DOES A NONREACTIVE FETAL HEART-RATE PATTERN REALLY MEAN FETAL DISTRESS

The aim of the study was to compare three different fetal heart rate ( FHR) patterns, namely, a nonreactive pattern with good long-term varia bility (fluctuation of 5 or more beats/min), a reactive pattern, and a nonreactive pattern with poor long-term variability (less than 5 beat s/min). For this purpose, nonstress tests done less than 24 hours befo re delivery and FHR patterns recorded during labor were separately ass essed. Endpoints for comparison were 5-minute Apgar scores, intrauteri ne growth retardation, and umbilical blood gas values at birth. Regard ing the nonstress test, the prevalence of low 5-minute Apgar scores in reactive, good variability, and in poor variability patterns were 7.2 %, 5.3%, and 24%, respectively. The prevalences of small for gestation al age newborns were 8%, 17.6%, and 60.6%, respectively. Blood gas val ues did not differ significantly. Regarding the FHR patterns during la bor, using the same sequence, the prevalences of low 5-minute Apgar sc ores were 3.5%, 6%, and 23%, respectively. Small for gestational age b abies occurred in 8.8%, 15.6%, and 80% of the different FHR patterns, respectively. Regarding umbilical artery blood gas values, the only si gnificant difference was a lower pH in the poor variability group. No difference was found between the blood gas values of babies with a rea ctive pattern and a nonreactive pattern with good variability.