The clinical interpretation and significance of electronic fetal heart rate patterns 2 h before delivery: An institutional observational study

Gianpaolo Maso, Caterina Businelli, Monica Piccoli, Marcella Montico, Francesco De Seta, Andrea Sartore, Salvatore Alberico

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the clinical significance of intrapartum fetal heart rate (FHR) monitoring in low-risk pregnancies according to guidelines and specific patterns. Methods: An obstetrician, blinded to neonatal outcome, retrospectively reviewed 198 low-risk cases that underwent continuous electronic fetal monitoring (EFM) during the last 2 h before delivery. The tracings were interpreted as normal, suspicious or pathological, according to specific guidelines of EFM and by grouping the different FHR patterns considering baseline, variability, presence of decelerations and bradycardia. The EFM groups and the different FHR-subgroups were associated with neonatal acid base status at birth, as well as the short-term neonatal composite outcome. Comparisons between groups were performed with Kruskal-Wallis test. Differences among categorical variables were evaluated using Fisher's exact test. Significance was set at p <0.05 level. Results: Significant differences were found for mean pH values in the three EFM groups, with a significant trend from normal [pH 7.25, 95 % confidence interval (CI) 7.28-7.32] to pathological tracings (pH 7.20, 95 % CI 7.17-7.13). Also the rates of adverse composite neonatal outcome were statistically different between the two groups (p <0.005). Among the different FHR patterns, tracings with atypical variable decelerations and severe bradycardia were more frequently associated with adverse neonatal composite outcome (11.1 and 26.7 %, respectively). However, statistically significant differences were only observed between the subgroups with normal tracings and bradycardia. Conclusions: In low-risk pregnancies, there is a significant association between neonatal outcome and EFM classification. However, within abnormal tracings, neonatal outcome might differ according to specific FHR pattern.

Original languageEnglish
Pages (from-to)1153-1159
Number of pages7
JournalArchives of Gynecology and Obstetrics
Volume286
Issue number5
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Electronic fetal monitoring
  • Labor
  • Neonatal outcome

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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