The significance of fetal heart rate reactivity with a positive oxytocin challenge test.
This study reviews 27 patients with positive OCTs who were subsequently allowed a trial of directly monitored labor. Of these, 19 patients (70%) developed FHR signs of fetal distress and 8 (30%) tolerated labor without late decelerations. These patients were evaluated for signs of fetal reactivity (acceleration of the FHR associated with fetal movement of contractions) during the OCT. Those with a reactive pattern during the OCT (15 patients) uniformly had a good fetal outcome (unless there was birth trauma or premature delivery), but 8 of these 15 patients showed fetal distress during monitored labor. If the positive OCT was associated with a nonreactive baseline FHR recording, a trial of labor uniformly resulted in FHR signs of fetal distress. It is therefore concluded that a patient with a nonreactive positive OCT is unlikely to tolerate subsequent labor without fetal distress.
D001034:Apgar Score; D004964:Estriol / Q000378:metabolism; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis / Q000503:physiopathology; D005318:Fetal Heart / Q000502:physiology*; D005323:Fetal Monitoring; D006339:Heart Rate; D006801:Humans; D007743:Labor, Obstetric; D008470:Meconium; D010121:Oxytocin; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies
D010121:Oxytocin; D004964:Estriol