IMPACT OF FETAL HEART RATE MONITORING & BLOOD SAMPLING ON INFANT MORTALITY & MORBIDITY - ONGOING STUDY

Abstract

Since the introduction of fetal monitoring (heart rate & acid base) 10 years ago, first on a research basis, then as an adjunct to clinical care, the proportion of patients being monitored during labor has increased to 70% (2,000 patients/year). Associated with this there has been a gradual reduction in morbidity as reflected by better Apgar scores and in mortality, for infants weighing 1000 g or more. The proportion of infants with a 1 min. Apgar score of 6 or less prior to monitoring averaged 25%; this has fallen to approximately 12%. There was a comparable improvement in the 5 min. Apgar score. Neonatal death rate has been reduced by almost 40% and perinatal mortality by approximately 10%. Furthermore, of infants requiring intensive care in the neonatal period, those who were monitored during labor were found to require a significantly shorter period in the ICU than those who were not monitored. This difference was even more striking when only infants above 2500 g were considered. Four factors appear to be of major importance in the acceptance and institution of monitoring: an adequate number of monitors maintained in good working order at all times; continuing education of the medical and nursing staff in the use of the equipment and interpretation of records; education of patients; services of a knowledgeable bioengineer and acid-base technician on a regular basis.

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