[FBA and/or CTG: fetal blood analysis and/or cardiotocography]. / Zum Thema: FBA und/oder CTG.

"The Ranking and Value of Intrapartum Cardiotocography--A Contribution to the Efficiency of the Method", and "Overrating of Cardiotocography and Negative Clinical Effects", two round-table discussions on specialist congresses during 1982/1983, prompted a controversial discussion on the subject: Intensive Care during Pregnancy and Delivery via FBA (foetal blood analysis) and/or CTG (cardiotocography)? In two recently published papers originating from the working team of Professor Saling, Hammacher's score was used as measure for assessing the value of cardiotocography. Hence, the author has been both prompted and challenged to this editorial not only as the inaugurator, but also as "interpretative acrobat" of cardiotocography. In his opinion, the overrated use of FBA represents an additional risk to the foetus due to possible compressions of the umbilical cord--placenta circulation because of the artificial rupture of the membranes which is often necessary when performing FBA. He pleads for preserving the "padding" provided by the amniotic fluid, by employing external cardiotocography--monitoring via the reliable beat-to-beat autocorrelation technique--while retaining the amniotic sack.

Significance of oscillation frequency in intrapartum fetal monitoring.

Until now, no statistical data have been available on the significance of the frequency of FHR oscillations. In order to evaluate the relation between oscillation frequency and neonatal outcome, the last 30 minutes of 812 FHR records were analyzed with respect to the number of 812 FHR records were analyzed with respect to the number of oscillations per minute only. Close correlations were found between slow oscillations below 2 per minute and the arterial cord pH as well as the Apgar scores after 1 and 5 minutes, respectively. No relation could be established between any oscillation frequency above 2 per minute and the measures of the neonatal outcome. In discussing the results, slow oscillations are suggested to be identical with the sinusoidal FHR. Emphasis is made that for an appropriate pattern recognition, true beat-to-beat recording is required, avoiding any averaging procedure.

[The significance of gestational age in evaluating the antepartal cardiotokogram (author's transl)]. / Die Bedeutung des Gestationsalters für eine prognostische Beurteilung des antepartalen Kardiotokogramms

The influence of gestational age on the probable meaning of features in the antepartal CTG which are not clearly pathological was investigated in 232 births in 1973/74. The umbilical artery pH was significantly lower among premature infants exhibiting abnormal, than among those exhibiting normal CTG patterns. No similar difference was found in term or overdue births. The clinical diagnosis of neonatal condition using the Apgar scheme confirmed biochemical findings: The frequency of depressed babies is in turn clearly higher in cases with abnormal antepartal CTG patterns. It is assumed that the reason for this is the higher sensitivity of premature babies to haemodynamic disturbances. Thus, it follows that premature babies exhibiting antepartal patterns which are not completely normal require close observation.