Prevention of Cerebral Palsy and Fetal Demise with Hypoxia Index, FHR Score and Pathologic Sinusoidal FHR in Fetal Monitoring

Kazuo Maeda

doi:10.52916/jogs204009

Abstract

Although fetal deaths was decreased by intrapartum Fetal Heart Rate (FHR) monitoring, infantile cerebral palsy was not decreased in Dublin trials of Electric Fetal Monitor (EFM), thus, an analysis to reduce cerebral palsy was studied, where cerebral palsy is prevented by setting the threshold of hypoxia index at 24 or less, in the analysis of FHR deceleration.

Highlights

Electronic Fetal Monitors (EFM) were internal method using fetal scalp ECG electrode and intrauterine pressure tracing, where Fetal Heart Rate (FHR) monitoring started limitedly after the rupture of the membrane, external monitor with fetal heart sound was used by Hammacher and Maeda, and mainly by ultrasonic Doppler autocorrelation fetal heart rate meter is distributed in the world and the uterine contraction by tocodynamometer
Hypoxic FHR decelerations classified into early, late, and variable decelerations with visual observations, where late deceleration of regular FHR change was ominous [1], while the loss of baseline variability was ominousin Hon and Hammaher’s FHR diagnosis [1,2], while it was not reported to be inevitable fetal brain damage followed by cerebral palsy [3]
The separation of pathologic and physiologic sinusoidal FHR was unable by CTG, while it was possible by actocadiogram [4] with the regular fetal movements

Summary

Introduction

Electronic Fetal Monitors (EFM) were internal method using fetal scalp ECG electrode and intrauterine pressure tracing, where Fetal Heart Rate (FHR) monitoring started limitedly after the rupture of the membrane, external monitor with fetal heart sound was used by Hammacher and Maeda, and mainly by ultrasonic Doppler autocorrelation fetal heart rate meter is distributed in the world and the uterine contraction by tocodynamometer. hypoxic FHR decelerations (transient bradycardia) classified into early, late, and variable decelerations with visual observations, where late deceleration of regular FHR change was ominous [1], while the loss of baseline variability was ominousin Hon and Hammaher’s FHR diagnosis [1,2], while it was not reported to be inevitable fetal brain damage followed by cerebral palsy [3]. Electronic Fetal Monitors (EFM) were internal method using fetal scalp ECG electrode and intrauterine pressure tracing, where Fetal Heart Rate (FHR) monitoring started limitedly after the rupture of the membrane, external monitor with fetal heart sound was used by Hammacher and Maeda, and mainly by ultrasonic Doppler autocorrelation fetal heart rate meter is distributed in the world and the uterine contraction by tocodynamometer. The separation of pathologic and physiologic sinusoidal FHR was unable by CTG, while it was possible by actocadiogram [4] with the regular fetal movements. The FHR pattern classification was vague in fetal outcome prediction on several occasions, e.g. a variable deceleration was “variable and early deceleration” by Dr Hon. numeric objective analysis is required in the intrapartum fetal monitoring, including the artificial neural network analysis [5] or FHR score [6] in the update trend to introduce quantitative FHR analysis

Methods

Results

Conclusion