Quality of Survival of Infants with Critical Fetal Reserve Detected by Antenatal Cardiotocography

Abstract

During the 8-year period 1973 to 1980, antenatal cardiotocographic monitoring was performed on 3,006 high-risk pregnancies selected from a total obstetric population of 37,856 patients. A critical fetal reserve was detected in 72 patients (2.3%) whose pregnancies resulted in 20 perinatal deaths and 52 infants who survived the neonatal period; 45 of these infants have been assessed at ages ranging from 2 months to 8 years, 9 months. Growth was below the tenth percentile in 25.0% for weight, 23.3% for length, and 22.5% for head circumference at the review examination. Neurological abnormalities were detected in 12 infants but the abnormality was major in only four, including one who has familial interstitial polyneuropathy. The quality of survival of infants delivered of pregnancies complicated by critical fetal reserve is satisfactory; 93.2% had no neurological impairment likely to interfere with quality of life and indeed 13.5% had superior intelligence. Cardiotocographic evidence of critical fetal reserve does not signify that the fetus is doomed; delivery by cesarean section is indicated if the fetus is viable and has no ultrasonic evidence of untreatable major malformation.