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International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026

Fetal autonomic responses inferred from heart rate variability during recurrent decelerations without acidosis-An observational study.

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Magawa Shoichi, Nii Masafumi, Tamaishi Yuya, Okumura Asumi, Takakura Sho, Maki Shintaro, Toriyabe Kuniaki, Takayama Erina, Kondo Eiji, Ikeda Tomoaki

Аннотация

OBJECTIVE: Recurrent fetal heart rate (FHR) decelerations without acidosis are frequently observed during labor; however, the underlying autonomic mechanisms remain incompletely understood. This study explored fetal autonomic responses to recurrent decelerations using FHR and FHR variability (FHRV) parameters.

METHODS: This retrospective observational study included healthy women with singleton pregnancies, no pregnancy complications requiring treatment, and an umbilical artery pH >7.2 at delivery. Continuous FHR monitoring using fetal head electrodes was performed for ≥2 h before delivery (June-December 2021). FHRV was assessed using time-domain, frequency-domain, and nonlinear indices.

RESULTS: Twenty-four patients were included. Baseline FHR did not differ between groups. In the recurrent deceleration group, root mean square of successive differences and high-frequency power were higher during the final 60 min before delivery. No differences were observed in standard deviation of normal-to-normal intervals or very-low-frequency power. Sample entropy was also higher, suggesting increased complexity of autonomic regulation.

CONCLUSION: Fetuses with recurrent decelerations without acidosis demonstrated patterns consistent with increased vagal modulation, as inferred from FHRV indices. These findings may reflect an adaptive autonomic response; however, given the exploratory nature and small sample size, further studies are warranted.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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