Predictive value of a fetal heart rate acceleration at the time of fetal blood sampling in labour.
It has been suggested that the fetal heart rate response to fetal stimulation in labour is an indication of fetal condition. This study was designed to evaluate scalp stimulation at the time of fetal blood sampling. All labours requiring fetal scalp pH measurement during one year at the John Radcliffe Maternity Hospital were reviewed to determine the association between pH result and the fetal heart rate response to the first scalp blood sample. Sixty-nine (50%) cases showed an acceleration and none had a scalp blood pH less than 7.20. Six (8.7%) of the cases which did not show an acceleration of the fetal heart rate had a pH less than 7.20 and this group had a greater incidence of analgesia usage and twice as many caesarean sections (39%). The detection rate for non-acidaemia using a fetal heart rate acceleration at the time of fetal blood sampling was 52 percent but the specificity and positive predictive value were both 100 percent. The false negative rate was 91 percent. Thus, whilst an acceleration was reassuring, the absence of an acceleration at the time of fetal blood sampling was not a good predictor of fetal acidaemia. These results are compared with the data from four other published reports.
Spencer
J A
JA
Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Maternity Hospital, Headington, Oxford, U.K.
D004562:Electrocardiography; D005260:Female; D005323:Fetal Monitoring; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007743:Labor, Obstetric; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies