Immediate newborn outcome and mode of delivery: Use of standardized fetal heart rate pattern management

Abstract

Objective: To determine whether a rule-based system for fetal heart rate interpretation can result in reduced metabolic acidemia without increasing obstetrical intervention. Methods: Rates of vacuum-assisted delivery and Cesarean sections, and umbilical artery pH and base excess values were determined over a 5-year period in a single hospital with 3907 deliveries in Japan. Results were compared for 2 years before and 2 years after a 6-month training period in rule-based fetal heart rate interpretation. Results: The pre- and post-training rates of unscheduled Cesarean deliveries (4.8% vs. 6.0%) and vacuum deliveries (21.2% vs. 18.1%) did not differ significantly. The rates of umbilical arterial pH <7.15 (1.51% vs. 0.18%, p < 0.05) and base excess <–12 mEq/L (1.76% vs. 0.25%, p < 0.05) were significantly lower after training. Conclusion: A standardized fetal heart rate pattern management system was associated with a 7-fold reduction of newborn metabolic acidemia with no change in operative intervention.

Keywords::

• Cesarean delivery
• fetal pH
• fetal base excess
• vacuum extraction delivery
• metabolic acidemia

Acknowledgements

We thank all the nurses of Noda clinic for their earnest dedication for each delivery.

Declaration of Interest: Funding was provided by institutional sources only. The authors report no declarations of interest.