Evidence mapPaperPMID 41393128Full record

ArticleFrontiers in medicine2025

Fetal heart and surroundings: umbilical cord traction triggers sympathetic heart rate surge in fetal lambs in the artificial womb.

Maria Antonietta Castaldi, Salvatore Giovanni Castaldi, Maria Silena Mosquera, Grace Hwang, Marina Heffelfinger, Aaron Weilerstein, Marcus G Davey, Alan W Flake

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Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Maria Antonietta CastaldiCenter for Fetal Research, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA, United States.
Salvatore Giovanni CastaldiDepartment of Medicine and Surgery, University of Salerno, Fisciano, Italy.
Maria Silena MosqueraCenter for Fetal Research, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA, United States.
Grace HwangCenter for Fetal Research, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA, United States.
Marina HeffelfingerCenter for Fetal Research, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA, United States.
Aaron WeilersteinCenter for Fetal Research, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA, United States.
Marcus G DaveyVitara Biomedical Inc., Philadelphia, PA, United States.
Alan W FlakeCenter for Fetal Research, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To investigate whether umbilical cord traction triggers a unique umbilico-neuro-cardio reflex via sympathetic autonomic nervous system (ANS) activation, potentially explaining fetal heart rate (FHR) increases such as the double mountain peak sign and unexplained tachycardia outside labor. Design: Experimental physiological study using the EXTrauterine Environment for Neonatal Development (EXTEND) system. Setting: Controlled laboratory environment at The Children's Hospital of Philadelphia with fetal lambs supported by the EXTEND system. Population or sample: Twenty-nine experiments were performed on three fetal lambs: 5 ANS-immature (<110 days gestational age) and 24 ANS-mature (>110 days GA), including subgroups for pharmacological intervention. Methods: Umbilical cord traction was performed in 20 experiments (5 ANS-immature, 15 ANS-mature). To investigate autonomic modulation, nine ANS-mature experiments included administration of either periumbilical capsaicin or intravenous propranolol. FHR changes were measured, and norepinephrine levels were sampled before and after interventions. Main outcome measures: Change in FHR (bpm) and circulating norepinephrine concentrations in response to umbilical cord traction and pharmacologic modulation. Results: Cord traction significantly increased FHR in ANS-mature lambs (mean +42 bpm, Conclusion: Umbilical cord traction appears to activate an umbilico-neuro-cardiac reflex through sympathetic ANS pathways in ANS-mature fetuses. This mechanism may underlie clinical CTG features such as the double mountain peak sign and fetal tachycardia outside of labor.

Indexed as

artificial wombcardiotocographyfetal heart ratemechanical activationsheep (ovine)sympathetic nervous systemtachycardia

Identifiers

PMID41393128
PMCPMC12696492

What Socratic holds

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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.