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Obstetrics & Gynecology 1974;43:22-30
© 1974 by The American College of Obstetricians and Gynecologists
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A Functional Umbilical Cord Occlusion Heart Rate Pattern

The Significance of Overshoot

ROBERT C. GOODLIN, MD, FACOG and ERNEST W. LOWE, MD, FACOG

From the Department of Obstetrics and Gynecology at Santa Clara Valley Medical Center, San Jose, California

Abstract

Based on human and sheep studies and a literature review, it is concluded that a variety of fetal heart rate patterns can reflect umbilical cord compression. At the same time, maternal aortal-caval compression during uterine contraction (Poseiro effect) can be associated with the typical umbilical cord compression fetal heart rate pattern. This same heart rate pattern occurs when the hypoxic sheep fetus grunts in utero. In reviewing fetal heart rate recordings and through experience with actual clamping of the umbilical cord, a heart rate pattern of abrupt deceleration with overshoot (or secondary acceleration) became apparent. This deceleration-overshoot pattern was associated with newborns requiring resuscitation and is probably caused by a fetal hypoxic insult which is rapidly relieved. Because the commonly defined cord occlusion pattern is imprecise and because the secondary acceleration (overshoot) after deceleration appears to be significant, it is proposed to redefine the "cord compression" (or intermittent fetal hypoxia) heart rale pattern.




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J. A. WESTGATE, L. BENNET, H. H. DE HAAN, and A. J. GUNN
Fetal Heart Rate Overshoot During Repeated Umbilical Cord Occlusion in Sheep
Obstet. Gynecol., March 1, 2001; 97(3): 454 - 459.
[Abstract] [Full Text] [PDF]


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