Fetal Distress
Conditions
Brief summary
Effect of acute exercise testing in pregnant athletes on maternal and fetal heart rate, fetal/maternal bloodflow and cardiotocogramm assessment.
Detailed description
The aim of the study is to evaluate in a preliminary step the validity of fetal heart rate measurement with the Nemo Healthcare Monitoring System - a wireless non-invasive CTG device. Furthermore, we will determine the reliability for CTG measurements (intraobserver and interobserver reliability) and for ultrasound (intraobserver reliability). The device is approved for use on pregnant women and is regularly used as a CTG device for monitoring fetal heart rate and contractions during childbirth. If in the preliminary step the heart rate measurements with the Nemo Fetal Monitoring System provide valid and fetal heart rate results compared to the standard Doppler ultrasound method and provide a reliable detection of fetal heart rate deceleration the effects of phys-ical activity on fetal heart rate pattern and changes in fetal blood flow, placento-fetal and materno-placental blood supply rate will be investigated in the main part of the study in a larger study population. It is hypothesized that CTG provides technically a valid and reliable continuous re-cording of fetal heart rate values, since fetal heart rate measurement under physical exertion has previously only been possible by intermittent but not continuous Dop-pler ultrasound. Furthermore, we will evaluate alterations in fetal heart rate pattern and changes in fetal blood flow, placento-fetal and materno-placental blood supply according to the level of exertion.
Interventions
OTHERexercise testing
incremental cycling test on a bicycle ergometer
Sponsors
University Hospital, Zürich
Balgrist University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Presence of signed informed consent form * healthy pregnant active female over the age of 18 years and below 45 years * sporting activity \>4h/week on 2 or more weekdays * single pregnancy, between 28+0 and 34+0 weeks of pregnancy
Exclusion criteria
* No signed informed consent form or revocation of consent * pre-existing pregnancy complications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| fetal heart rate | through exercise testing, an average of 90 minutes | The fetal heart rate is continuously monitored via the CTG device during the entire performance test. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Medial cerebral artery pulsatility index | through exercise testing, an average of 90 minutes | (systolic velocity - diastolic velocity) / mean velocity |
| Medial cerebral artery resistance index | through exercise testing, an average of 90 minutes | (systolic velocity - diastolic velocity) / systolic velocity |
| medial cerebral artery peak systolic velocity | through exercise testing, an average of 90 minutes | in cm/s |
| Umbilical cord artery pulsatility index | through exercise testing, an average of 90 minutes | (systolic velocity - diastolic velocity) / mean velocity |
| Umbilical cord artery resistance index | through exercise testing, an average of 90 minutes | (systolic velocity - diastolic velocity) / systolic velocity |
| right and left uterine artery pulsatility index | through exercise testing, an average of 90 minutes | (systolic velocity - diastolic velocity) / mean velocity |
| right and left uterine artery resistance index | through exercise testing, an average of 90 minutes | (systolic velocity - diastolic velocity) / systolic velocity |
| umbilical cord artery S/D ratio | through exercise testing, an average of 90 minutes | (S = maximum systolic flow velocity; D = maximum diastolic flow velocity) |
| pregnancy complications | during pregnancy and up to12 weeks after birth | incidence of pregnancy complications (yes/no); |
| birth complications | On the day the child is born | incidence of birth complications (yes/no); |
| mode of delivery | On the day the child is born | spontaneous birth vs. vacuum-assisted birth vs. forceps-assisted birth vs planned cesarean section vs. unplanned cesarean section |
| APGAR score | On the day the child is born | APGAR score (1-10) |
| gestational age at birth | On the day the child is born | gestational age at birth (in weeks and days); |
| pH value of the umbilical cord artery | On the day the child is born | pH value of the umbilical cord artery mesured directly after birth |
| fetal admission to Neonatal Intensive Care Unit | up to 12 weeks | admission (yes/no) |
| cerebro-placental ratio | through exercise testing, an average of 90 minutes | pulsatility index of the middle cerebral artery / pulsatility index of the umbilical artery |
Contacts
Primary ContactNora Wieloch, Dr. med.
Backup ContactNina Kimmich, PD Dr. med.
Outcome results
None listed