PREGNANCY-BIRTH Messages for June, 1999: Re: AMA guidelines for determining fetal distress

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Re: AMA guidelines for determining fetal distress

From: Dr. (anonymous@obgyn.net)
Tue, 22 Jun 1999 10:05:54 -0500 (CDT)

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In reply to: juiwanna: "Re: AMA guidelines for determining fetal distress"

In the UK the definition of "fetal distress" is made on the basis of a sample of blood taken from the scalp of the baby, prior to delivery, when indicated by the fetal heart trace. A fetal pH less than 7.2 with increased base excess on the sample is an indication for delivery by the easiest and quickest mode (which may be vaginally with forceps or ventouse).

All the large studies have shown that fetal heart trace alone is a very poor predictor of fetal outcome and simply leads to unnecessary caesarean sections. The "worst" fetal heart trace has only a 50% chance of detecting fetal acidaemia.

In the real world of the delivery suite the decision is best made by the doctor looking after the case in "real time". Unfortunately in retrospect our vision is always better!

--
Ross Welch
Consultant in Fetomaternal medicine
Duchess of Westminster Wing
Arrowe Park Hospital
Upton, Wirral.
UK

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