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Summary Fetal circulation was studied by means of combined realtime and pulsed Doppler ultrasound in 14 women with pregnancy‐associated hypertension before and during the first and third days of treatment with the β1‐selective blocker, atenolol; in seven of the women the maternal uterine arcuate blood velocity waveform was also studied. Blood flow characteristics were normal both in the fetus and in the maternal arcuate artery, compared with those in uncomplicated pregnancies of corresponding gestational ages. Volume blood flow remained unchanged in the fetal descending aorta, and in the umbilical vein during atenolol treatment, whereas the pulsatility index increased in the fetal descending aorta and in the arcuate artery. This suggests that the peripheral vascular resistance, both on the maternal and fetal side of the placenta, increased during short‐term antihypertensive treament with atenolol.

Ninety-nine consecutive diabetic pregnancies (101 infants) were monitored with altogether 2672 nonstress tests (NSTs) from about 30 weeks of gestation until parturition. In 96% of the women the last NST was performed within 2 days of delivery. Fifty-nine percent had normal NSTs throughout pregnancy. Only 3.7% of the 2 672 tests were classified as pathological. When performed within 2 days antepartum, a normal NST predicted the 1-min Apgar score to be greater than or equal to 7 in 92%, and at 5 and 10 min in 99%. When all NSTs ever performed were included, the predictive value improved to 100%. The baby's first cry within 1 min after birth was predicted in 96%. Furthermore, the predictive value of a normal NST regarding the absence of ominous intrapartum cardiotocographic (CTG) patterns, normal pulmonary function and normal metabolic balance, was about 80%. The perinatal mortality was 1%. The specificity was in general good (86-96%), whereas the predictive value of pathological tests and the sensitivity almost without exception were poor. It is concluded that the very low rate of pathological NSTs indicates that obstetric interventions were made soon after the occurrence of the first sign of fetal jeopardy. Only then, and with meticulous care, is it possible to obtain good results. A normal NST is an excellent predictor of a normal Apgar score at 5 and 10 min, and also very good for a normal 1-min Apgar and an early cry from the baby. The predictive value is quite acceptable concerning the intrapartum CTG and the neonatal course likewise regarding the pulmonary function and metabolic balance.(ABSTRACT TRUNCATED AT 250 WORDS)

Phonocardiography, abdominal electrocardiography and ultrasound cardiography are the three methods for external fetal cardiography. In the present study the methods have been compared regarding the quality of the graphs. The patients (163) were between the 34th and the 40th week of gestation. Graphs with less than 15 per cent failure or artifacts were found in 23.4 per cent for phonocardiography, 55.2 per cent for abdominal electrocardiography and 85.9 per cent for ultrasound cardiography. It could be shown that the number of successful abdominal electrocardiograms was higher with advancing gestational age. The quality of the phonocardiograms was influenced adversely by an anterior placenta. No obvious influence of a thick abdominal wall on external cardiography could be demonstrated.