Document Detail

Electronic fetal heart rate monitoring: early neonatal outcomes associated with normal rate, fetal stress, and fetal distress.
MedLine Citation:
PMID:  10649181     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to test the ability of a clearly defined classification system for electronic fetal heart rate monitoring to predict early neonatal outcome. STUDY DESIGN: All labors of women with singleton pregnancies > or = 32 weeks' gestation electronically monitored at 2 institutions were examined. Tracings in the final hour before delivery were defined as normal, fetal stress, or fetal distress. After delivery, Apgar scores, cord blood gas values, and admission to the neonatal intensive care unit were examined as measures of early neonatal outcome. RESULTS: Among the 898 patients who qualified for study, 627 (70%) had tracings classified as normal, 263 (29%) had tracings classified as fetal stress, and 8 (1%) had tracings classified as fetal distress. There was a significant worsening of neonatal outcome across these 3 groups with regard to depressed Apgar scores 1 minute (5.1%, 18.3%, and 75.0%; P <.05), depressed Apgar scores at 5 minutes (1.0%, 3.8%, and 37.5%; P <.05), and admission to the neonatal intensive care unit (5.6%, 10.6%, and 37.5%; P <.05). There was also a progressive worsening of cord blood pH (7.27 +/- 0.06, 7.21 +/- 0.08, and 7.06 +/- 0.14; P <.05), a progressive increase in PCO (2) (53.39 +/- 8.34 mm Hg, 58.51 +/- 10.55 mm Hg, and 78.31 +/- 20.35 mm Hg; P <.05), and a progressive decline in base excess (-3.18 +/- 2.02 mEq/L, -5. 11 +/- 3.11 mEq/L, and -9.07 +/- 4.59 mEq/L; P <.05). CONCLUSION: This simple classification system for interpreting fetal heart rate tracings accurately predicts normal outcomes for fetuses as well discriminating fetuses in true distress. Further, it identifies an intermediate group of fetuses with a condition labeled fetal stress who might benefit from additional evaluation and possibly from expeditious delivery.
E H Dellinger; F H Boehm; M M Crane
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  182     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-17     Completed Date:  2000-02-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  214-20     Citation Subset:  AIM; IM    
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Greenville Hospital System, SC, USA.
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MeSH Terms
Apgar Score
Carbon Dioxide / blood
Cesarean Section
Fetal Blood / chemistry
Fetal Diseases / diagnosis*
Fetal Distress / diagnosis*
Fetal Monitoring*
Gestational Age
Heart Rate, Fetal*
Hydrogen-Ion Concentration
Intensive Care, Neonatal
Labor, Obstetric*
Stress, Physiological / diagnosis*
Reg. No./Substance:
124-38-9/Carbon Dioxide

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