title: Immediate newborn outcome and mode of delivery: use of standardized fetal heart rate pattern management.
abstract: OBJECTIVE
  To determine whether a rule-based system for fetal heart rate interpretation can result in reduced metabolic acidemia without increasing obstetrical intervention.
  
  
  METHODS
  Rates of vacuum-assisted delivery and Cesarean sections, and umbilical artery pH and base excess values were determined over a 5-year period in a single hospital with 3907 deliveries in Japan. Results were compared for 2 years before and 2 years after a 6-month training period in rule-based fetal heart rate interpretation.
  
  
  RESULTS
  The pre- and post-training rates of unscheduled Cesarean deliveries (4.8% vs. 6.0%) and vacuum deliveries (21.2% vs. 18.1%) did not differ significantly. The rates of umbilical arterial pH <7.15 (1.51% vs. 0.18%, p < 0.05) and base excess <-12 mEq/L (1.76% vs. 0.25%, p < 0.05) were significantly lower after training.
  
  
  CONCLUSIONS
  A standardized fetal heart rate pattern management system was associated with a 7-fold reduction of newborn metabolic acidemia with no change in operative intervention.
authors.affiliation: Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Osaka, Japan. skatsura12@yahoo.co.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.forename: Shunichi
authors.initials: S
authors.lastname: Noda
authors.forename: Junji
authors.initials: J
authors.lastname: Onishi
authors.forename: Tsuyomu
authors.initials: T
authors.lastname: Ikenoue
authors.forename: Julian T
authors.initials: JT
authors.lastname: Parer
mesh_terms: D000138:Acidosis / Q000517:prevention & control*; D015148:Cardiotocography / Q000592:standards*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004493:Education; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*