OB-02 : Differences of linear and non-linear indices of antepartum fetal heart rate in patients with fetal distress at delivery

( Laura Hyeyeon Boo ),( Jeong Kyu Hoh ),( Eun Hyun Lee ),( Young Sun Park ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The purpose of this study was to compare and analyze differences in antepartal fetal heart rate (FHR) parameters, non-linear indices, and perinatal outcomes between fetuses of normal and fetal distress at delivery. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital between 2003 and 2010, and selected 725 cases (fetal distress without any other complications=25 cases and normal 700 cases). NSTs were performed between 38 and 42 weeks of gestation, and all cases were delivered in 2 weeks after NST. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method and a non-linear method using approximate entropy (ApEn), correlation dimension (CD), and short-term/ long-term scaling exponents (α1/ α2). One and 5 minutes Apgar scores (Ap1/Ap5) of fetal distress group were significantly lower than those of normal group (Ap1, 5.92±1.85 vs 6.89±0.73, p=0.0151; Ap5, 6.44±1.45 vs 8.87±0.58, p<0.0001). Other perinatal outcomes and NST parameters showed no significant difference between two groups. Non-linear indices (ApEn, CD, and α2) were significantly different in two groups (ApEn, 0.71 ± 0.18 vs 0.91 ± 0.13, p<0.0001; CD 3.49 ± 0.40 vs 3.83 ± 0.27, p=0.0003; α2, 0.91 ± 0.06 vs 0.86 ± 0.05, p=0.0016, respectively). Compared to normal fetuses, fetal distress cases at delivery show a difference in that the irregularity and complexity of the heart rate dynamics are decreased in antepartal NST, although no differences of FHR parameters between two groups. A more apparent difference is that the long-term fractal correlation of the fetal heart is increased and the fetal heart is smoother in the long-term scale.

OB-46 : Differences of maternal oxygen saturation, blood pressure, and heart rate when performed non-stress test according to the fetal reactivity

( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Young Sun Park ),( Kyung Joon Cha ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The purpose of this study was to compare and analyze differences in maternal oxygen saturation (SpO2), blood pressure (BP), and heart rate (HR) when non-stress test (NST) was performed, according to the fetal reactivity. We selected 8 non-reactive and 119 reactive cases from total NST acquired using a computerized FHR analysis system at Hanyang University Hospital in 2012. Maternal SpO2, BP, and HR were recorded simultaneously when NST was performed. NSTs were performed between 31 and 42 weeks of gestation. Perinatal outcomes were compared, and FHR parameters analyzed. Statistical analysis was performed by Median test or Fisher`s exact test. General characteristics between two groups were not different. NST parameters showed no significant difference between two groups except the amplitude (29.73 vs 24.35; p=0.0274). Maternal BP and HR showed no significant difference between two groups, however, SpO2 showed a statistical difference (96.90 vs 97.23; p=0.0269). Neonatal outcomes between two groups were not different. It might be thought that maternal SpO2 was related to the fetal heart rate reactivity. Further studies would be needed for clarifying our result.

OB-49 : Differences of linear and non-linear indices of fetal heart rate between fetuses with partial abruptio placenta and non-placental abruption

( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Young Sun Park ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The purpose of this study was to compare and analyze differences in fetal heart rate (FHR) parameters during pregnancy between fetuses with partial abruptio placenta and non-placental abruption. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital. 31 cases of partial abruptio placenta, which were identified after delivery, from total NST data between 2003 and 2010 were selected as a study group. NSTs were performed between 31 and 42 weeks of gestation. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method. Non-linear methods; approximate entropy (ApEn), sample entropy (SampEn), short-term/ long-term scaling exponents (α1/ α2) and correlation dimension (CD) were used for analysis of FHR dynamics and system complexity. General characteristics between two groups were not different. NST parameters showed no significant difference between two groups, however, the non-linear indices; ApEn (mean±SD, 0.67±0.17 vs 0.77±0.17; p=0.0005), SampEn (0.54±0.14 vs 0.66±0.17; p<0.0001), / long-term scaling exponents (0.90±0.06 vs 0.87±0.05; p=0.0022), and CD (3.19±0.40 vs 3.34±0.33; p=0.0118) of the partial abruptio placenta group was significantly lower than the non-placental abruption group. Compared to non-placental abruption cases, FHR of partial abruptio placenta cases at delivery show a difference in that the irregularity and complexity of the heart rate dynamics are decreased in antepartal NST, although no differences of FHR parameters between two groups. Non-linear indices of FHR are useful tools for detecting abnormal FHR patterns that are not found in patients with partial abruptio placenta using conventional linear analysis.

OB-48 : Nonlinear analyses of heart rate variability between male and female fetuses

( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Young Sun Park ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The purpose of the present study was to compare and analyze differences in antepartal fetal heart rate (FHR) parameters and non-linear indices (approximate entropy, ApEn; sample entropy, SampEn) between male and female fetuses. We surveyed all non-stress test (NST) data acquired using a computerized FHR analysis system at Hanyang University Hospital. NST of 1,687 male fetuses and 1,831 female fetuses were selected. NSTs were performed between 24 and 42 weeks of gestation. The average baseline FHR and non-linear indices was analyzed according to the gestational ages. Perinatal outcomes were compared, and FHR parameters analyzed using a linear method. Non-linear methods; approximate entropy (ApEn), sample entropy (SampEn), short-term/ long-term scaling exponents (α 1/ α2) and correlation dimension (CD) were used for analysis of FHR dynamics and system complexity. The average of FHR variability, with respect to amplitude (AMP), mean minute range (MMR) and non-linear indices were not different between two groups. Compared by gestational weeks, the ApEn of female group was higher than that of male group from 25 to 30 gestational weeks, however, between 31 and 32 gestational weeks, ApEn of male group was higher than that of female group. The peak of the ApEn of female group was 29-30 gestational weeks (0.92±0.14), whereas the peak of male group was 31-32 gestational weeks (0.93±0.10). Neonatal outcomes were not different between two groups. It might be thought that the heart rate dynamics of female fetuses are matured earlier than that of male fetuses until 30 gestational week. After 32 gestational week, the heart rate dynamics are matured at the same rate until the term pregnancy.

OB-47 : The effectiveness of interval cerclage in patients with incompetent internal os of cervix having preterm labor; preliminary study

( Jeong Kyu Hoh ),( Laura Hyeyeon Boo ),( Eun Hyun Lee ),( Moon Il Park ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.99 No.-

The aim of this study was to determine whether an interval cerclage reduced preterm delivery in those women who had undergone an emergency transvaginal cerclage due to dilated cervix and/or protruding fetal membrane with labor. A retrospective cohort study was conducted on women with a transvaginal cervical cerclage who also went over the interval cerclage. Sixteen cases underwent a transvaginal cerclage and composed the 7 cases of interval cerclage group, whereas 9 others without interval cerclage, only elective cerclage group due to bad obstetric history. Interval cerclage was performed to patients who previously had emergency cerclage due to symptoms of impending preterm delivery at a distance of time. Antibiotics and prophylactic tocolysis were given to all patients. Neonatal outcomes and perinatal complications were analyzed between two groups. Mean initial cervical length before the first surgery was 0.07 cm in interval cerclage group and 4.3 cm in elective cerclage group. Cervical length before second surgery in interval cerclage group was 1.94 cm. Of all 16 cases, no fetal loss was found during present pregnancy. Mean delivery weeks was 35+0 weeks in interval cerclage group while 35+1 weeks in elective cerclage group (p=0.4981). Mean birth weight in interval cerclage group was 1920.0 g and 2145.0 g in elective cerclage group (p=0.2901). Apgar score (1/5 min) was 6/8 in interval cerclage group and 6/8 in elective cerclage group (p=1.000). Other neonatal outcomes and perinatal complications were not different between two groups as well. It is thought that interval cerclage might be a good emergent surgical procedure that can be used in preventing preterm delivery in patients with incompetent internal os of cervix having preterm labor.