Intrapartum clinical assessment of fetal distress

Abstract

Continuous fetal heart rate monitoring and fetal scalp blood sampling were used to evaluate 76 fetuses with distress. Fetuses with moderate to severe heart rate patterns and/or meconium had significant acidosis at some point during labor. Fetuses passing light or heavy meconium were significantly acidotic and hypoxic early in labor while those with moderate to severe heart rate patterns became acidotic during the active phase of labor. The passage of meconium has been related to hypoxia which may result from cord compression occurring prior to or during early labor. Those fetuses passing heavy meconium have the greatest morbidity and mortality rates as a result of meconium aspiration. Fetuses with tachycardia do not have biochemical abnormalities during labor; however, they have a high neonatal morbidity. Fetuses with moderate-severe late deceleration heart rate patterns have relative low morbidity and mortality rates even though they are acidotic during labor and demonstrate low one-minute Apgar scores. The assessment of the biochemistry of the fetus by fetal scalp blood sampling has been an aid in predicting the condition of the fetus at birth.