Effect of acute exercise testing in pregnant athletes on maternal and fetal heart rate, fetal/maternal bloodflow and cardiotocogramm assessment.
The aim of the study is to evaluate in a preliminary step the validity of fetal heart rate measurement with the "Nemo Healthcare Monitoring System" - a wireless non-invasive CTG device. Furthermore, we will determine the reliability for CTG measurements (intraobserver and interobserver reliability) and for ultrasound (intraobserver reliability). The device is approved for use on pregnant women and is regularly used as a CTG device for monitoring fetal heart rate and contractions during childbirth. If in the preliminary step the heart rate measurements with the "Nemo Fetal Monitoring System" provide valid and fetal heart rate results compared to the standard Doppler ultrasound method and provide a reliable detection of fetal heart rate deceleration the effects of phys-ical activity on fetal heart rate pattern and changes in fetal blood flow, placento-fetal and materno-placental blood supply rate will be investigated in the main part of the study in a larger study population. It is hypothesized that CTG provides technically a valid and reliable continuous re-cording of fetal heart rate values, since fetal heart rate measurement under physical exertion has previously only been possible by intermittent but not continuous Dop-pler ultrasound. Furthermore, we will evaluate alterations in fetal heart rate pattern and changes in fetal blood flow, placento-fetal and materno-placental blood supply according to the level of exertion.
Study Type
OBSERVATIONAL
Enrollment
20
incremental cycling test on a bicycle ergometer
Balgrist University Hospital
Zurich, Canton of Zurich, Switzerland
RECRUITINGUniversity Hospital Zurich
Zurich, Canton of Zurich, Switzerland
RECRUITINGfetal heart rate
The fetal heart rate is continuously monitored via the CTG device during the entire performance test.
Time frame: through exercise testing, an average of 90 minutes
Umbilical cord artery pulsatility index
(systolic velocity - diastolic velocity) / mean velocity
Time frame: through exercise testing, an average of 90 minutes
Umbilical cord artery resistance index
(systolic velocity - diastolic velocity) / systolic velocity
Time frame: through exercise testing, an average of 90 minutes
umbilical cord artery S/D ratio
(S = maximum systolic flow velocity; D = maximum diastolic flow velocity)
Time frame: through exercise testing, an average of 90 minutes
Medial cerebral artery pulsatility index
(systolic velocity - diastolic velocity) / mean velocity
Time frame: through exercise testing, an average of 90 minutes
Medial cerebral artery resistance index
(systolic velocity - diastolic velocity) / systolic velocity
Time frame: through exercise testing, an average of 90 minutes
medial cerebral artery peak systolic velocity
in cm/s
Time frame: through exercise testing, an average of 90 minutes
right and left uterine artery pulsatility index
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(systolic velocity - diastolic velocity) / mean velocity
Time frame: through exercise testing, an average of 90 minutes
right and left uterine artery resistance index
(systolic velocity - diastolic velocity) / systolic velocity
Time frame: through exercise testing, an average of 90 minutes
cerebro-placental ratio
pulsatility index of the middle cerebral artery / pulsatility index of the umbilical artery
Time frame: through exercise testing, an average of 90 minutes
pregnancy complications
incidence of pregnancy complications (yes/no);
Time frame: during pregnancy and up to12 weeks after birth
birth complications
incidence of birth complications (yes/no);
Time frame: On the day the child is born
mode of delivery
spontaneous birth vs. vacuum-assisted birth vs. forceps-assisted birth vs planned cesarean section vs. unplanned cesarean section
Time frame: On the day the child is born
APGAR score
APGAR score (1-10)
Time frame: On the day the child is born
gestational age at birth
gestational age at birth (in weeks and days);
Time frame: On the day the child is born
pH value of the umbilical cord artery
pH value of the umbilical cord artery mesured directly after birth
Time frame: On the day the child is born
fetal admission to Neonatal Intensive Care Unit
admission (yes/no)
Time frame: up to 12 weeks