Document Detail

The fetal admission test and intrapartum fetal death.
MedLine Citation:
PMID:  9565228     Owner:  NLM     Status:  MEDLINE    
Our objective was to describe the admission and subsequent intrapartum fetal heart rate (FHR) patterns in 21 singleton term pregnancies with an intrapartum fetal death. Through a retrospective chart review, 21 pregnancies with a term intrapartum fetal death were divided into 2 groups based on the fetal admission test (FAT): Group I-reactive (one or more FHR accelerations of 15 bpm x 15 sec in the first 30 min of monitoring); and Group II-nonreactive (NR [the absence of accelerations]). The FAT was compared with the subsequent intrapartum FHR pattern. Of the 21 deaths, the FAT was reactive in 7 fetuses (33%) or NR in 14 fetuses (67%). While the demographic features of these groups were statistically similar, Group II had higher rates of meconium (12 out of 14 (86%) vs. 2 out of 7 [29%] p = 0.017) and admission FHR decelerations (9 out of 14 (64%) vs. 1 out of 7 [14%] p = 0.06). In Group I, a sudden catastrophic event such as a uterine rupture produced a prolonged FHR deceleration in six fetuses (86%). One (14%) fetus died after a Hon pattern. In Group II, four patients had a stair steps to death pattern. Intrapartum fetal death can occur after a reactive or NR FAT. With a reactive FAT, a catastrophic event appears necessary to cause fetal death. The higher rates of meconium, FHR decelerations, and stair steps to death patterns in the NR group suggest the underlying basis for the fetal demise was related to preadmission fetal compromise.
B D Golditch; M O Ahn; J P Phelan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of perinatology     Volume:  15     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-06-09     Completed Date:  1998-06-09     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  273-6     Citation Subset:  IM    
Kaiser Permanente Medical Center, Department of Obstetrics and Gynecology, Santa Clara, California, USA.
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MeSH Terms
Fetal Death / etiology*
Fetal Monitoring*
Heart Rate, Fetal / physiology*
Obstetric Labor Complications / physiopathology*
Patient Admission / statistics & numerical data*
Retrospective Studies

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