ROLE OF ANTEPARTUM COMPUTERIZED FETAL HEART-RATE ANALYSIS IN THE PREDICTION OF FETAL DISTRESS DURING LABOR

Objective: To ascertain the diagnostic ability of a computerized fetal heart rate (FHR) analysis system in the identification of patients at risk of fetal distress in labor. Study design: Five-hundred and seven ty-seven healthy term pregnancies were enrolled in a prospective, cros s-sectional study and subdivided into two groups, with (n = 90) or wit hout (n = 487) fetal distress in labor. Computerized FHR recordings we re performed periodically and regression analysis was performed in a u nivariate and multivariate way to assess the ability of the last FHR r ecording in the prediction of subsequent fetal distress. Results: The two groups showed a significant difference in almost all of the FHR pa rameters studied. The multivariate analysis showed that only the FHR b aseline and the percentage of small accelerations were independently a nd significantly related to the labor outcome. The combination of thes e two parameters reaches a sensitivity of 45%, specificity of 91%, pos itive predictive value of 48% and negative predictive value of 90%, wi th an overall accuracy of 84%. Conclusions: The increase in FHR baseli ne and in small FHR accelerations can be major factors in the predicti on of subsequent fetal distress in healthy term fetuses. (C) 1997 Else vier Science Ireland Ltd.