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Intrapartum Fetal Acidosis in Preterm Infants

Fetal Monitoring and Long-Term Morbidity

Department of Obstetrics and Gynecology and the Neonatal Intensive Care Unit, University Hospital of Lund, Sweden.

Fetal heart rate (FHR) and fetal acid–base status were studied prospectively in 61 patients in pretem labor of unknown etiology. Neonatal data were analyzed, and all surviving infants participated in a follow-up study for at least two years. Ominous FHR patterns correlated well with fetal acidosis. Infants with fetal acidosis (pH less than 7.25 in scalp blood) had more neurologic abnormalities in the neonatal period and a higher rate of neurodevelopmental disabilities at the follow-up than nonacidotic infante of the same gestational weeks. In the surveillance of patients in pretem labor electronic fetal monitoring is mandatory. At late or pronounced variable decelerations, pH analysis of fetal scalp blood should be performed immediately. If not available, prompt abdominal delivery is recommended.