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Am J Perinatol 2005; 22(3): 165-167
DOI: 10.1055/s-2005-864852
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Intrapartum Repetitive Maternal Heart Rate Deceleration Pattern Simulating Nonreassuring Fetal Status

David M. Sherer1 , Mudar Dalloul1 , Nadia Pierre1 , Ovadia Abulafia1
  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY), Downstate Medical Center, Brooklyn, New York
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Publication History

Publication Date:
11 April 2005 (online)

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ABSTRACT

Uterine contraction-associated accelerations of the maternal heart rate are considered to reflect both a transient contraction-related increase in cardiac output and endogenous catecholamine secretion. Uterine contraction-associated decelerations of the maternal heart rate are rare and remain unexplained. A young multiparous patient with systemic lupus erythematosus (postrenal transplant for lupus nephropathy-related renal failure) presented in early labor at 39 weeks gestation, prior to elective repeat cesarean section. Intrapartum continuous maternal heart rate monitoring demonstrated repetitive uterine contraction associated decelerations of the maternal heart rate of 60 beats per minute, each lasting 2 minutes, simulating nonreassuring fetal status. Simultaneously depicted fetal heart rate was reassuring. This case demonstrates an unusual marked early intrapartum affect of uterine contractions upon the maternal heart rate. In addition, this case illustrates the potentially dangerous similarity of an intrapartum maternal heart rate to an abnormal fetal heart rate pattern, and emphasizes the importance of correct identification of the maternal and fetal heart rates, respectively.

KEYWORDS

Maternal heart rate - intrapartum monitoring - cardiotocography - uterine contractions

REFERENCES

  • 1 Sherman D J, Frenkel E, Kurzweil Y, Padua A, Arieli S, Bahar M. Characteristics of maternal heart rate patterns during labor and delivery.  Obstet Gynecol. 2002;  99 542-547
    CrossrefPubMedGoogle Scholar
  • 2 Herman A, Ron-El R, Arieli S, Schreyer P, Caspi E. Maternal ECG recorded by internal monitoring closely mimicking fetal heart rate in a recent fetal death.  Int J Gynaecol Obstet. 1990;  33 269-271
    CrossrefPubMedGoogle Scholar
  • 3 Odentaal H J. False interpretation of fetal heart rate monitoring in cases of intrauterine fetal death.  S Afr Med J. 1976;  50 1963-1965
    PubMedGoogle Scholar
  • 4 Klapholtz H, Schifrin B S, Myrick R. Role of maternal artifact in fetal heart rate pattern interpretation.  Obstet Gynecol. 1974;  44 373-378
    PubMedGoogle Scholar
  • 5 Lackritz R, Schiff I, Gibson M, Safon L. Decelerations on fetal electrocardiography with fetal demise.  Obstet Gynecol. 1978;  51 367-368
    PubMedGoogle Scholar

David M ShererM.D. 

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York (SUNY)

Downstate Medical Center, 450 Clarkson Avenue, Box 24

Brooklyn, NY 11203