Change of Spectral Analysis of Fetal Heart Rate During Clinical Hypnosis: a Prospective Randomised Trial from the 20th Week of Gestation Till Term

Abstract

Objective: To investigate the functional adaptive process of the fetal autonomic nervous system during hypnosis from the 20th week of gestation till term. Are there changes in the power spectrum analysis of fetal heart rate when the mother is having a clinical hypnosis or control period? Study Design: Fourty-nine FHR recordings were analysed. Included recordings were from singletons and abdominal fetal ECG-monitored pregnancies. All women were randomised to receive clinical hypnosis followed by a period with no intervention or vice versa. Statistical analyses were performed with the Wilcoxon signed ranks and Spearman rho correlation tests. Results: There was a significant difference found between fetal heart rate at baseline (144.3 ± 6.0) and hypnosis (142.1 ± 6.4). A difference was also detected between the standard deviation of the heart rate between baseline (6.7 ± 1.9) and hypnosis (6.8 ± 3.5). LFnu was smaller during baseline (80.2 ± 5.3) than during hypnosis (82.1 ± 5.7), whereas HFnu was significantly larger (19.8 ± 5.3 vs. 17.9 ± 5.7). There was no correlation between the gestation age and the change in LFnu, HFnu or ratio LF/HF due to the hypnosis intervention. Conclusion: The functional adaptive process of the fetal autonomic system during hypnosis is reflected by a sympathovagal shift towards increased sympathetic modulation.

Zusammenfassung

Fragestellung: In der vorliegenden Studie sollte überprüft werden, wie das autonome Nervensystem auf eine Hypnoseintervention zwischen der 20. Schwangerschaftswoche bis zum Entbindungstermin reagiert. Gibt es einen Unterschied der Spektralanalyse der fetalen Herzfrequenz, wenn die werdende Mutter eine Hypnoseintervention erhält im Vergleich mit der Kontrollperiode ohne Intervention? Studiendesign: 49 Einlingsschwangerschaften mit abdominaler fetaler EKG-Ableitung wurden analysiert. Alle Schwangeren wurden randomisiert, um eine Hypnoseintervention und eine Kontrollperiode oder vice versa zu erhalten. Zur statistischen Analyse wurden der Wilcoxon-Signed-Rank-Test und der Spearman-Rho-Korrelationstest herangezogen. Ergebnisse: Es ergab sich eine statistisch signifikante Differenz zwischen der fetalen Herzfrequenz zwischen Kontrollphase (144,3 ± 6,0) und der Hypnoseintervention (142,1 ± 6,4), sowie in der Standard-Deviation der Kontrollphase (6,7 ± 1,9) und der Hypnoseintervention (6,8 ± 3,5). LFnu war niedriger in der Kontrollphase (80,2 ± 5,3) als während der Hypnoseintervention (82,1 ± 5,7), wohingegen HFnu statistisch signifikant größer war (19,8 ± 5,3 vs. 17,9 ± 5,7). Es gab keine Korrelation zwischen dem Gestationsalter und einer Änderung der LFnu, HFnu oder LF/HF während der Hypnoseintervention. Schlussfolgerung: Das fetale autonome Nervensystem reagiert bei einer mütterlichen Hypnoseintervention durch einen sympathovagalen Shift in der Richtung eines erhöhten Sympathikotonus.

Key words

Fetal heart monitoring - spectral analysis - frequency analysis - heart rate variability - clinical hypnosis

Schlüsselwörter

fetale Herzfrequenzüberwachung - Spektralanalyse - Frequenzanalyse - Herzfrequenzvariabilität - Hypnose/Hypnotherapie

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