Intrapartum fetal heart rate patterns: correlation with apgar score and umbilical cord blood pH and gases in preterm labour

ABSTRACT

A prospective study of 106 preterm pregnancies [28-36 weeks gestational age] were admitted in active labor to the Labor Ward of Northern Area Armed Forces Hospital, KSA, during 15-month period starting March 1992. Continuos intrapartum fetal heart rate [FHR] records were analyzed and statistically compared to neonatal outcome as reflected by Apgar scores and umbilical cord blood pH and gases. Abnormal intrapartum fetal heart patterns were reported in 42 cases and correlated well with low 5-minutes Apgar scores and neonatal blood acidosis [cord blood pH < 7.25]. In this group, neonatal resuscitation and endotracheal intubations were significantly higher compared to cases with normal FHR patterns. Moreover, the cesarean section rate was significnatly higher compared to cases with normal FHR patterns. In the abnormal FHR group, there was no significant difference in the cord blood pH values between cases of vaginal and abdominal deliveries. Normal FHR patterns were associated with a good outcome as regard neonatal acidosis and Apgar scores. In conclusion, a normal intrapartum FHR patterns predicts a good fetal tolerance to the stress of preterm labor. With abnormal FHR patterns, neonatal asphyxia and low Apgar scores would be expected and prompt obstetric intervention is required including all measures necessary for neonatal resuscitation