# Fetal Electrophysiologic Abnormalities in High-risk Pregnancies Associated with Fetal Demise

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $611,690

## Abstract

PROJECT SUMMARY
Fetal demise occurs in over 25,000 pregnancies annually in the US and over 2.5 million in pregnancies world-
wide. Certain maternal-fetal-placental abnormalities can have a high risk of fetal demise. Despite advances in
fetal surveillance with ultrasound and cardiotocography, the reduction in fetal mortality lags behind that of the
neonate and has shown little decline in the past decade. This suggests that the type of fetal monitoring used
may not be assessing the correct indicators of mortality. In all other age groups, electrocardiographic (ECG)
and continuous heart rate (HR) monitoring are used in every intensive care unit or emergency setting;
however, for the fetus, the ECG signal is nearly completely insulated and inaccessible. As the result, indirect
assessment of cardiac rhythm is obtained using echocardio-graphy/Doppler, but echo/Doppler does not have
the precision to assess beat-to-beat HR variability and cannot assess cardiac repolarization at all. In this study,
we will evaluate five high risk conditions (major congenital heart disease in the fetus, fetal hydrops (immune
and non-immune), monochorionic twin pregnancy, prior pregnancy ending in fetal demise, and gastroschisis)
using Fetal Magnetocardiography (fMCG)which detects the natural magnetic signals accompanying the cardiac
electrical signal. It is a new, safe, and non-invasive recording technique that has been performed for several
decades, and has recently gained FDA approval for recording cardiac signals at all ages, including in the fetus.
Normative data has been obtained at the University of Wisconsin - Madison Biomagnetism Laboratory in 257
healthy fetuses by co-investigator Ronald T. Wakai, PhD. Over 550 serious fetal arrhythmias have been
evaluated to date. Fetal MCG has proven invaluable in fetal Long QT Syndrome in identifying markers for risk
of sudden death such as Torsades de Pointes Ventricular Tachycardia (VT), T wave alternans, 2nd degree AV
block, and QTc>590 ms. To date, fMCG has not been systematically applied to diseases that are not
associated with recognizable arrhythmias because the impact of silent conduction and repolarization defects
has been underappreciated. In this grant, we hypothesize that beat-to-beat fetal heart rate variability
abnormalities and electrophysiologic abnormalities, are present in five high risk maternal-fetal-placental
conditions associated with fetal demise. We will determine which electrophysiologic abnormalities precede fetal
demise or adverse pregnancy outcome. Our preliminary findings in healthy normal subjects show
repolarization abnormalities in up to 5%, and some of these are modifiable once recognized. We will study 200
pregnant patients over a 5 year period both at referral (~20-25 weeks GA) and later in pregnancy at 32-37
weeks GA to determine whether specific abnormal rate, rhythm and conduction patterns emerge that
characterize the condition which will allow the high risk obstetrician to better predict r...

## Key facts

- **NIH application ID:** 9906264
- **Project number:** 5R01HL143485-03
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Janette F Strasburger
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $611,690
- **Award type:** 5
- **Project period:** 2018-07-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9906264

## Citation

> US National Institutes of Health, RePORTER application 9906264, Fetal Electrophysiologic Abnormalities in High-risk Pregnancies Associated with Fetal Demise (5R01HL143485-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9906264. Licensed CC0.

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