The relationship of fetal heart rate (FHR) to neonatal heart rate (NHR) was examined in 81 uncomplicated term (>37 weeks) deliveries. Average baseline FHR during the 30 minutes before delivery was compared with baseline NHR obtained on the same infants at 5 and 10 minutes, 1, 12, and 24 hours after delivery. Fetal status and gestational age were determined by Apgar score and Dubowitz examination. Five minutes following delivery, a 30 percent increase in NHR over FHR baseline was noted in 75 neonates (93%). The NHR returned to FHR within 12 to 24 hours. There were no differences in heart rate patterns of neonates, whether delivered vaginally or by cesarean section. Neonates delivered spontaneously or with forceps also had comparable HR patterns.It appears that the events of labor and delivery are not responsible for the increased heart rate observed in the early newborn.NVESTIG~TI~?~15 of the neonatal heart rate (NHR) and its relationship to the fetal heart rate (FHR) have demonstrated that NHR abruptly increases within minutes after birth and rapid~y declines within an hour to its former FHR levels.1-4 Since neonatal monitoring was continued only until the baseline heart rate had stabilized, data on heart rate beyond the first 60 to 90 minutes were not presented. The purpose of our study was to measure changes in baseline heart rate in the healthy term neonate during the first 24 hours following delivery, and to determine if the changes are influenced by the method of delivery.
Materials and Methods
Patient SelectionEighty-one patients at term gestation (>37 weeks) were selected for the study. All patients had an uneventful prenatal course as documented e by the 'obstetrical clinic records. Gestation age° prior to delivery was established by standard obstetrical criteria and connrmed after delivery by the Dubowitz evaluation .5 Sixty-one of 81 patients delivered vaginally (42 normal spontaneous delivery and 19 by elective low outlet forceps). Of the 20 patients who underwent cesarean section, 13 were delivered in this manner for cephalopelvic disproportion, 5 for breech presentation in early labor, and 2 for repeat cesarean section. Vaginal deliveries were accomplished at MOUNT ALLISON UNIV on June 14, 2015 cpj.sagepub.com Downloaded from