Abstract
The introduction of intrapartum fetal monitoring has failed to achieve one of its major goals - to reduce perinatal morbidity and mortality secondary to intrapartum hypoxic events. Despite this, it remains at common place in labour wards around the world. Although there is now a much greater understanding of fetal physiology and the fetus’ normal adaptation in labour, there continues to be around 500 intrapartum stillbirths in the UK each year, many with avoidable factors that are related to cardiotocograph (CTG) misinterpretation. This review article aims to consider the mechanisms for the control of the fetal heart rate as well as features of a normal CTG. It also discusses the physiology behind abnormal fetal heart rate patterns in labour and by explaining these changes in terms of physiological mechanisms, it is hoped that readers will better understand how the fetus adapts in labour and hence guide appropriately timed intervention rather than intervention based purely upon pattern recognition.
Keywords: Birth asphyxia, cardiotocograph, decelerations, fetal monitoring, hypoxia, labour, physiology.
Call for Papers in Thematic Issues
RARE CASES IN GYNECOLOGY-OBSTETRICS
With the development of diagnostic and therapeutic techniques (such as ART techniques) and the immersion of new pathologies (such as COVID19), we are witnessing an increase in the incidence of pathologies that were previously described as rare or exceptional. the practitioner sometimes confronts difficult situations in these cases in diagnostic ...read more
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