The significance of a single fetal heart rate acceleration in antenatal cardiotocography

SummaryTwo hundred and sixty antenatal cardiotocograms on 68 ‘at risk’ antenatal patients were evaluated against 3 definitions of fetal outcome. Reactivity was defined by a single fetal heart rate acceleration of at least 15 beats per minute above the baseline lasting at least 15 seconds. The low sensitivity of a non-reactive antenatal cardiotocogram precludes its application as a screening procedure or as confirmation of a compromised fetus. The excellent specificity of a reactive antenatal cardiotocogram reassures the clinician that the fetus is not compromised. Cardiotocography performed closer to the onset of labour predicts the likelihood of intrapartum fetal distress more accurately.