{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:37:41Z","timestamp":1788514661700,"version":"build-2803163510"},"reference-count":60,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001511","name":"Auckland Medical Research Foundation","doi-asserted-by":"publisher","award":["1122002"],"award-info":[{"award-number":["1122002"]}],"id":[{"id":"10.13039\/501100001511","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["17\/601"],"award-info":[{"award-number":["17\/601"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["22\/559"],"award-info":[{"award-number":["22\/559"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002001","name":"Health Services and Delivery Research Programme","doi-asserted-by":"publisher","award":["CDF\u20102016\u201009\u2010004"],"award-info":[{"award-number":["CDF\u20102016\u201009\u2010004"]}],"id":[{"id":"10.13039\/501100002001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Deceleration area (DA) and capacity (DC) of the fetal heart rate can help predict risk of intrapartum fetal compromise. However, their predictive value in higher risk pregnancies is unclear. We investigated whether they can predict the onset of hypotension during brief hypoxaemia repeated at a rate consistent with early labour in fetal sheep with pre\u2010existing hypoxaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, controlled study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Chronically instrumented, unanaesthetised near\u2010term fetal sheep.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One\u2010minute complete umbilical cord occlusions (UCOs) were performed every 5\u2009minutes in fetal sheep with baseline p<jats:sub>a<\/jats:sub>O<jats:sub>2<\/jats:sub> &lt;17\u2009mmHg (hypoxaemic, <jats:italic>n<\/jats:italic>\u00a0=\u00a08) and &gt;17\u2009mmHg (normoxic, <jats:italic>n<\/jats:italic>\u00a0=\u00a011) for 4\u2009hours or until arterial pressure fell &lt;20\u2009mmHg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>DA, DC and arterial pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Normoxic fetuses showed effective cardiovascular adaptation without hypotension and mild acidaemia (lowest arterial pressure 40.7\u2009\u00b1\u20092.8\u2009mmHg, pH 7.35\u2009\u00b1\u20090.03). Hypoxaemic fetuses developed hypotension (lowest arterial pressure 20.8\u2009\u00b1\u20091.9\u2009mmHg, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and acidaemia (final pH 7.07\u2009\u00b1\u20090.05). In hypoxaemic fetuses, decelerations showed faster falls in FHR over the first 40\u2009seconds of UCOs but the final deceleration depth was not different to normoxic fetuses. DC was modestly higher in hypoxaemic fetuses during the penultimate (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.04) and final (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.012) 20\u2009minutes of UCOs. DA was not different between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chronically hypoxaemic fetuses had early onset of cardiovascular compromise during labour\u2010like brief repeated UCOs. DA was unable to identify developing hypotension in this setting, while DC only showed modest differences between groups. These findings highlight that DA and DC thresholds need to be adjusted for antenatal risk factors, potentially limiting their clinical utility.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17425","type":"journal-article","created":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T17:50:38Z","timestamp":1676742638000},"page":"881-890","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Fetal heart rate responses in chronic hypoxaemia with superimposed repeated hypoxaemia consistent with early labour: a controlled study in fetal sheep"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8937-0846","authenticated-orcid":false,"given":"C. A.","family":"Lear","sequence":"first","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Georgieva","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health, The John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. J.","family":"Beacom","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Wassink","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. K.","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. A.","family":"Lear","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. J.","family":"Mills","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Westgate","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Bennet","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0656-7035","authenticated-orcid":false,"given":"A. J.","family":"Gunn","sequence":"additional","affiliation":[{"name":"Fetal Physiology and Neuroscience Group, Department of Physiology The University of Auckland  Auckland New Zealand"},{"name":"Starship Children's Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2016.1174207"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.046"},{"key":"e_1_2_11_4_1","article-title":"Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour","volume":"2","author":"Alfirevic Z","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199603073341001"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2018.05.002"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13639"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP282276"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.06.046"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.01.026"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13136"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1256993"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767050601134603"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05419-y"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1678130"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.11.009"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14638"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14274"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68735-7"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16638"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104193"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.626450"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70621-0"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199205000-00016"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-0845-2"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000475927"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0276451"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199701000-00015"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199809000-00006"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.111932"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.108084"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1999.tb08365.x"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-196006000-00011"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP280389"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP279573"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00357.2020"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2990.1979.tb00664.x"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.11.035"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12568"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1088\/0967-3334\/32\/10\/004"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1088\/0967-3334\/35\/7\/1357"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1063\/1.3515594"},{"key":"e_1_2_11_43_1","first-page":"5888","article-title":"Computerized intrapartum electronic fetal monitoring: analysis of the decision to deliver for fetal distress","volume":"2011","author":"Georgieva A","year":"2011","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(97)80004-X"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00431.2005"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073895"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.09.084"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.03.024"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP274937"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.bmb.a069888"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1959.sp006208"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(16)32286-4"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP274928"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP271205"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00340.2016"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200103000-00026"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.02.032"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.14365"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14558"},{"key":"e_1_2_11_60_1","first-page":"292","article-title":"A study of fetal heart rate deceleration areas. II. Correlation between deceleration areas and fetal pH during labor","volume":"45","author":"Beguin F","year":"1975","journal-title":"Obstet Gynecol"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpme.1976.4.2.118"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17425","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.17425","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T08:56:34Z","timestamp":1692435394000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.17425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,28]]},"references-count":60,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/1471-0528.17425"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.17425","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,28]]},"assertion":[{"value":"2022-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}