Mathematical Modelling of Fetal Cardiovascular and Metabolic Response to Acidemia During Labour
Acidemia (blood pH < 7.00) resulting from umbilical cord occlusions caused by uterine contractions poses one of the most significant risks to fetal well-being during labour. Acidosis is associated with long lasting neurological deficits such as cerebral palsy, and even death in some cases. Presently, there exists no accurate way of detecting and diagnosing acidemia with existing clinical monitoring technology, due to a lack of knowledge about which features of available data best represent acidosis. In recent work, we develop a dynamical systems model of fetal cardiovascular and metabolic response to umbilical cord occlusions in fetal sheep experiments simulating human labour. By modelling the effects of occlusions on the autonomic nervous system and fetal metabolism, our model is able to match salient features of fetal heart rate and metabolite recording from experiments. We also present sensitivity analysis of model parameters to identify the most important features related to acidosis, and use the model to investigate different features of the fetal heart rate that may be used for clinical monitoring. Finally, we present some model simplifications, and their effect on the model accuracy.