Distance to Healthy Metabolic and Cardiovascular Dynamics From Fetal Heart Rate Scale-Dependent Features in Pregnant Sheep Model of Human Labor Predicts the Evolution of Acidemia and Cardiovascular Decompensation

The overarching goal of the present work is to contribute understanding relations between fetal heart rate (FHR) temporal dynamics and well-being fetus, notably in terms predicting cardiovascular decompensation (CVD). It makes uses an established animal model human labor, where fourteen near-term ovine fetuses subjected umbilical cord occlusions (UCO) were instrumented permit regular intermittent measurements metabolites, pH, continuous recording electrocardiogram (ECG) systemic arterial blood pressure (to identify CVD) during UCO. ECG-derived FHR was digitized at sampling 1000 Hz resampled 4Hz, as used clinical routine. We focused on four variability features which are tunable scales dynamics, robustly computable from sampled $4$Hz within short-time sliding windows, hence permitting a time-dependent, or local, analysis helps dealing with signal noise. Results show sensitivity proposed for early detection CVD, correlation metabolites useful acidosis importance coarse time (2.5 8 seconds) not disturbed by low rate. Further, we introduce performance individualized self-referencing metric distance healthy state, based combination features. demonstrate that this novel metric, applied clinically available alone, accurately predicts occurrence CVD heralds significant degradation health reserve tolerate trial labor.