ABSTRACT
OBJECTIVE: Several studies have suggested that the analysis of heart rate variability (HRV) during gestation provides indications of the development or maturation of fetal cardiovascular regulatory mechanisms. In this study, we evaluate the existence of short-range fractal-like correlations in fetal RR fluctuations data from the second half of human gestation. METHODS: Fifty-six short-term abdominal ECG recordings were obtained from low-middle-risk pregnant women. Gestational age varied from estimated 21 weeks to term. For comparison, RR-interval data of 51 healthy adults were also analysed. RESULTS: Principal findings along the gestational period explored were the existence of fractal RR dynamics in prenatal fetal data as revealed by the short-range scaling exponent alpha(1). No significant differences of alpha(1) (p = 0.4770) were found between fetal (median 1.2879) and adult data (median 1.3214), either between the fetal cases before or after 24 weeks (p = 0.6116) despite observing more variation at early stages. However, fetal RR data did involve lower magnitude in comparison with adults as we found significant differences in pNN20 and SDNN values. CONCLUSION: The fetal short-range fractal behaviour of RR data could then be linked to the functional development of the parasympathetic activity, which appears to become manifested before 21 weeks of gestation.
Subject(s)
Cardiotocography/methods , Electrocardiography , Fetal Heart/physiology , Heart Rate, Fetal/physiology , Prenatal Diagnosis/methods , Adolescent , Adult , Aged , Cardiovascular Physiological Phenomena , Female , Fractals , Gestational Age , Humans , Male , Middle Aged , PregnancyABSTRACT
Heartbeat fluctuations show fractal-like correlations that are associated with highly adaptive cardiovascular regulatory systems. Moreover, the short-range fractal or scaling exponent alpha(1) extracted from these correlations has been found to be a predictor of mortality for subjects with an impaired left ventricular function. In general, the RR-interval data required for this analysis are derived from long-term ECG recordings during free-running conditions. Yet short-term recordings are more likely to be obtained in some practical circumstances, so becoming relevant to assess the possibility of obtaining representative alpha(1) exponents from these recordings. Here, we compare the alpha(1) exponents extracted from the RR-interval series (9:00 AM-6:00 PM) of 51 healthy adults in normal sinus rhythm and the alpha(1) calculated from three shorted segments of only 700 beats obtained from the same series at 9:00 AM, 1:30 PM and 5:00 PM. We found no significant differences between the scaling exponents derived from the whole 9 h series and the short segments at 9:00 AM and 5:00 PM, but did find significant differences when comparing the whole series with the short segment at 1:30 PM. Thus, only if the time of day is taken into consideration can short segments of heartbeat fluctuation data be used to obtain representative alpha(1) exponents.
Subject(s)
Heart Rate, Fetal/physiology , Wakefulness/physiology , Adult , Algorithms , Cardiovascular Physiological Phenomena , Electrocardiography , Female , Fractals , Humans , PregnancyABSTRACT
Antecedentes:La ruptura traumática de un quiste hidatídico hepático en la cavidad abdominal es infrecuente. Objetivo: Comunicar una observación, mostrando la sintomatología, metodología diagnóstica, conducta terapéutica y la evolución postquirúrgica. Lugar de realización: Servicio de Cirúgia General de Hospital Público. Diseño: Análisis de un caso clínico.Población: Paciente sexo femenino, 8 años, atendida por dolor abdominal, secundario a un traumatismo. Diagnóstico: quiste hidatídico hepático roto en la cavidad peritineal. Cirugía: Tratamiento del quiste(Mabit-Lagrot)y lavado de cavidad. Resultados: Buena evolución postquirúrgica. Tratamiento médico con albendazol. Actualmente asintomática
Subject(s)
Humans , Child , Echinococcosis, Hepatic , Peritoneal Cavity , Wounds and InjuriesABSTRACT
Antecedentes:La ruptura traumática de un quiste hidatídico hepático en la cavidad abdominal es infrecuente. Objetivo: Comunicar una observación, mostrando la sintomatología, metodología diagnóstica, conducta terapéutica y la evolución postquirúrgica. Lugar de realización: Servicio de Cirúgia General de Hospital Público. Diseño: Análisis de un caso clínico.Población: Paciente sexo femenino, 8 años, atendida por dolor abdominal, secundario a un traumatismo. Diagnóstico: quiste hidatídico hepático roto en la cavidad peritineal. Cirugía: Tratamiento del quiste(Mabit-Lagrot)y lavado de cavidad. Resultados: Buena evolución postquirúrgica. Tratamiento médico con albendazol. Actualmente asintomática
