Computerized analysis of the fetal heart rate in pregnancies complicated by preterm premature rupture of membranes (pPROM)

Objective. We aimed to show that in pregnancies complicated by preterm premature rupture of membranes (pPROM), there are alterations to the fetal heart rate pattern that can be detected by computerized analysis. Methods. The study population consisted of 27 pregnant women with pPROM at 29-34 weeks of gestation and 33 normal pregnancies matched according to age, parity and gestation. A 30-minute fetal heart rate (FHR) tracing was analyzed by computer and umbilical artery cord blood was collected at birth. Results. The baseline heart rate, the number of decelerations exceeding 20 beats per minute and the duration of episodes of low variation were higher in the pPROM group versus the controls. The number of decelerations exceeding 20 beats per minute had an independent, statistically significant association with umbilical artery pH at birth. Conclusions. Even if our data require a prospective validation involving a larger number of pathological cases, a computerized FHR tracing analysis may improve the clinical care and the timing of delivery during pPROM by definition of the risk of acidemia and pre-acidemia.