{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:30:30Z","timestamp":1759941030390},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T00:00:00Z","timestamp":1443571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Intrapartum fetal bradycardia necessitates immediate operative delivery. Our aim was to investigate the hypothesis that some non\u2010reassuring fetal heart rate (FHR) patterns were present before the onset of terminal bradycardia in infants who developed subsequent brain damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>From a population\u2010based study of 65\u2009197 deliveries, 190 stillbirths, 115 neonatal deaths, and 136 neurologically high\u2010risk infants were registered by the Miyazaki Perinatal Conference. There were 15 cases of neurologically high\u2010risk infants born at <jats:styled-content>&gt;<\/jats:styled-content>34\u2009weeks of gestation exhibiting intrapartum terminal bradycardia. Focusing on the brain\u2010damaged infants, we retrospectively analyzed FHR patterns for at least 1\u2009h prior to the bradycardia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Brain damage (cerebral palsy [<jats:italic>n<\/jats:italic>\u2009=\u200911] and mental retardation [<jats:italic>n<\/jats:italic>\u2009=\u20092]) was diagnosed at 2\u2009years old in 13 out of 15 neurologically high\u2010risk infants. Two infants had bradycardia on admission. In the remaining 11 infants, FHR patterns were reassuring in six (55%) and non\u2010reassuring in five (45%), including late decelerations (<jats:italic>n<\/jats:italic>\u2009=\u20094) and variable decelerations (<jats:italic>n<\/jats:italic>\u2009=\u20092). Clinically relevant factors in the non\u2010reassuring group included intrauterine infection (<jats:italic>n<\/jats:italic>\u2009=\u20093), malpresentation with umbilical cord coiling (<jats:italic>n<\/jats:italic>\u2009=\u20091), and unknown causes (<jats:italic>n<\/jats:italic>\u2009=\u20091). Clinically relevant features in the reassuring group included cord prolapse (<jats:italic>n<\/jats:italic>\u2009=\u20091), vaginal breech delivery (<jats:italic>n<\/jats:italic>\u2009=\u20091), shoulder dystocia (<jats:italic>n<\/jats:italic>\u2009=\u20091), rupture of membranes (<jats:italic>n<\/jats:italic>\u2009=\u20091), and unknown causes (<jats:italic>n<\/jats:italic>\u2009=\u20092).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>More than half of the brain\u2010damaged infants born at <jats:styled-content>&gt;<\/jats:styled-content>34\u2009weeks of gestation who exhibited intrapartum terminal bradycardia had unremarkable FHR patterns before abrupt\u2010onset bradycardia. For those with non\u2010reassuring patterns preceding bradycardia, intrauterine infection was the major sentinel event.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.12797","type":"journal-article","created":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T06:25:58Z","timestamp":1443594358000},"page":"1738-1743","source":"Crossref","is-referenced-by-count":6,"title":["Intrapartum fetal heart rate patterns preceding terminal bradycardia in infants (&gt;34\u2009weeks) with poor neurological outcome: A regional population\u2010based study in Japan"],"prefix":"10.1111","volume":"41","author":[{"given":"Yuki","family":"Kodama","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology and Perinatal Center, Faculty of Medicine University of Miyazaki  Miyazaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Sameshima","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Perinatal Center, 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