The significance of fetal heart rate reactivity with a positive oxytocin challenge test.

This study reviews 27 patients with positive OCTs who were subsequently allowed a trial of directly monitored labor. Of these, 19 patients (70%) developed FHR signs of fetal distress and 8 (30%) tolerated labor without late decelerations. These patients were evaluated for signs of fetal reactivity (acceleration of the FHR associated with fetal movement of contractions) during the OCT. Those with a reactive pattern during the OCT (15 patients) uniformly had a good fetal outcome (unless there was birth trauma or premature delivery), but 8 of these 15 patients showed fetal distress during monitored labor. If the positive OCT was associated with a nonreactive baseline FHR recording, a trial of labor uniformly resulted in FHR signs of fetal distress. It is therefore concluded that a patient with a nonreactive positive OCT is unlikely to tolerate subsequent labor without fetal distress.