Fetal heart rate monitoring in labour

Abstract

Continuous FHR monitoring in labour is indicated in all cases. Acceleration of labour and epidural analgesia, although essentially beneficial to the fetus, are further potential hazards and increase the need for FHR monitoring. Analysis of FHR patterns, and in particular measurement of dip area, can provide a quantitative assessment of fetal condition by which the obstetrician may base his judgement on the management of labour. Each case should be managed according to the suspected cause of fetal hypoxia and on the stage and progress of labour. The temporal relationship of transient bradycardia to uterine activity cannot be relied upon to indicate the aetiology of the fetal hypoxia. FHR monitors in the future could be equippped with a small computer which would enable a read out of dip area in the preceding 20 min. Nevertheless, it must be stressed that a close approximation to the dip area can be calculated in minutes on the labour ward without sophisticated equipment. This measurement is essentially practical and is of value to obstetricians in the management of labour.