Non-hormonal Methods of Antenatal Monitoring

One aim of obstetric practice is to ensure the wellbeing of the fetus. This is by no means an easy task and recent years have seen the development of a variety of tests, with varying degrees of success, to evaluate fetal health.Fetal wellbeing may be assessed at a variety of levels: genetic/cellular, physical/structural or functional. Ideally the evaluation of fetal health should provide information about the functional outcome of any particular condition, especially the performance of the central nervous system. Current tests may not do this. Thus, whilst tests of the fetal chromosomal or genetic constitution may determine the presence of particular genetic/chromosomal conditions, they may not predict functional outcome especially the functioning of the cerebral cortices, the ultimate arbiter of excellence in man. For example, Down's syndrome may be accurately diagnosed by analysis of fetal cells to detect the presence of Trisomy 21 but this in itself provides little information on the subsequent functional performance of the individual. The development of tests of fetal heart function such as antenatal cardiotocography have provided a means of assessing cardiac function and, to a certain extent, the functioning of parts of the autonomic nervous system. However such tests can only indirectly assess cortical function.

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The Relevance of Antenatal and Intrapartum Fetal Heart Rate Patterns to Fetal Outcome

Liu

Blackwell

Tukel

1978

BJOG

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Summary Antenatal fetal heart rate (FHR) as an indicator of fetal status was evaluated in two separate studies. The first attempted to determine, in 30 minutes of continuous recording from each of 50 antenatal patients, relationships between spontaneous FHR changes and fetal condition before and after birth. No significant association was found between observed FHR patterns and antenatal or neonatal fetal status. The second study used induction of labour as a stress test, because similar conditions to that required for oxytocin stress testing were present and there was the advantage of direct FHR recording. In 150 induced and monitored labours, FHR changes associated with the first six suitable contractions seldom related to Apgar scores at birth or development of fetal distress in active labour. Fetuses showing no response to contractions tended to have better Apgar scores than those which showed FHR decelerations. Results from these studies do not substantiate reports that FHR changes arising spontaneously, or in response to induced contractions, reflect satisfactorily the existing or subsequent fetal status.

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Non-hormonal Methods of Antenatal Monitoring

Cited by 6 publications

References 51 publications

A prospective study of three biochemical fetoplacental tests: Serum human placental lactogen, pregnancy-specific β1-glycoprotein, and urinary estrogens, and their relationship to placental insufficiency

A prospective study of three biochemical fetoplacental tests: Serum human placental lactogen, pregnancy-specific β1-glycoprotein, and urinary estrogens, and their relationship to placental insufficiency

Fetal Habituation

The Relevance of Antenatal and Intrapartum Fetal Heart Rate Patterns to Fetal Outcome

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