Abstract
Objective
Histological chorioamnionitis (CAM) is related to neonatal mortality and morbidity.
However, identifying intrauterine inflammation before delivery is challenging. The
aim of this study was to investigate the changes in fetal heart rate (FHR) short-term
variability (STV) during the course of histological CAM.
Study Design
Changes in STV were measured in 7 chronically instrumented fetal sheep at 111–120
days of gestation. Lipopolysaccharide (LPS) was infused into the amniotic cavity for
2 days following the 4th postoperative day to develop histological CAM. STV was determined
based on the R to R interval of the fetal electrocardiogram. We continued to observe
the changes in STV until the time of intrauterine fetal death (IUFD). The umbilical
cord and fetal membranes were evaluated histologically after IUFD. The experiment
was divided into two phases: 1) the acute phase, defined as the 24-hour period between
the first and second injections of LPS and 2) the perimortem phase, defined as the
period between the second injection of LPS and IUFD. Changes in STV in both the acute
and perimortem phases were evaluated using Friedman’s test. A probability of <0.05
was accepted as statistically significant.
Results
The fetuses died, on average, at 23.7 ± 4.9 h after the second injection of LPS. Both
the umbilical cord and fetal membranes showed histological evidence of severe inflammation.
During the perimortem phase, there were statistically significant differences in STV
at each time point. STV increased significantly at 6, 4, and 3 h before intrauterine
fetal death compared to the baseline.
Conclusion
Our study suggests that STV increased as the fetal condition deteriorated during the
course of histological CAM.
Keywords
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Article info
Publication history
Published online: June 11, 2018
Accepted:
June 10,
2018
Received in revised form:
May 30,
2018
Received:
March 2,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
