancies did researchers find a correlation between maternal and fetal Root Mean Square of the Successive Differences (RMSSDs), maternal RMSSD, and the umbilical vein's 0.5 Hz peak amplitude. The discovered relationships provided evidence for a potential link between healthy pregnancy maternal hemodynamic fluctuations (found as a 0.5 Hz peak in the umbilical vein) and fetal hemodynamics. The relationship concerned both the mother and the fetus' Respiratory Sinus Arrhythmia (RSA). Patients with pre-eclampsia showed the regulatory dissociation between mother and fetal HRV. In severe PE, there is no longer a correlation between the maternal and fetal heart rate patterns due to the overactive sympathetic nervous system and an absence of vagal regulation.