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  • 1. Amer-Wåhlin, I
    et al.
    Kjellmer, I
    Maršál, K
    Olofsson, P
    Rosén, Karl Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Swedish randomized controlled trial of cardiotocography only versus cardiotocography plus ST analysis of fetal electrocardiogram revisited: analysis of data according to standard versus modified intention-to-treat principle.2011Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, ISSN 0001-6349, Vol. 90, nr 9, s. 990-996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To undertake a renewed analysis of data from the previously published Swedish randomized controlled trial on intrapartum fetal monitoring with cardiotocography (CTG-only) vs. CTG plus ST analysis of fetal electrocardiogram (CTG+ST), using current standards of intention-to-treat (ITT) analysis and to compare the results with those of the modified ITT (mITT) and per protocol analyses. METHODS: Renewed extraction of data from the original database including all cases randomized according to primary case allocation (n=5 049). MAIN OUTCOME MEASURE: Metabolic acidosis in umbilical artery at birth (pH <7.05, base deficit in extracellular fluid >12.0 mmol/l) including samples of umbilical vein blood or neonatal blood if umbilical artery blood was missing. RESULTS: The metabolic acidosis rates were 0.66% (17 of 2 565) and 1.33% (33 of 2 484) in the CTG+ST and CTG-only groups, respectively [relative risk (RR) 0.50; 95% confidence interval (CI) 0.28-0.88; p=0.019]. The original mITT gave RR 0.47, 95%CI 0.25-0.86 (p=0.015), mITT with correction for 10 previously misclassified cases RR 0.48, 95%CI 0.24-0.96 (p=0.038) and per protocol analysis RR 0.40, 95%CI 0.20-0.80 (p=0.009). The level of significance of the difference in metabolic acidosis rates between the two groups remained unchanged in all analyses. CONCLUSION: Re-analysis of data according to the ITT principle showed that regardless of the method of analysis, the Swedish randomized controlled trial maintained its ability to demonstrate a significant reduction in metabolic acidosis rate when using CTG+ST analysis for fetal surveillance in labor.

  • 2. Amer-Wåhlin, Isis
    et al.
    Kjellmer, Ingemar
    Marsal, Karel
    Olofsson, Per
    Rosén, Karl Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Cardiotocography and ST analysis for intrapartum fetal monitoring2012Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, Vol. 91, nr 4, s. 519-Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Letter to the Editor

  • 3. Amer-Wåhlin, Isis
    et al.
    Rosén, KG
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    ST-Analysis of the Fetal ECG2013Ingår i: Antenatal and Intrapartum fetal surveillance, Universities Press , 2013, s. 220-236Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 4. Ayres-de-Campos, D.
    et al.
    Ugwumadu, A.
    Banfield, P.
    Lynch, P.
    Amin, P.
    Horwell, D.
    Costa, A.
    Santos, C.
    Bernardes, J.
    Rosen, Karl Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    A randomised clinical trial of intrapartum fetal monitoring with computer analysis and alerts versus previously available monitoring2010Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 10, nr 71Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Intrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related to fetal surveillance. Cardiotocographic (CTG) monitoring remains the basis of intrapartum surveillance, but its interpretation by healthcare professionals lacks reproducibility and the technology has not been shown to improve clinically important outcomes. The addition of fetal electrocardiogram analysis has increased the potential to avoid adverse outcomes, but CTG interpretation remains its main weakness. A program for computerised analysis of intrapartum fetal signals, incorporating real-time alerts for healthcare professionals, has recently been developed. There is a need to determine whether this technology can result in better perinatal outcomes. Methods/design: This is a multicentre randomised clinical trial. Inclusion criteria are: women aged ≥ 16 years, able to provide written informed consent, singleton pregnancies ≥ 36 weeks, cephalic presentation, no known major fetal malformations, in labour but excluding active second stage, planned for continuous CTG monitoring, and no known contra-indication for vaginal delivery. Eligible women will be randomised using a computer-generated randomisation sequence to one of the two arms: continuous computer analysis of fetal monitoring signals with real-time alerts (intervention arm) or continuous CTG monitoring as previously performed (control arm). Electrocardiographic monitoring and fetal scalp blood sampling will be available in both arms. The primary outcome measure is the incidence of fetal metabolic acidosis (umbilical artery pH < 7.05, BDecf > 12 mmol/L). Secondary outcome measures are: caesarean section and instrumental vaginal delivery rates, use of fetal blood sampling, 5-minute Apgar score < 7, neonatal intensive care unit admission, moderate and severe neonatal encephalopathy with a marker of hypoxia, perinatal death, rate of internal monitoring, tracing quality, and signal loss. Analysis will follow an intention to treat principle. Incidences of primary and secondary outcomes will be compared between groups. Assuming a reduction in metabolic acidosis from 2.8% to 1.8%, using a two-sided test with alpha = 0.05, power = 0.80, and 10% loss to follow-up, 8133 women need to be randomised. Discussion: This study will provide evidence of the impact of intrapartum monitoring with computer analysis and real-time alerts on the incidence of adverse perinatal outcomes, intrapartum interventions and signal quality. (Current controlled trials ISRCTN42314164)

  • 5. Blad, Sofia
    et al.
    Larsson, David
    Outram, Nicolas
    Rosén, Karl G
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Assessment of fetal reactivity biopatterns during labour by fetal ECG analysis2009Konferensbidrag (Refereegranskat)
    Abstract [en]

    Reactivity is the pattern of reactions associated with response to changes in the environment such as stress. Labour with uterine contractions hampering fetal and uterine blood flow provides significant stress and we need to improve our ability to assess fetal reactivity biopatterns during delivery. The study illustrates progress made with regard to detailed analysis of the fetal heart rate (FHR) and beat-to-beat variations (RR-intervals) as a clinical measure of fetal reactivity. A method, named residuals, is presented of using a small set of index cases to identify parameter settings which are then further evaluated in extensive database tests of 8100 cases.

  • 6. Blad, Sofia
    et al.
    Welin, Anna-Karin
    Kjellmer, Ingemar
    Rosén, Karl-Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Mallard, Carina
    ECG and heart rate variability changes in preterm and near-term fetal lamb following LPS exposure2008Ingår i: Reproductive Sciences, ISSN 1933-7191, E-ISSN 1933-7205, Vol. 15, nr 6, s. 572-583Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study is to evaluate the myocardial response in the preterm and near-term fetal lamb with infection. Chronically instrumented fetal lambs were exposed to lipopolysaccharide (LPS), and the fetal electrocardiogram (FECG) ST waveform was examined using STAN. Fetal heart rate variability (FHRV) was automatically analyzed by adapting a polynomial function to the RR sequence in the FECG. Preterm fetuses exposed to >90 ng/kg LPS died within 8 hours of LPS administration, a response not seen in near-term fetuses. In both surviving and nonsurviving preterm fetuses, cardiovascular responses were characterized by decreased arterial pressure, negative T waves, and tachycardia accompanied by an increase in FHRV. Similar changes were not observed in the near-term fetuses after LPS. The study shows that preterm lambs are more sensitive to LPS in terms of myocardial/cardiovascular response than the more mature fetuses are. High FHRV and negative ST waveform seem to characterize the LPS-induced stress response in preterm fetuses.

  • 7. Hafström, Maria
    et al.
    Ehnström, Siv
    Blad, Sofia
    Norén, Håkan
    Renman, Cecilia
    Rosén, Karl Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Kjellmer, Ingemar
    Developmental Outcome at 6.5 Years After Acidosis in Term Newborns: A Population-Based Study2012Ingår i: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 129, nr 6, s. 1-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Infants who develop encephalopathy after perinatal asphyxia have an increased risk of death and adverse neurologic outcome. Conflicting results exist concerning outcome in healthy infants with metabolic acidosis at birth. The aim of the current study was to evaluate whether metabolic acidosis at birth in term infants who appear healthy is associated with long-term developmental abnormalities. METHODS: From a population-based cohort (14 687 deliveries), 78 infants were prospectively identified as having metabolic acidosis (umbilical artery pH , 7.05 and base deficit in the extracellular fluid .12.0 mmol/L). Two matched controls per case were selected. The child health and school health care records were scrutinized for developmental abnormalities. RESULTS: Outcome measures at 6.5 years of age for 227 of 234 children (97%) were obtained. No differences were found concerning neurologic or behavioral problems in need of referral action or neurodevelopmental diagnosis in comparison of control children with acidotic children who had appeared healthy at birth, ie, had not required special neonatal care or had no signs of encephalopathy. CONCLUSIONS: Infants born with cord metabolic acidosis and who appear well do not have an increased risk for neurologic or behavioral problems in need of referral actions or special teaching approaches at the age of 6.5 years. Pediatrics 2012;129:1–7

  • 8. Hopkins, P
    et al.
    Outram, N
    Löfgren, N
    Ofeachor, E. C.
    Rosén, K. G.
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    A comparative study of fetal heart rate variability analysis techniques2006Konferensbidrag (Refereegranskat)
  • 9. Kro, G.
    et al.
    Yli, B.
    Rasmussen, S.
    Norèn, H.
    Amer-Wåhlin, I.
    Didrik Saugstad, O.
    Stray-Pedersen, B.
    Rosén, Karl Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    A new tool for the validation of umbilical cord acid: base data2010Ingår i: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 117, nr 12, s. 1544-1552Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective To identify the distribution of carbon dioxide tension (pCO2) relative to pH in validated umbilical cord acid–base data. Design Observational study. Setting European hospital labour wards. Population Data for 36 432 term newborns were obtained from three sources: two trials of fetal monitoring with electrocardiography (ECG; the Swedish randomised controlled trial and the European Union Fetal ECG trial) and data from Mölndal Hospital. Methods From the total study population, cases with missing values or obvious typing errors were excluded. The remaining data were validated based on specified criteria. Percentiles of arterial pCO2 by pH were calculated using multilevel regression modelling. Main outcome measures Umbilical cord pH, pCO2 and base deficit. Results Acid–base values were considered invalid in one out of seven cases. Percentiles for arterial pCO2 corresponding to specified values of arterial pH were developed from the validated data of 26 690 cases. Conclusions Percentiles for arterial pCO2 for a specified arterial pH can be used as a tool to identify cases with erroneously low pCO2 values, and thus avoid an incorrect interpretation of the newborn’s acid–base status.

  • 10. Kro, GA
    et al.
    Yli B, M
    Rasmussen, S
    Norèn, H
    Amer-Wåhlin, I
    Rosén, KG
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Stray-Pedersen, B
    Saugstad, OD
    Association between umbilical cord artery pCO₂ and the Apgar score; elevated levels of pCO₂ may be beneficial for neonatal vitality after moderate acidemia.2013Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, nr 6, s. 662-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To determine the association between 5-min Apgar score and umbilical cord artery carbon dioxide tension (pCO₂). DESIGN: Observational study. SETTING: European hospital labor wards. POPULATION: Data from 36,432 newborns ≥36 gestational weeks were obtained from three sources: two trials of monitoring with fetal electrocardiogram (the Swedish randomized controlled trial and the European Union Fetal ECG trial) and Mölndal Hospital data. After validation of the acid-base values, 25,806 5-min Apgar scores were available for analysis. METHODS: Validation of the umbilical cord acid-base values was performed to obtain reliable data. 5-min Apgar score was regressed against cord artery pCO₂ in a polynomial multilevel model. MAIN OUTCOME MEASURES: Five-min Apgar score, umbilical cord pCO₂, pH, and base deficit. RESULTS: Overall, a higher cord artery pCO₂ was found to be associated with lower 5-min Apgar scores. However, among newborns with moderate acidemia, lower umbilical cord artery pCO₂ (≤median pCO₂ for the specific cord artery pH) was associated with lower 5-min Apgar scores, with a relative risk of 2.0 (95% confidence interval: 1.4-2.8) for 5-min Apgar scores 0-6. CONCLUSIONS: Metabolic acidosis affects the newborn's vitality more than respiratory acidosis. In addition, elevated levels of pCO₂ may be beneficial for fetuses with moderate acidemia, and thus cord artery pCO₂ is a factor that should be considered when assessing the compromised newborn.

  • 11.
    Magnusson, Lennart
    et al.
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Sandman, Lars
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Rosén, Karl G
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Nyttoeffekter med mobila trygghetslarm för personer med demenssjukdom och deras anhöriga2013Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    För kommunerna utgör kostnaderna för personer med demenssjukdom mer än 40 procent av deras totala kostnader för vård och omsorg och vi vet att samhällets insats förväntas öka framgent. Risken är att resurserna inte kommer att räcka till för att bevara en optimal livskvalité. Ett sätt att möta detta är att utnyttja olika tekniska lösningar. Mobila trygghetslarm är en möjliggörande teknologi med stor potential. Huvudsyftet med studien var att se på vilken grund mobila trygghetslarm kan vara ett verktyg som utvecklar vården och omsorgen för personer med demenssjukdom och underlättar för deras familjer i den dagliga tillvaron. Studien fokuserade på personer med demenssjukdom i eget boende.

  • 12. Magnusson, Lennart
    et al.
    Sandman, Lars
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Rosén, Karl Gustaf
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Hanson, Elizabeth
    Extended safety and support systems for people with dementia living at home2014Ingår i: Journal of Assistive Technologies, ISSN 1754-9450, E-ISSN 2042-8723, Vol. 8, nr 4, s. 188-206Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Purpose – The purpose of this paper is to highlight the complexity surrounding the implementation of advanced electronic tracking, communication and emergency response technologies, namely, an extended safety and support (ESS) system for people with dementia (pwd) living at home. Results are presented from a Swedish demonstration study (2011-2012) conducted in 24 municipalities. Design/methodology/approach – It is a descriptive intervention study with a pre-post test design. Questionnaires were administered to pwd, carers and professionals at the outset and eight months later. ESS logging data were analyzed. Findings – ESS usage rates varied widely. A total of 650 alerts were triggered, mainly when the pwd was outdoors. Activities were reduced amongst pwd, most likely due to a progression of their disease. Carers noted that pwd were more independent than previously on those occasions when they engaged in outdoor activities. Staff considered that nearly half of pwd could remain living at home due to the ESS, compared with a third amongst carers. In total, 50 per cent of carers felt it was justified to equip their relative with an ESS without their explicit consent, compared to one in eight staff. Research limitations/implications – A limitation is the amount of missing data and high drop- out rates. Researchers should recruit pwd earlier in their illness trajectory. A mixed-methods approach to data collection is advisable. Practical implications – Carers played a crucial role in the adoption of ESS. Staff training/supervision about assistive devices and services is recommended. Social implications – Overall, use of ESS for pwd living at home was not an ethical problem. Originality/value – The study included key stakeholder groups and a detailed ethical analysis was conducted.

  • 13.
    Magnusson, Lennart
    et al.
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Sandman, Lars
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Rosén, KG
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Hanson, Elisabeth
    Extended safety and support systems for people with dementia living at home.2014Ingår i: Journal of Assistive Technologies, ISSN 1754-9450, E-ISSN 2042-8723, Vol. 8, nr 4, s. 188-206Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose – The purpose of this paper is to highlight the complexity surrounding the implementation of advanced electronic tracking, communication and emergency response technologies, namely, an extended safety and support (ESS) system for people with dementia (pwd) living at home. Results are presented from a Swedish demonstration study (2011-2012) conducted in 24 municipalities. Design/methodology/approach – It is a descriptive intervention study with a pre-post test design. Questionnaires were administered to pwd, carers and professionals at the outset and eight months later. ESS logging data were analyzed. Findings – ESS usage rates varied widely. A total of 650 alerts were triggered, mainly when the pwd was outdoors. Activities were reduced amongst pwd, most likely due to a progression of their disease. Carers noted that pwd were more independent than previously on those occasions when they engaged in outdoor activities. Staff considered that nearly half of pwd could remain living at home due to the ESS, compared with a third amongst carers. In total, 50 per cent of carers felt it was justified to equip their relative with an ESS without their explicit consent, compared to one in eight staff. Research limitations/implications – A limitation is the amount of missing data and high drop- out rates. Researchers should recruit pwd earlier in their illness trajectory. A mixed-methods approach to data collection is advisable. Practical implications – Carers played a crucial role in the adoption of ESS. Staff training/supervision about assistive devices and services is recommended. Social implications – Overall, use of ESS for pwd living at home was not an ethical problem. Originality/value – The study included key stakeholder groups and a detailed ethical analysis was conducted.

  • 14. Nunes, I
    et al.
    Ayres-de-Campos, D
    Kwee, A
    Rosén, KG
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Prolonged saltatory fetal heart rate pattern leading to newborn metabolic acidosis2014Ingår i: Clinical and Experimental Obstetrics and Gynecology, ISSN 0390-6663, Vol. 41, nr 5, s. 507-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The saltatory pattern, characterized by wide and rapid oscillations of the fetal heart rate (FHR), remains a controversial entity. The authors sought to evaluate whether it could be associated with an adverse fetal outcome. Material and Methods: The authors report a case series of four saltatory patterns occurring in the last 30 minutes before birth in association with cord artery metabolic acidosis, obtained from three large databases of internally acquired FHR tracings. The distinctive characteristics of this pattern were evaluated with the aid of a computer system. Results: All cases were recorded in uneventful pregnancies, with normal birth weight singletons, born vaginally at term. The saltatory pattern lasted between 23 and 44 minutes, exhibited a mean oscillatory amplitude of 45.9 to 80.0 beats per minute (bpm) and a frequency between four and eight cycles per minute. Conclusions: A saltatory pattern exceeding 20 minutes can be associated with the occurrence of fetal metabolic acidosis.

  • 15.
    Rosén, Karl G
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    In-cabin air quality: electrostatic field to capture sub-micron size particles2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    Traffic is regarded as the main reason for the air pollution problem and it seems obvious to try to reduce the particulate bioload affecting those travelling. Recently Volvo Cars introduced their Interior Air Quality System forcing the cabin air to be recirculated in case of a high level of noxious gases shutting out carbon monoxide, ground-level ozone and nitrogen dioxide. Ionization is another component of Mercedes AIR-BALANCE package. Considering the fact that it is the nano-size ultra-fine particles (UFP) that are known to cause the “oxidative” stress of the immune system one may ask if even the most well designed HEPA filter would sufficiently affect the in-cabin air particulates or is there a need for additional means by which the sub-micron class particles may be captured. An electrostatic field of sufficient strength may serve as an additional tool to clean the cabin air from sub-micron size particles.The initial data from the study indicate that electrostatic mechanisms substantially add to the in-cabin air cleaning properties of ultra-fine particulates compared to the standard filtering technology when recirculating the cabin air.

  • 16.
    Rosén, Karl G
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    The impact of electrostatic air cleaning in free-ranging egg production2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    The development of a patented polymer based electron emitting technology (EAC) has provided a means to study the impact of reduced bioload in stable air on productivity. Apart from capturing particles in a negatively charged electrostatic field operating over the entire stable with hundreds of meters of emitting structure, the electrons combine with oxygen and vapor to produce H2O2 to block mould metabolism. Before and after data from three egg producing farms with 20-50 000 free-roaming layers were collected as part of their standard productivity control. The number of mould colonies decreased from >7 (range 7 – 30) to single colonies. Lay percentage over the production period covering 22 to 75 weeks of age increased by 3% and the feed conversion improved by 9%. During the last 10 production weeks, the overall improvement in productivity was 27% enabling the farmers to maintain a high productivity despite an ageing population of layers.

  • 17.
    Rosén, KG
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    ST analysis reviewed2013Ingår i: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 209, nr 4, s. 394-Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [en]

    Comment on Effectiveness of electronic fetal monitoring with additional ST analysis in vertex singleton pregnancies at >36 weeks of gestation: an individual participant data metaanalysis

  • 18. Siira, Saila M.
    et al.
    Ojala, Tiina H.
    Vahlberg, Tero J.
    Rosén, Karl G.
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Ekholm, Eeva M.
    Do spectral bands of fetal heart rate variability associate with concomitant fetal scalp pH?2013Ingår i: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 89, nr 9, s. 739-742Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Objective information on speci fi c fetal heart rate (FHR) parameters would be advantageous when assessing fetal responses to hypoxia. Small, visually undetectable changes in FHR variability can be quanti fi ed by power spectral analysis of FHR variability. Aims: To investigate the effect of intrapartum hypoxia and acidemia on spectral powers of FHR variability. Study design: This is a retrospective observational clinical study with data from an EU multicenter project. Subjects: We had 462 fetuses with a normal pH-value (pH > 7.20; controls) in fetal scalp blood sample (FBS) and 81 fetuses with a low scalp pH-value ( ≤ 7.20; low-FBS pH-fetuses). The low-FBS pH-fetuses were further divided into two subgroups according to the degree of acidemia: fetuses with FBS pH 7.11 – 7.20 (n = 58) and fetuses with FBS pH ≤ 7.10 (n = 23). Outcome measures: Spectral powers of FHR variability in relation to the concomitant FBS pH-value. Results: Fetuses with FBS pH ≤ 7.20 had increased spectral powers of FHR variability compared with controls (2.49 AU vs. 2.23 AU; p = 0.038). However, the subgroup of most affected fetuses (those with FBS pH ≤ 7.10) had signi fi cantly lower FHR variability spectral powers when compared to fetuses with FBS pH 7.11 – 7.20. Conclusions: This study shows that spectral powers of FHR variability change as a fetus becomes hypoxic, and that spectral powers decrease with deepening fetal acidemia.

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