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de Vet CM, van Oostrum NHM, Clur SB, Oei SG, van Laar JOEH. Reply. Ultrasound Obstet Gynecol 2023; 62:448-449. [PMID: 37647041 DOI: 10.1002/uog.26317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 09/01/2023]
Affiliation(s)
- C M de Vet
- Department of Gynecology and Obstetrics, Máxima Medical Center, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - N H M van Oostrum
- Department of Gynecology and Obstetrics, Ghent University Hospital, Ghent, Belgium
| | - S B Clur
- Department of Pediatric Cardiology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart - ERN GUARD-Heart (ERN GUARDHEART)
| | - S G Oei
- Department of Gynecology and Obstetrics, Máxima Medical Center, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - J O E H van Laar
- Department of Gynecology and Obstetrics, Máxima Medical Center, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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de Vet CM, van Oostrum NHM, Clur SB, van der Woude DAA, Oei SG, van Laar JOEH. Reply. Ultrasound Obstet Gynecol 2023; 61:275-277. [PMID: 36722426 DOI: 10.1002/uog.26151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 05/27/2023]
Affiliation(s)
- C M de Vet
- Department of Gynaecology and Obstetrics, Máxima Medical Centre, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - N H M van Oostrum
- Department of Gynaecology and Obstetrics, Ghent University Hospital, Ghent, Belgium
| | - S B Clur
- Department of Paediatric Cardiology, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - D A A van der Woude
- Department of Gynaecology and Obstetrics, Máxima Medical Centre, Veldhoven, The Netherlands
| | - S G Oei
- Department of Gynaecology and Obstetrics, Máxima Medical Centre, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - J O E H van Laar
- Department of Gynaecology and Obstetrics, Máxima Medical Centre, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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van Oostrum NHM, de Vet CM, Clur SB, van der Woude DAA, van den Heuvel ER, Oei SG, van Laar JOEH. Fetal myocardial deformation measured with two-dimensional speckle-tracking echocardiography: longitudinal prospective cohort study of 124 healthy fetuses. Ultrasound Obstet Gynecol 2022; 59:651-659. [PMID: 34558747 PMCID: PMC9321172 DOI: 10.1002/uog.24781] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 05/27/2023]
Abstract
OBJECTIVES Two-dimensional speckle-tracking echocardiography (2D-STE) is a promising technique which allows assessment of fetal cardiac function, and can be used in the evaluation of cardiac and non-cardiac diseases in pregnancy. However, reliable fetal reference values for deformation parameters measured using 2D-STE are needed before it can be introduced into clinical practice. This study aimed to obtain reference values for fetal global longitudinal strain (GLS) and GLS rate (GLSR) measured using 2D-STE and compare right and left ventricular values. METHODS This was a prospective longitudinal cohort study of uncomplicated pregnancies that underwent echocardiography every 4 weeks from inclusion at 18-21 weeks until delivery to obtain four-chamber loops of the fetal heart. Left and right ventricular GLS and GLSR were measured using 2D-STE at each examination. Using Bayesian mixed-effects models, reference values with lower and upper 5% prediction limits were calculated according to gestational age. Right and left ventricular GLS values according to gestational age were compared using the Wilcoxon signed-rank test. RESULTS A total of 592 left ventricular and 566 right ventricular GLS and GLSR measurements were obtained from 124 women with uncomplicated pregnancy and non-anomalous, appropriately grown fetuses. Reference values were obtained for both fetal ventricles according to gestational week. GLS and GLSR values of both ventricles increased (i.e. became less negative) significantly during pregnancy. Right ventricular GLS values were significantly higher (i.e. less negative) than the respective left ventricular values at every gestational week. CONCLUSIONS Reference values were obtained for fetal GLS and GLSR measured using 2D-STE. GLS and GLSR values increased significantly for both ventricles from the second trimester until delivery. GLS values were significantly higher for the right ventricle compared with the left ventricle. Future studies are needed to assess whether the obtained reference values are helpful in clinical practice in the assessment of pregnancy complications, such as fetal growth restriction or cardiac anomaly. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N. H. M. van Oostrum
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsGhent UniversityGhentBelgium
| | - C. M. de Vet
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
| | - S. B. Clur
- Department of Paediatric Cardiology, Emma Children's Hospital, Academic Medical CenterAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - D. A. A. van der Woude
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
| | - E. R. van den Heuvel
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Mathematics & Computer ScienceEindhoven University of TechnologyEindhovenThe Netherlands
| | - S. G. Oei
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
| | - J. O. E. H. van Laar
- Eindhoven MedTech Innovation Centre (e/MTIC)EindhovenThe Netherlands
- Department of Electrical EngineeringEindhoven University of TechnologyEindhovenThe Netherlands
- Department of Gynaecology and ObstetricsMáxima Medical CentreVeldhovenThe Netherlands
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Nichting TJ, Frenken MWE, van der Woude DAA, van Oostrum NHM, de Vet CM, van Willigen BG, van Laar JOEH, van der Ven M, Oei SG. Non-invasive fetal electrocardiography, electrohysterography and speckle-tracking echocardiography in the second trimester: study protocol of a longitudinal prospective cohort study (BEATS-study). BMC Pregnancy Childbirth 2021; 21:791. [PMID: 34823483 PMCID: PMC8613985 DOI: 10.1186/s12884-021-04265-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/10/2021] [Indexed: 11/20/2022] Open
Abstract
Background Worldwide, hypertensive disorders of pregnancy (HDP), fetal growth restriction (FGR) and preterm birth remain the leading causes of maternal and fetal pregnancy-related mortality and (long-term) morbidity. Fetal cardiac deformation changes can be the first sign of placental dysfunction, which is associated with HDP, FGR and preterm birth. In addition, preterm birth is likely associated with changes in electrical activity across the uterine muscle. Therefore, fetal cardiac function and uterine activity can be used for the early detection of these complications in pregnancy. Fetal cardiac function and uterine activity can be assessed by two-dimensional speckle-tracking echocardiography (2D-STE), non-invasive fetal electrocardiography (NI-fECG), and electrohysterography (EHG). This study aims to generate reference values for 2D-STE, NI-fECG and EHG parameters during the second trimester of pregnancy and to investigate the diagnostic potential of these parameters in the early detection of HDP, FGR and preterm birth. Methods In this longitudinal prospective cohort study, eligible women will be recruited from a tertiary care hospital and a primary midwifery practice. In total, 594 initially healthy pregnant women with an uncomplicated singleton pregnancy will be included. Recordings of NI-fECG and EHG will be made weekly from 22 until 28 weeks of gestation and 2D-STE measurements will be performed 4-weekly at 16, 20, 24 and 28 weeks gestational age. Retrospectively, pregnancies complicated with pregnancy-related diseases will be excluded from the cohort. Reference values for 2D-STE, NI-fECG and EHG parameters will be assessed in uncomplicated pregnancies. After, 2D-STE, NI-fCG and EHG parameters measured during gestation in complicated pregnancies will be compared with these reference values. Discussion This will be the a large prospective study investigating new technologies that could potentially have a high impact on antepartum fetal monitoring. Trial registration Registered on 26 March 2020 in the Dutch Trial Register (NL8769) via https://www.trialregister.nl/trials and registered on 21 October 2020 to the Central Committee on Research Involving Human Subjects (NL73607.015.20) via https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm.
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Affiliation(s)
- T J Nichting
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands. .,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands. .,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.
| | - M W E Frenken
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - D A A van der Woude
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - N H M van Oostrum
- Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Department of Gynaecology and Obstetrics, University Hospital Gent, 9000, Gent, Belgium
| | - C M de Vet
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - B G van Willigen
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - J O E H van Laar
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - M van der Ven
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
| | - S G Oei
- Department of Gynaecology and Obstetrics, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.,Eindhoven MedTech Innovation Centre, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands
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Moors S, Joshi R, Bullens LM, van Oostrum NHM, Regis M, van den Heuvel ER, Oei SG, van Laar JOEH, van der Hout-van der Jagt MB. A randomized controlled trial studying the effect of maternal hyperoxygenation on fetal heart rate in suspected fetal distress. Physiol Meas 2020; 41:115002. [PMID: 33049730 DOI: 10.1088/1361-6579/abc0b6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the effect of maternal hyperoxygenation on fetal heart rate (FHR) when applied for suspected fetal distress during the second stage of term labor. APPROACH A single-center randomized controlled trial was conducted in a tertiary care hospital in The Netherlands. Participants were included during the second stage of labor in case of an intermediary or abnormal FHR pattern. Patients were randomized to receive either 100% oxygen at 10 l/min until delivery, or conventional care without additional oxygen. The primary outcome was the change in FHR pattern before and after the onset of the study, measured as the change in depth and duration of FHR decelerations. Secondary outcome measures were features based on phase-rectified signal averaging (PRSA), baseline assignability, and deceleration characteristics of the FHR pattern. MAIN RESULTS Between March 2016 and April 2018, 117 women were included. The FHR pattern could be analyzed for 71 participants, the other 46 women delivered before the end of the post time-frame. A 2.3% reduction in depth and duration of FHR decelerations was found after maternal hyperoxygenation, compared to a 10% increase in the control group (p = 0.24). Maternal hyperoxygenation had a significantly positive effect on PRSA metrics, with a decrease in PRSA-acceleration capacity (p = 0.03) and PRSA-deceleration capacity (p = 0.02) in the intervention group compared to the control group. SIGNIFICANCE The difference in depth and duration of decelerations after the start of the study was not significantly different between both study groups. A statistically significant positive effect on PRSA-deceleration capacity and PRSA-acceleration capacity was found after maternal hyperoxygenation, which might be associated with a positive effect on neonatal outcome.
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Affiliation(s)
- S Moors
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands. Eindhoven MedTech Innovation Center (e/MTIC), Groene Loper 19, Eindhoven 5600 MB, The Netherlands. Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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