By Daljit Singh Sahota, E Malcolm Symonds, Mang Zing Allan Chang
This quantity summarizes a century of analysis and sensible purposes in foetal electrocardiography. even supposing foetal ECG is most typically used for the calculation of foetal middle charges, different parameters were hired within the prediction of foetal acidons. The e-book provides new methods to the translation and research of the foetal ECG sign and discusses attainable new techniques to the medical exploitation of job of the foetal middle. The authors have made a number of contributions to the learn of foetal electrocardiography during the last 3 many years.
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Additional resources for Fetal Electrocardiography (Series in Cardiopulmonary Medicine)
Despite a further report by Lee and Hon in 1963 on a series of seven cases in which there was notching or splitting and widening of the R wave, the authors concluded that spontaneous variations in the R wave amplitude were not rare during labour and that these morphological changes did not indicate an adverse fetal environment. In their paper on the dying fetus (1963), the same authors concluded that, whilst there was on occasions evidence of a wandering pacemaker and widened QRS complexes, these changes were not consistent and were generally agonal.
ADP is converted to ATP during intermediary metabolism, completing the energy cycle. A failure in metabolism results in an accumulation of ADP (Fig. 4), and this in turn is broken down into hypoxanthine. Some of this is further changed into uric acid and is eventually excreted. Hypoxanthine also reacts directly with oxygen to produce free hydroxyl and oxygen radicals. These are ions with an extra electron attached and are Fetal Adaptation Intermediate metabolism r 37 1 Adenosine triphosphate Adenosine diphosphate Adenosine monophosphate ) Hypoxanthine Oxygen -+• Xanthine Hydroxyl and oxygen radicals -+• Urate Scavanged by antioxidants 4 Damaged DNA I Damaged cell membranes Altered water and electrolyte contents Changes to membrane permeability Cell death Apoptosis I Decreased cell number Fig.
From this specific starting point, the predominant spread of the electrical activity will depend on where the greatest mass of myocardium is available. The sino-atrial node is influenced by both the sympathetic and parasympathetic (vagal) nerves, the latter being more prevalent in the atrioventricular node, and of all the structures in the heart, it contains the greatest number of cells capable of "automaticity". These cells possess the ability to spontaneously produce a cardiac impulse. The sino-atrial node, therefore, controls the action of the heart as the cells in this node have the fastest automatic speed of response of all the fibres in the heart and the development of this ability occurs at the very early stages of embryonic development.