Summary
Analysis of fetal heart rate records has shown that the frequency, duration and amplitude of transient episodes of fetal bradycardia, regardless of their relationship to uterine activity, are factors of great importance in assessing fetal condition. Dip area is a quantitative measure of these factors; it is easily communicated and avoids the present confusion of classification and nomenclature.
Summary
Eighty‐two premenopausal patients treated by the Manchester repair operation were reviewed 6 to 12 years later. Two patients had developed uterine carcinoma, 29 had heavy or painful periods, and 8 had required abdominal hysterectomy. Unwanted pregnancies and the fear of pregnancy were major problems.
Nuchal encirclement by the umbilical cord is a common cause of fetal distress, and may result in neonatal depression and acidaemia. Severe irregularity of the fetal heart gives prolonged warning of the condition. The temporal relationship of transient episodes of bradycardia to uterine contractions is not helpful in differentiating cord entanglement from other causes of fetal hypoxaemia. Tipton, R. H. (1971): M.D. Thesis, Sheffield University. Tipton, R. H., and Shelley, T. (1971): Journal of Obstetrics and Gynaecology of the British Commonwealth. 78,702.
Summary
An index of fetal welfare in labour has been devised based upon the fetal basal heart rate, the dip area (Shelley and Tipton, 1971) and the presence or absence of meconium. This index appears to surpass other methods of predicting fetal outcome in labour.
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