Clinical application of a scoring system for evaluation of antepartum fetal heart rate monitoring

Diminution des mouvements actifs du fœtus au troisième trimestre : que faire ?

“…L'hospitalisation rend plus commode cette surveillance. Le test à l'ocytocine n'a pas démontré une supériorité pour évaluer le bien-être foetal par rapport à l'ERCF passif (nonstress test) [34]. L'analyse informatisée de l'ERCF (système Oxford) avec notamment la mesure de la variabilité à court terme des oscillations pourrait répondre aux insuffisances de l'enregistrement visuel [32].…”

“…(14-47 ans). Le terme moyen de l'accouchement était de 39 semaines d'aménor-rhée (SA) (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Une patiente sur deux était une primipare.…”

The significance of a single fetal heart rate acceleration in antenatal cardiotocography

“…Initially, antenatal cardiotocograms were evaluated by a scoring system taking into account several parameters, but it soon became apparent that the most critical of these factors were fetal heart acceleration in response to fetal movementfetal reactivity (Rochard et al, 1976;Krebs and Petres, 1978;Keirse and Trimbos, 1980). While the definition of reactivity varies in the literature, the most commonly accepted is two fetal movement associated accelerations of at least 15 beats per minute in a 20 minute period of recording.…”

Fetal Heart Rate Monitoring: Interpretation and Collaborative Management

“…In extreme cases, this was linked to the subsequent development of neonatal damage and cerebral palsy. Given this apparent cause‐effect relationship between events known to contribute to fetal hypoxia and acidemia and the incidence of decelerations in the FHR, clinicians perceived many commonly occurring FHR decelerations as “ominous.” However, two aspects of FHR physiology not consistently acknowledged and factored into early clinical practice were the importance of FHR variability and pattern evolution over time (7, 12, 22–31).…”

“…Studies examining the relationship between FHR patterns, acidemia, and neonatal morbidity have shown the presence of FHR decelerations, as an independent variable, to be poorly predictive of significant fetal acidemia, except in cases of extreme and persistent severe fetal bradycardia (sustained FHR of less than 60 bpm for 10 minutes) (15,23,25,26, 30–36). Rather, the preponderance of evidence supports the premise that the degree of baseline FHR variability that accompanies the decelerations is the most sensitive predictor of neonatal outcome (6,22,23, 25–30).…”