Factors influencing fetal heart rate measurement during labor.
Fetal heart rate (FHR) was measured with the ultrasonic Doppler technique in 493 deliveries to evaluate factors that may influence the reproducibility of this technique. In a group of 158 women delivering vaginally, the heart rate was measured with the ultrasound at different times of labor. The aim of this study was to evaluate factors influencing the reproducibility of FHR measurement. During the first stage of labor, no significant difference in the mean (+/- SD) heart rate was found between the anterior and the posterior part of the uterus in women delivering vaginally. During the second stage of labor, the mean heart rate of the uterine fundus was 3.6 +/- 8.5% higher than that of the lower uterine segment, whereas no difference in mean heart rate could be found between the anterior and posterior part of the uterus. The heart rate of the lower uterine segment was significantly higher than that of the fundus in the second stage of labor. The heart rate decreased significantly when the uterine segment was in the flexed position. The interobserver variability of the method was 0.33 beats/min. A high interobserver variability was found during the second stage of labor. It is concluded that reproducible FHR measurements can be obtained with the ultrasonic Doppler technique in the anterior and posterior parts of the uterus during the first stage of labor and in the fundus during the second stage of labor. The heart rate was significantly lower when the uterine segment was in the flexed position.About me
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