Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption
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AIM: The aim of this study was to determine the correlation between non-reassuring fetal heart rate (NRFHR) patterns and poor neonatal outcome in placental abruption. MATERIAL AND METHODS: A retrospective study was performed involving 83 placental abruptions with a live fetus at one tertiary and one secondary hospital in Miyazaki prefecture, Japan. We examined the correlation among NRFHR, umbilical arterial blood gas status, and neonatal poor outcomes, including neonatal death (ND) and cerebral palsy (CP). RESULTS: A total of 83 cases were divided into bradycardia (n=27), recurrent late deceleration (rLD, n=29), severe variable deceleration or prolonged deceleration (sVD/PD, n=8), and other cases (n=19). In the bradycardia group, the incidence of low umbilical artery (UA) pH (<7.0) was 59% and the average UA pH was 6.96±0.22. Among these cases, 10 showed severe bradycardia (less than 80 b.p.m.) and an average UA pH of 6.85±0.24, and four cases resulted in poor outcome (three CP and one ND). In the rLD group, the incidence of low UA pH (<7.0) was 7% and the average UA pH was 7.24±0.12. In this group, a 40-week-old fetus with umbilical phlebitis had a lower UA pH (6.92) and developed CP. In the sVD/PD group, there were no cases of a low UA pH (<7.0) and the average UA pH was 7.30±0.04. In this group, a 31-week-old boy with a UA pH of 7.36 developed CP (PVL). The remaining 19 cases had no CP. CONCLUSION: Poor neonatal outcome of placental abruption is closely related to NRFHR, especially the degree of bradycardia. In the rLD and sVD/PD groups, risk factors, such as prematurity and fetal inflammation, co-existed.
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Several studies suggest that acute abruption is a significant contributor to category III fetal heart rate patterns due to terminal bradycardia and sinusoidal fetal heart rate patterns.
“Several studies suggest that acute abruption is a significant contributor to category III FHR patterns due to terminal bradycardia and sinusoidal FHR patterns (62, 64–68).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [62]
A wide array of abnormal fetal heart rate patterns is possible in abruption, reflecting the underlying pathophysiology of this condition.
“A wide array of abnormal FHR patterns is possible (62–65), reflecting the underlying pathophysiology of this condition (TABLE 3).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [62]
Abruption is associated with a 6- to 10-fold increased risk of cerebral palsy in infants born of abruption pregnancies.
“Abruption is associated with 6 to 10-fold increased risk of cerebral palsy and 2 to 4-fold increased risk of developmental disorders in infants born of abruption pregnancies (62, 118–121).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [62]
Abruption is associated with a 2- to 4-fold increased risk of developmental disorders in infants born of abruption pregnancies.
“Abruption is associated with 6 to 10-fold increased risk of cerebral palsy and 2 to 4-fold increased risk of developmental disorders in infants born of abruption pregnancies (62, 118–121).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [62]
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- Authors
- Takano, Y., Furukawa, S., Ohashi, M., Michikata, K., Sameshima, H., & Ikenoue, T.
- Affiliations
- University of Miyazaki (JP)
- Miyazaki Medical Association Hospital (JP)
- Corresponding author
- Furukawa, Seishi
- Venue
- Journal of obstetrics and gynaecology research
- Publisher
- Wiley
- Published
- 2012-07-29
- Volume
- 39
- Issue
- 1
- Pages
- 61-66
- ISSN
- 1341-8076 (ISSN-L)
- 1447-0756
- OpenAlex
- W1571028801
- Cited by
- 20
- References
- 19
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 3 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 3 · 2014: 2
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of obstetrics and gynaecology research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- placental abruption, neonatal brain injury, neonatal death, cerebral palsy, umbilical artery blood gas, umbilical artery pH, fetal bradycardia, variable decelerations, periventricular leukomalacia, preterm birth, fetal inflammation
- MeSH terms
- Abruptio Placentae, Brain Injuries, Cerebral Palsy, Female, Fetal Blood, Fetal Heart, Heart Rate, Fetal, Humans, Male, Pregnancy, Retrospective Studies, Stillbirth
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