ReviewThe Journal of physiology2016
The myths and physiology surrounding intrapartum decelerations: the critical role of the peripheral chemoreflex.
Review in The Journal of physiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
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Who cites it
41 citing papers in PubMed, 102 citations in OpenAlex.
- Time-surrogate variables enhance the association between cardiotocographic features and intrapartum hypoxic-ischemic encephalopathy.PLOS digital health · 2026Article
- Intrapartum CTG characteristics associated with isolated single umbilical artery in term fetuses: A matched case-control study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Is amnioinfusion for intrapartum variable decelerations effective? Evaluation of the total deceleration area: A retrospective cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Comparison and verification of detection accuracy for late deceleration with and without uterine contractions signals using convolutional neural networks.Frontiers in physiology · 2025Article
- The effect of continuous electronic fetal monitoring on mode of delivery and neonatal outcome among low-risk laboring mothers at Debre Markos comprehensive specialized hospital, Northwest Ethiopia.Frontiers in global women's health · 2024Article
- Computerised Cardiotocography Analysis for the Automated Detection of Fetal Compromise during Labour: A Review.Bioengineering (Basel, Switzerland) · 2023Review
- The Impact of Total Deceleration Area and Fetal Growth on Neonatal Acidemia in Vacuum Extraction Deliveries.Children (Basel, Switzerland) · 2023Article
- Predelivery placenta-associated biomarkers and computerized intrapartum fetal heart rate patterns.AJOG global reports · 2023Article
- Types of intrapartum hypoxia in the newborn at term with metabolic acidemia: A retrospective study.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Increased variability of fetal heart rate during labour: a review of preclinical and clinical studies.BJOG : an international journal of obstetrics and gynaecology · 2022Review
- Is It Time to Redefine Fetal Decelerations in Cardiotocography?Journal of personalized medicine · 2022Review
- Associations between fetal heart rate variability and umbilical cord occlusions-induced neural injury: An experimental study in a fetal sheep model.Acta obstetricia et gynecologica Scandinavica · 2022Article
- Heart rate markers for prediction of fetal acidosis in an experimental study on fetal sheep.Scientific reports · 2022Article
- Making the Argument for Intact Cord Resuscitation: A Case Report and Discussion.Children (Basel, Switzerland) · 2022Review
- Editorial: Fetal-maternal monitoring in the age of artificial intelligence and computer-aided decision support: A multidisciplinary perspective.Frontiers in pediatrics · 2022Article
- Fetal growth restriction and stillbirth: Biomarkers for identifying at risk fetuses.Frontiers in physiology · 2022Review
- Approaches to Preventing Intrapartum Fetal Injury.Frontiers in pediatrics · 2022Review
- Machine Learning Algorithm to Predict Acidemia Using Electronic Fetal Monitoring Recording Parameters.Entropy (Basel, Switzerland) · 2021Article
- Intrapartal cardiotocographic patterns and hypoxia-related perinatal outcomes in pregnancies complicated by gestational diabetes mellitus.Acta diabetologica · 2021Article
- Temporal Evolution of Intrapartum Fetal Heart Rate Features.Computing in cardiology · 2021Article
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Authors and funding
8 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A distinctive pattern of recurrent rapid falls in fetal heart rate, called decelerations, are commonly associated with uterine contractions during labour. These brief decelerations are mediated by vagal activation. The reflex triggering this vagal response has been variably attributed to a mechanoreceptor response to fetal head compression, to baroreflex activation following increased blood pressure during umbilical cord compression, and/or a Bezold-Jarisch reflex response to reduced venous return from the placenta. Although these complex explanations are still widespread today, there is no consistent evidence that they are common during labour. Instead, the only mechanism that has been systematically investigated, proven to be reliably active during labour and, crucially, capable of producing rapid decelerations is the peripheral chemoreflex. The peripheral chemoreflex is triggered by transient periods of asphyxia that are a normal phenomenon associated with all uterine contractions. This should not cause concern as the healthy fetus has a remarkable ability to adapt to these repeated but short periods of asphyxia. This means that the healthy fetus is typically not at risk of hypotension and injury during uncomplicated labour even during repeated brief decelerations. The physiologically incorrect theories surrounding decelerations that ignore the natural occurrence of repeated asphyxia probably gained widespread support to help explain why many babies are born healthy despite repeated decelerations during labour. We propose that a unified and physiological understanding of intrapartum decelerations that accepts the true nature of labour is critical to improve interpretation of intrapartum fetal heart rate patterns.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.