Can fetal electrocardiography improve the prediction of intrapartum fetal acidosis?

An outline is given of a computer-based system which continuously enhances and measures the waveform of the intrapartum fetal electrocardiogram. This system has been used to examine the behaviour of the ST segment and T wave in a group of 14 fetuses where the outcome was biochemically and clinically normal, and in a group of 10 fetuses which were acidotic at birth. When the mean values in each group were compared, highly significant differences were found for both of these components of the waveform. These differences have also been demonstrated by the analysis of long-term trends in the behaviour of these variables. The highly significant correlation between both a long-term increase in ST segment and T wave height and fetal acidosis, found in this study, reflects earlier work by others in the experimental animal fetus. The findings suggest that continuous monitoring of the waveform of the fetal electrocardiogram in labour may give a much better prediction of fetal acidosis than is currently achieved with the monitoring of heart rate alone.