Standardizing management of variant intrapartum FHR tracings was suggested to reduce this variability and to lead to improvement in fetal outcome ( Downs & Zlomke, 2007). One potential reason is the wide variability in clinical decision making associated with its use. A detailed meta-analysis of available studies on the use of intrapartum cardiotocogram showed reduction of perinatal mortality by 50%, but an increase of operative intervention by factor 2.5 ( Vintzileos et al., 1995). However, in several randomized trials it became evident that there is only limited efficacy in improving fetal outcome using CTG antenatally ( Pattison & McCowan, 2004). Recording of fetal heart rate (FHR) via cardiotocography (CTG) monitoring is routinely performed as an important part of antepartum and intrapartum care. However, further studies should confirm that such asymmetric alarm limits are safe, with a particular focus on the lower bound, and should give insights about how to show and further improve the usefulness of the widely used practice of CTG monitoring. Many international guidelines define ranges of 110 to 160 bpm which seem to be safe in daily practice. Normal ranges for FHR are 120 to 160 bpm. FHR decreases slightly during gestation.Ĭonclusions. Validation in all three data sets identified 120 to 160 bpm as the correct symmetric “normal range”. Based on the training data set, the “best” FHR range was 115 or 120 to 160 bpm. After analyzing 40% of the dataset as “training set” from one hospital generating a hypothetical normal baseline range, evaluation of external validity on the other 60% of the data was performed using data from later years in the same hospital and externally using data from the two other hospitals. For each tracing, the baseline FHR was extracted by eliminating accelerations/decelerations and averaging based on the “delayed moving windows” algorithm. We analyzed all recorded cardiotocography tracings of singleton pregnancies in three German medical centers from 2000 to 2007 and identified 78,852 tracings of sufficient quality. We started with a precise definition of “normality” and performed a retrospective computerized analysis of electronically recorded FHR tracings. Current international guidelines recommend for the normal fetal heart rate (FHR) baseline different ranges of 110 to 150 beats per minute (bpm) or 110 to 160 bpm. There is no consensus about the normal fetal heart rate. Mood disorders in pregnant women with thyroid dysfunction. 162: Prenatal Diagnostic Testing for Genetic Disorders. doi:10.1503/cmaj.091580Īmerican College of Obstetricians and Gynecologists. Exercise and mental health: What did we learn in the last 20 years?. Generalized anxiety disorder and hypoglycemia symptoms improved with diet modification. Relationships among depression, anxiety, and insomnia symptoms in perinatal women seeking mental health treatment. Swanson LM, Pickett SM, Flynn H, Armitage R. Prevalence and relevance of pruritus in pregnancy. Szczęch J, Wiatrowski A, Hirnle L, Reich A. Interventions for heartburn in pregnancy. Predictors of pregnancy-related emotions. Neurobiological underpinnings of the estrogen-mood relationship. Wharton W, Gleason CE, Olson SR, Carlsson CM, Asthana S. Pregnancy dating by fetal crown-rump length: a systematic review of charts.
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